I really have a terrible time getting enough symptoms lined up to interest a doctor.
I can’t tell you how many times I have developed Nocturnal Cancer only to be completely recovered by daylight. I can’t tell you how much pain I’ve had with my knees and back and neck that surely was going to worsen with age—and I had x-rays to prove it—only to start doing Egoscue exercises and have them go away completely and, apparently, permanently. Nothing ever hangs on long enough for me to plan the music for my funeral. But I had great expectations for my heart palpitations.
After all, your heart is supposed to be popping along like a metronome. You don’t want it skipping beats, in case it gets the notion to skip all of them. I’ve had palpitations numerous times, but most notably during puberty and menopause. There seems to be a hormonal element to it, but all my feminizing hormones have long since packed their bags and split town, taking my muscle tone with them, and leaving behind nothing but a short note on my chin hairs. Consequently, my palpitations have subsided to a few random short episodes a month. Naturally, I’ve brought them up to the doctor before, but she always shoos me away, explaining that she’d love to chat but she has sick people to attend to.
But in the last two weeks, for no discernible reason, I have been having these skipped heartbeats about once a minute. It felt just new and alarming enough to merit a call to the advice nurse. He asked a lot of questions that I believe I had the right answers to (“No, no, never, no, yes but only two or three and sometimes a little splash of gin later”). And then he said they’d like to see me in person. Today. Or tomorrow.
Oh!
Unfortunately…he went tappity-tap for a while…we don’t have any clinicians available today or tomorrow, so we recommend you go to Urgent Care. Today. Or tomorrow.
Today? Or tomorrow? It doesn’t feel that Urgent. Really?
Really, he said.
Tomorrow, then. I hung up the phone and for the rest of the day everything felt a lot more Urgent.
When I woke up the next day, and sat quietly with my coffee, I felt no palpitations whatsoever. My check-engine light was no longer lit up, and except for those ominous noises coming from the bottom of my chassis, which I swear are normal, I was good as new. I went in anyway. Got an EKG. Got my vitals taken. Got this and got that. Got listened to.
The doctor was very confident. He said my vital signs were that of a fifty-year-old. He said my EKG was unchanged from the last time I had one, during the menopause palpitation episode. He said I was healthy as a horse, and not one of your sickly spavined numbers, either. I am a freaking stallion in a recliner. He said I was “lean.” I heard him the first time but I made him repeat it just for fun. “Lean.”
Shouldn’t I wear one of those 24-hour dealies to make sure?
A Holter monitor? No. In fact, you do not even qualify for one. There’s nothing wrong with you.
All right. That’s good, I guess. Just seems like for a thirty-buck copay he could at least find a mole or something.
“Got listened to.”
I hope this means that the doctor heard your concerns, not just that he slapped an icy stethoscope on your blouse and made you take deep breaths.
Because being listened to is one of the greatest therapies known to man, for whatever ails us.
Glad you don’t need to wear the 24 hour dealy! Carry on, lean one, you!
I’m lean, for a hippo. As a friend pointed out, if you take a look at your average Urgent Care waiting area, I’m shaped like a pencil.
I’m about your age ( well, a bit older ) Just went through the same business and after complaining enough about it got referred to a cardiologist. Seems I have good insurance. Told me I was fine and after I whined enough to him, gave me meds that I didn’t take. It went away on its own. I’m sure it’ll come back for a visit.
That’s exactly how I plan to handle it. I’ve got Kaiser insurance and I can’t say enough good things about those people.
Yep, had skipped beats several times in my life. Tests revealed nothing to worry about. I guess it’s just one of those things.
Gets to where there are more and more of those things all the time.
I’ve gotten these off and on, sometimes for weeks at a time (especially back when I was working, so that was definitely stress). Did the Holter monitor thing a number of years ago and of course didn’t have a lot of them over THAT 24 hours, but the few I had were nothing to worry about. Later I had a stress test b/c of an abnormality in my ekg (result: “yeah, you still have it when you exercise but we don’t know why but guess you’re ok”). Beats me. I just ignore it now or take deep breaths. I find sometimes I can calm it down that way when it acts up! I’m always worried it’s A-fib but apparently, it isn’t.
The first time I brought it up to a doctor, maybe twenty years ago, he said “Do you cough once or twice to stop it?” I said Why yes I do. Huh! He said “Nothing to worry about.”
I’ve always had PVCs, and they are just as annoying as heck.
I had some other issues in 2019 and I’m so glad for the wake up call. I decided I was gonna do everything I could to not EVER have to go through another heart procedure, botched or otherwise, and all the painful aftermath.
Now I climb mountains.
Let’s all keep our hearts healthy and ticking in a nice, easy, regular manner.
Climbing mountains is my favorite thing. Except for my other favorite things. I had to look it up–I was worried you had polyvinyl chloride in your heart.
Nope, but I’ve been accused of ice in my veins.
Palpate is not the same as palpitations. It’s important to remember that. I have also had the occasional burst of palpitations, but just hoped that if I ignored the hard enough, they would go away. I see I’m in good company here, and have been doing just what the doctor ordered, without even bringing my doctor into it. This is why it’s important for us vintage persons to have our “organ recitals”. We learn a lot from one another. thank you, Murr!
Depending on what you palpate, you could get palpitations out of it, though.
It’s always somethin’! Any day I get up and nothing hurts is a great day! Thanks for the gentle education on heart palpitations. Lots of love.
You’re a better man than I am. I rarely have anything hurting but STILL have not-so-great days. I need a gentle education in gratitude!
With all the litigation in our society, your own doctor undoubtedly suspected it was nothing to worry about, but sent you to Urgent Care to avoid being sued in the event that she was wrong. I’ve read that a lot of unnecessary tests are run for that very reason. A book I’ve read on this subject is Less Medicine, More Health: 7 Assumptions That Drive Too Much Medical Care by Dr. H. Gilbert Welch. It’s not a dry read and is very informative.
I’ll bet you’re right in general, but I’m so impressed with the coordinated care I get at Kaiser Permanente. Swear to Pete sometimes I think my optician looks at my file and sends me to get a vaccination. There might be some kind of structure in that HMO that mitigates some of the unnecessaries.
I woulda made him say, ‘lean’ a whole bunch more times. Dang.
Right? I totally did make him repeat it and asked Dave if he heard it too. But Dave would be nonplussed. He’s one of those guys with big red hearts for eyeballs.
Palpitations and a big tent, covering everthing from ‘I can feel my heart beat’ to ‘it’s skipping’, etc. The two genre’s are usually PAC’s (atrial in nature) and PVC’s (coming from the ventricle).
Normally, a heartbeat starts, electrically, from the Sinoatrial node in the atrium, the top chamber, of the heart. Sometimes, some point elsewhere in the heart decides it want’s in on the action, and sends out a electrical impulse. Causing the heart to be confused as to which partner to dance with.
Both are usually benign, usually. Myself, I have them a lot. Although I was a ‘provider’ for over 50 years, I’m now a ‘consumer’, and have to wait in line with the sans culottes. I’ve had holters, and now the new variety, which can record up to three weeks at a whack, and you can shower with (!).
One of the two day variety showed around 5,000 arrhythmia a day. The cardiologist yawned. “Yeah, don’t worry about it.” he said as he looked at his tee off time.
So, don’t worry about.
Man, Mike, after all that I’m wondering how we ever make it from one day to the next. All I know is I’m in that minority that really hates Frank Sinoatria.
Lol. I’m sure Old Blue Eyes understands
I’m 85 and I’ve given up worrying. It frees up the mind for nicer things such as appreciating Mother Nature on my daily walks. To keep from worrying on my walk, I listen to audiobooks. Lotsa good stuff there!
It’s true. In fact I hardly ever worry while I’m walking.
Wait, didn’t you have a column a while back about how to tell if you have a brain tumor? Are you sure that’s not it?
I don’t remember. Is that a sign? I know I’ve written about ovarian cancer, which has no symptoms, which is *exactly* what I have.
I’ve had a few EKGs and in every one of them there’s a blip where my heart decides whether or not it wants to beat, sort of like a half-hearted beat instead of a full one. There’s nothing else wrong so no one worries about it, not even me.
You get used to a lot of things. I’ve only hollered about this when something changes a little. Now I’m back to almost no palpitations. Tune in next week!
Well, you got me worried for a while. Glad they were able to say “No big deal” and send you on home. I have had a few of those, but much better than than “Hmmm.. Maybe you should stay here in our care for an indefinite time while we take lots of tests.”
Sometimes sending you home isn’t the best thing. That’s what they told my brother to do–go home and come back on Monday for some more tests. He didn’t make it to Monday!
You could get a six lead version Kardia for about a hundred bucks. And run your own EKG any time you want. I have palpitations from SVT on occasion but am reaching the age where Afib is a concern. Just because everyone around me is starting to have Afib, doesn’t mean I want to join them. Strokes are no fun. I can interpret my own EKG but I can also send the readings to my Dr or pay a fee to have a Kardia Dr read it. Small investment for peace of mind IMO.
Don’t they have watches that will do that too? And shoot the info straight to your doctor through the air with lots of bits in it? And maybe tell time?
I have yet to see a watch that can do a six-lead, or even less likely, a twelve.
It’s my understanding that what feels like skipped beats are usually actually extra beats (unless you’re like my friend who is wearing an implanted pacemaker so his heart doesn’t skip a whole lot of beats and kill him). I had my first episode of tachycardia (in my case a sudden jump to about 140 bpm at rest) at 18. Since then it happened every now and again, until one day it wouldn’t stop. I was on vacation at the time, and a small country hospital where they didn’t want to bother with a 12-lead filled me up with Inderal to slow it down while recording a 3-lead, then sent me on my way with the EKG strip to show my regular doctor when I got home, and he told me it was useless. It resolved the next day. That was decades ago. Meanwhile, I studied the DIY interventions — Valsalva maneuver to send a message COD to slow down down the vagus nerve, jugular-carotid massage to fool your heart into thinking the blood pressure’s too high, dipping the face into a basin of ice water to trigger the diving reflex (like a marine mammal, which I have increasingly come to resemble with age). They worked, until they didn’t. Recently I couldn’t make it stop, and in the ER they said “AFIB,” and injected me with a slug of Metoprolol, which did the trick. I’ll never know if the previous incidents were AFIB or not. Once I wore a Holter for 24 hours and of course nothing happened during that interval. Now I take Metoprolol daily, which makes the episodes easy to control by just taking a deep breath and relaxing. And yes, blood thinner. An MD who is a sleep specialist told me the Metoprolol may well be the reason I wake up exhausted with no thought but a wish that I could go back to sleep. Fortunately that feeling wears off after about an hour. Usually.
Gadzooks. Ablation?
There are certainly trade-offs to weigh. I don’t like the idea of going through ablation and finding that either 1) it didn’t work, or 2) the morning fatigue is actually due to something ELSE, or 3) I don’t like the side-effects of the ablation but it’s done. One of my wife’s cousins had ablation years ago, and that is clearly when his memory started going downhill. There might be no simple cause-and-effect there — but then again there might. The medical histories of some of my family members has taught me to expect the unexpected. Zebra, as they say.
Can you imagine what all of this is going to look like when we are in our mid-90s?
Why have they not invented the Tricorder they had on Star Trek? I mean geez, they just ran a thing that looked like a remote control over your supine body and had a full medical work up.
They will, eventually. We already have gone from “communicators” to “com badges” to cell phones to smart phones. We already have 3D copiers and computers that talk with us. Tricorders will be next! I’m waiting for “synthehol”, an alcoholic beverage that you can just shake off the effects of if your adrenaline tells you that you need to take action. (This was a Next Gen thing, not original Trek.)