Long Story About A Crazy Heart (Bear With Me) -PACs, PVCs, and more...

Ok so the reason I asked about taking your Mother to therapy is that I'm trying to figure out how stressful this is on you. Caring for loved ones is incredibly stressful at times, but you push through because you want to be there. This is something I'm very aware of. I'm trying to establish the idea that this stress alone could be significant in your anxiety and symptoms.

Secondly, having read through your posts again I find it impossible to believe you have a heart condition causing this that has yet to be fully diagnosed. Heart disease is relatively easy to spot, and treatment is sophisticated. In America especially, the medical profession would jump at the chance of getting you into treatment. This alone doesn't make sense to me, and your 'formal diagnosis' could easily be descriptive of your underlying anxiety (in my completely unqualified opinion).

There is still nothing you have described that I haven't experienced myself at my worst and most stressed. Everything you say is familiar to me, and I'm almost 20 years older than you and was never diagnosed with any kind of heart disease either, despite being tested numerous times.

How would you describe your diet now?

You should pursue the diagnosis for your own peace of mind, but what I'm reading points towards multiple layers of stress, a mind that's tuned into the inevitability of illness and doom and a completely worn down central nervous system.

Even if you do have some kind of heart condition (and at this point it can't be anything serious), then it will be treated and you'll still be left dealing with the anxiety. Dealing with the anxiety has to be priority right now I think.

Joe,

I appreciate the swift response as always. I agree that taking care of my mother has been incredibly difficult. It is exacerbated by the fact that she sort of blames me for the level of anxiety getting to this point and feels I should be medicating for the nonstop symptoms. I personally don’t agree, and we have a major disagreement as such. She and I have always been incredibly close, but the mess that has happened these past few months has created a wedge between us. She can’t cope, and I can’t seem to find relief. It’s an impasse.

As far as finding an organic cause or disease, the doctors do believe this can be SVT and are pushing me for further monitoring to catch an episode that clearly identifies this with utmost precision. My father has SVT, and it surfaced around a similar age. I imagine this is a factor, so it may very well be that. What I don’t like is that these fainting feelings coupled with the “half-ectopics” or “quivers” which can’t seem to be defined on the EKG strips are very invasive. They make me constantly short of breath. This has been a symptom that’s gotten progressively worse for the last year or two even. In my sleep, I truly believe the autonomic system in my body goes haywire and causes these insane electrical patterns which throw me into either SVT episodes or tachy attacks. During the day, it is less likely, but being at a slower heart rate similarly seems to allow these beats to persist and creep in, causing opportunities for these episodes to happen. Case in point, on Feb. 6, being at 65-68 BPM without any beta blocker seemed to open the door for those ectopics which created the SVT. Interestingly, same goes for last night. Today while driving, I was on a low dose of beta blocker at a slow heart rate and STILL had them come in when nervous. Therefore, yes, anxiety does have SOME component. It is so hard to distinguish.

My diet has been fair, if not as perfect as I’d like. Being far more sedentary than I prefer, I did gain a few pounds. I crave carbohydrates mostly, and protein. Nuts are a staple of my diet. I also love eggs, lean meats, and some veggies. I tend to have no sodium pretzels often, just as a snack. I do have a history of calorie restriction, but being this sick, I could give a darn about my weight. I just eat now when I’m hungry. My guilty pleasure is ice cream. I tend to buy organic things if that makes a difference. Try to keep simple ingredients and clean foods - even my cheat ones.

The doctor did call back and suggest yet another monitor. I literally just had one this past week. I am over going to appointments and dealing with the ones who don’t call back and act holier than thou. It’s just a vicious cycle.

I do believe anxiety and doom are major factors here, Joe. For the life of me, I have no idea how to get rid of these crippling symptoms. They are so severe and real - tangible and measurable. That makes me crazy.

It's really easy for me to read what you're writing and see parallels in my past. It's also easy for me to perceive the complicated layers of stress that have built up in you, externally and internally. Something you possibly aren't seeing as clearly, because it's difficult to see the wood for the trees.

1) The situation with your Mother is incredibly stressful. Without going into detail my partner has a severe mental health issue and I am technically her carer. It's hard, and persistent. I think you need to find a way of giving yourself a break from being a carer for at least an hour per day. That in itself is hard because of guilt, but it is what you need.

2) The mental picture you have built up of your own situation needs managing. I did exactly the same as you in the past, I would focus on every single heart beat and reaction and try to analyse why it was happening, what caused it, how I could stop it. At my worst I was able to tell my partner what my heartbeat was within 1-2bpm at any time, without checking. I could be driving and say '84' and I was always close enough to be spot on. I became that hyper focused on it.

3) I think your diet is still playing a part in your overall health, but this is more guesswork. I have found over the years that a sporadic diet is almost as bad as a bad diet. I now fast for approximately 16 hours a day and although my diet is by no means perfect, I eat a LOT of veg and fruit. Mostly organic, mostly raw. I track what I eat with the chronometer app not so much for calories, but more so that I know I'm getting enough sodium, potassium and magnesium etc. These are important electrolytes for good heart function, far more so when you're under duress. The only caveat here is that you need to decide yourself if a tracking app is a good idea as they can be a double edged sword for people with historical eating issues. Be mindful of that, but stay on top of electrolytes. You might only need to monitor it for a few weeks to realise your nutrients are deficient somewhere. As an example, I tried the keto diet last year and after 4-5 days I pee'd so much that I lost a lot of electrolytes. This caused a sudden episode of tachycardia (well over 120bpm) for 14 hours after not experiencing anything like that for years. Just goes to show that diet+stress can do things to you that you might not realise.

4) Try and remember that my symptoms were identical to yours, and nothing was ever found. I have read everything you wrote and I'm just sitting here nodding 'yep, done that', 'yep, had that'. I know many, many other people have had the same experiences too. This is not negating the fact that there might be a medical reason too, but if it was anything serious I guarantee you it would be smothered in medical care already. I'm not sure yet how you manage and rationalise these symptoms, but I do know it's really important to accept that this is where you are right now. The thing to accept right now (and only right now) is that you can't get rid of them...right now. Even if there are zero medical issues and you had 100% certainty that you are fit and healthy, it would be months before the symptoms disappeared. Stress takes a long time to recover from. This is why acceptance is so important. It's also really hard, so it's best to start this journey asap. Again, meditation is a magic bullet for this.

This is my overall perception of where you are right now. I think you need to try and unpick some of the layers and do what you can today. You can't deal with this all at once, it's too big. Choose your battle today, and start with one thing. Get a hold on that one thing and then move onto and add the next layer. If it were me, I would focus on the acceptance and meditation. It's the umbrella for everything imo. It won't be immediate, but it's a subtle and slow change into a much easier mental outlook.

Joe,

I sincerely appreciate you sharing so much information about your life. I find that being open like this, even for myself, helps put an emphasis on how personally we all are affected by these demons and somehow it allows fellow sufferers to unite/strengthen through expression. So again, thank you for being so honest, forthright, and detailed.

Even though caring for my mother has been challenging, I'm finding its the bigger picture and context AROUND what has happened that makes it harder for me. The looming prospect of this destination wedding (even though it has been postponed) is truly wearing me thin. I don't think my fiance is very happy that I'm leaning towards canceling those plans altogether. In fact, I'm worried this might be the beginning of a very bad trajectory which may lead to her not being happy enough to leave. She's been through a lot too in her life, and I completely understand her point of view or choosing to go if I can't even give her the wedding she has always wanted. It is indeed no way to begin a marriage, and frankly (having endured a broken engagement before many years ago in my past), I would rather see her be honest and leave than wait for the misery which comes with not knowing or her hiding those feelings. It's not a question of love here at this point. We both adore each other. It's a moral dilemma as to whether or not someone such as myself even warrants a lifelong partner or being married. My lack of ability to hold a more conventional job, travel, or even be outside the house is pretty horrible. I'm ashamed of it and loath myself for it. I never was this bad. The last thing I needed was whatever process threw all this out of whack with my parents, feeling ill, the stress of just already being anxious in general, etc. It was a recipe ripe for disaster - now I'm picking up the pieces. And poorly at that.

I guess you could say my parents' baggage has always fallen on my shoulders anyway. I've often felt like a proverbial punching bag (verbally I mean), and it seems that I can do nothing right in my years as their adult son. I don't want to belabor the point, but yes, I'm well aware my domestic situation has facilitated a huge portion of my mental health. If not most of it. Be that as it may, I would never abandon or leave them. They've done a lot for me too in ways I could never pay them back. And they are far better people than myself in those respects. My fiance is totally fine with the situation as long as I am not emotionally affected or distanced from her by them. Normally, this was never the case. Perhaps the overwhelming nature of the current scenario has begun to override the status quo, and I'm facing a huge existential issue here about my future on every front, with my body telling me through somatic changes. I also think there is some natural, biological illness related to progression of time and age involved as well. A complex picture is an understatement.

For diet and meditation, I try my best. Like I said, feeling this low, I just make sure to eat nothing processed and blatantly unhealthy. But, I love my carbs and some sugars/fats when I need them. I was eating in a disordered way for years (like...salad and chicken with brown rice only), and putting an emphasis on watching my diet (even from a nutrient perspective) may not be the best option given my vulnerabilities/habits. Meditation is new to me. I think I'm too hyper for this approach sometimes, and focusing isn't my strong suit. I do have some mantras I repeat in moments of extreme nerves, and I have learned breathing techniques which help keep some sensations at bay. Some are just too strong, even for these methods.

It might be worth trying to simplify your outlook on life a little. This isn't always easy when life becomes a multi layered shitstorm, but it still needs doing.

I would focus on this -

1) Speak with your fiance and lay your cards on the table. Right now, you definitely have to focus on your recovery, and she may well fully understand and agree. Your assumption that she will leave if she can't have a flash wedding is likely to be based on incorrect assumption and fear, and in itself that is a burden that needs clarifying. Do this sooner rather than later. Whatever the outcome you will know where you stand and can act on reality, not imagination.

2) Push hard now for a diagnosis on your heart, if there is one to be made. Do not let up, push as hard as you can. If you are told there is nothing wrong, LET IT GO. If there is something wrong, mentally prepare yourself now and know that heart conditions are almost always perfectly manageable. A couple of years ago my neighbour told me he had a pacemaker fitted because of a little niggle in his heart rate sometimes. He was 33 and lived a perfectly normal life. This is likely to be your absolute worst case scenario IF something is wrong.

3) Please try and understand just how stressful the life you have described is. I genuinely believe you are spending most of your day living on nerves and a hyperactive adrenal system. Remember that when I was under massive stress, my symptoms were exactly the same as yours, almost word for word. A lot of your life seems to be spent worrying about how your behaviour and your condition affects other people, and this needs to steer towards how you can find time to calm your system down. Try and figure out what it is you need to allow yourself to 'come down' a bit. Don't pick things like 'I want to be symptom free' because that's unrealistic right now, but perhaps finding 30 minutes a day where nobody is allowed to call on you for anything is what you need. That can be a time where you practice meditation, yoga or even just put some headphones in and listen to some music. Whatever it is you need. It's easy to underestimate the importance of down time from yourself and your habitual thought patterns.

And as for the diet, don't worry about it. I was only suggesting that to track your electrolytes. I still think it's worth doing just so you know where they are. Being low on any of them will cause palpitations. It's one of the reasons you're always put on a drip if you go to A&E with palpitations, just to level out your electrolytes and rule that out as a problem.

Joe,

Your advice is well-appreciated and timed, as I did speak with my fiance about this just last night.

Based on everything that's going on both here with us and in the world at large (which I'll refrain from naming due to it being a trigger for many people), we think it's best the idea of a destination wedding gets shelved for now. I do believe she is disappointed, but not mad per se. I'm hoping at some point I can give her an experience that is comparable, if not even better. Right now, it just will not work. I think she understands, but it didn't lessen her emotional response nonetheless. She's still having a bit of a hard time accepting that my current mental/physical state is that disabling and needs care beyond which she may have initially perceived.

As far as the stress component on my parents' end is concerned, I don't think that's ever going to change. You're right in suggesting removing myself from the situation during the day at necessary intervals. It is important to have alone time, and that has become an issue here for quite a while, even before we all got sick. I'm really tired of them telling me to take beta-blockers and anti-anxiety med so I can just shut up to "be normal" according to their standards. Sometimes, I believe it is selfishly motivated. At others, I see them as older people who have their own illnesses and can't fully help me anymore in the ways they possibly could have many years ago. The truth is probably more the latter, as I'm extremely upset and probably am not in the right frame of mind to be assessing people's intentions every minute.

I am INDEED pushing for a diagnosis on my heart, and I'm going to be pretty unrelenting until they can empirically prove to me I have zero cause for concern. That may be a bit unrealistic, but I'm keeping these expectations more basic. If another 2 week monitor doesn't pick up abnormalities, perhaps I will rest a bit more easy. I have every intention of trying a bit of LIGHT exercise when they place it on me. This way, I can build some small confidence toward trusting my body again. Let's hope I don't go into some wacky SVT attack and end up back in the ER (I know, positive thoughts not bad ones lol).

I understand what you're saying about the diet, and I totally concur. Electrolytes are vital, and I probably should pay more attention or at the very least take a magnesium or vitamin supplement daily. I hate to admit fear holds me back from this too. If that makes sense.

I guess you're right about being "symptom free" for now. It is hard to accept, that I will definitely tell you. It's so strange how sometimes I'm better than others, and I can't seem to detect any emotional difference when these physical shifts happen. It feels so unrelated, yet it isn't. I wish I could explain it better. Right now sitting here at my keyboard, I feel lightheaded and like my heart is quivering or "half-stopping" every so often. I get faint when this happens or dizzy but yet nothing ever happens from it. It's like my blood-pressure feels super low but its actually normal or even high. Like the electrical system of my body is malfunctioning, even to my brain. This sounds so crazy lol I'm sorry, I don't know how to describe these sensations any better. And trust me, that's a scary notion for someone such as myself.