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

  1. #1

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

    Dear all,

    I'm Jon - 31 y/o male from the US. I'm not sure if this is the right forum to put this in, so moderators please forgive me. I am desperate for some help/guidance/reassurance.

    I am a lifelong anxiety sufferer with severe panic attacks who was very overweight as a child and has now for the last decade or so been very fit due to long-term endurance exercise (high-intensity stationary cycling for at least 60 minutes nearly 5 or more days a week). I did drop nearly underweight at one point (I am 5'11' and was 135 lbs) but now I am around 150 lbs and my eating troubles have mainly balanced out for the last few years (this all pertains to my heart, just stick with me).

    When I was overweight, I suffered from formally diagnosed PVCs by my cardiologist. They were sudden onset, sporadic, and constantly on/off for months on end. After starting my rigorous exercise regime many years ago, they have literally disappeared. Instead, I was now diagnosed with chronic PACs which seem to also have had a similar onset (sudden, no rhyme or reason, happening even while sleeping, etc.). I also am starting to experience these more often upon exertion, which has prompted me to visit my cardio quite a few times to run an insane amounts of tests (holters, event monitors, stress echoes, ekgs, bloodwork, even a highly invasive CAT scan with dye of the coronary arteries). I always complain of chest pain and bizarre cardiac symptoms, chronic shortness of breath even when not doing anything, for years on end now, but nothing seems to show up. I'm afraid I've been "labeled" so to speak, and that my distress is not being taken seriously (especially coupled with the fact I am someone who works out constantly and doesn't seem to "drop dead" doing it regardless of how I feel).

    Fast forward to around two months ago - my symptoms were getting progressively worse and I was starting to not even want to leave the house. I was feeling very hopeless, and my psychiatrist and talk therapist were not helping as by this point I was convinced this was something organic they just can't see or pinpoint. I was prescribed Xanax .25-.5 mg for the panic attacks, but admittedly, it does very little for my physical symptoms and just numbs me (it doesn't even really do that anymore, and I rarely ever take it).

    My aging mother suddenly fell in late November. She nearly died and needed an entire shoulder reconstruction surgery at a hospital in NYC (where I reside). I am her primary caretaker and her only child, so the entire burden fell on me and my fiance to keep things going at home. As I do not work (mostly due from anxiety, but also because I do some side work from home), this wasn't the end of the world on most fronts, except when it came to my mental health. I have rarely wanted to leave the house for a long while now, even since before my mother fell (still from the fear of dying in public from a heart problem). I stopped exercising out of symptoms getting worse, and though I tried to keep up with my very regular and vigorous routine, it was getting harder and harder.

    Suddenly, things took a turn for the worst. I came down with severe flu (even with the flu shot!) and needed to be hospitalized for 2 days (I passed out at one point with a BP of 60/40 - they said severe dehydration from 103 Fahrenheit fever). Immediately, my heart problems got worse. Throughout the entire sickness, my pulse was racing. I attributed this to the fever and prayed for the best. 2 weeks after the bout, the heart rate came down, so I decided to go back to exercising. On Christmas night, I did my usual workout after a couple of test workouts earlier in the week. My heart rate shot to 130. It never came down. I was sent to the ER via ambulance, and the doctors did absolutely nothing. They monitored me for about 2 hours, and as soon as the heart rate went down to about 89, they threw me out and sent me home. I told them I wasn't comfortable with this, as my baseline numbers are usually VERY low (considering how much cardio I do). I knew something was very off, but they didn't want to hear it at all.

    That brings me to this week. My heart has been pounding and consistently elevated for days on end. I went back to the ER yesterday with a pulse of 130 BPM after waking up with horrendous PACs. I nearly passed out again in the ER. The doctors took 2 ECGs and a bedside echo. They said I was panicking and needed Xanax. They proceeded to give me 1 mg of Xanax and 25 mg of Atarax. I was knocked out in a way I've never been before (I'm a firm believer in being good to our bodies, so I do not drink or do drugs of ANY KIND, ever, at all.) I am not used to this sort of sedation. I was out for 3 hours. The whole time my pulse stayed in the 90s and blood pressure was 130/89. Again, they sent me home saying I was "nuts" and to follow up with an electrophysiologist (if they can even help me, cause no one is convinced I actually have an arrhythmia). I have an appointment for as soon as possible, but I'm literally disabled at this point. If I do anything, my heart rate spikes to over 100. I have to sit still to keep it under 100. Every doctor I call keeps saying its anxiety, including my psychiatrist. They keep throwing Xanax at me, which now out of desperation I am taking, but it really isn't doing anything at all except keeping me from going back to that scary ER (which based on the American medical system, might ACTUALLY be a fate worse than death, but that's a whole other story). I've been advised to just hope things get better and "pretend like its not there."

    Has anyone ever experienced anything quite like this? I feel so demeaned, hurt, scared, and broken by people who truly do NOT understand and claim they are there to do work for others' safety. Even the EMS who showed up here at my house to take me to the ER treated me like I wasn't a person. My parents and fiance (who is a psychotherapist herself and doesn't think these are somatic symptoms!) are devastated and don't even know what to do. This doesn't feel like anxiety. I've struggled my whole life with panic disorder and never have I ever experienced symptoms so obvious, empirical, dangerous, yet I'm being told it's all in my head.

    Sorry for the long post, and any help or just some kind words would mean everything to me.

    Thank you with all my heart,

    Jon1821 In NYC

  2. #2
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    Re: Long Story About A Crazy Heart (Bear With Me) -PACs, PVCs, and more...

    John,
    First off I am so sorry you are going through this. I, of course, believe everything you are saying. I work in the medical field and do think it is a travesty that doctors just throw drugs at patients just to get them to “go away”. I work in a cancer center, and I have heard my doctors explain that they are prescribing Ativan to a patient “so they just leave me alone”. An anxious, scared cancer patient. Medicine is terrible like that. But, a lot of doctors are good too! Your heart symptoms sound legit to me and it’s frustrating that the ER treated you like that. I have severe health anxiety, OCD, depression and PTSD and have had my fair share of ER trips for symptoms that I believed were legit. The last time was actually three months ago. I thought I was going to pass out and that my blood sugar was dropping (I’m not a diabetic). The ER doctor completely laughed me off, ordered a head CT scan, and gave me Ativan and something else and I was in a knocked out stupor. It was terrible, and my diagnosis was “panic disorder”. I absolutely hate the ER but when we have legit symptoms and are scared that’s the only place to really go. It’s great that your tests came back negative! If something was really wrong it would have showed on the test. I would recommend CBT. Therapy really helps me. I am also on medicine. I wouldn’t push that on anyone but it’s taken away so many of my physical symptoms and it was crazy how many things were related to anxiety, like my doctors have said. I’m lucky to have an amazing GP. I recommend finding a doctor you like and trust. I also bought a couple of health anxiety books on amazon and it helps to read through them. Try meditation, eating healthy and staying hydrated. A constant baseline high level of anxiety will definitely increase your heart rate, cause palpations and can increase blood pressure. When your mind becomes more clear you will see your symptoms get better. Prayers, you got this <3 you have a great group of people here on this website as well

  3. #3
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    Re: Long Story About A Crazy Heart (Bear With Me) -PACs, PVCs, and more...

    Quote Originally Posted by Js2019 View Post
    Try meditation, eating healthy and staying hydrated. A constant baseline high level of anxiety will definitely increase your heart rate, cause palpations and can increase blood pressure. When your mind becomes more clear you will see your symptoms get better.
    This is absolute truth.

    I have been in a similar situation as the OP. Mine happened because of chronic long term stress, this stress went on for a period of five years and my central nervous system was essentially worn down.

    The reason that meditation, diet and 'calm' is so important is that your body has been stripped of its ability to switch on the parasympathetic nervous system. You are effectively always in fight or flight mode.

    This isn't a situation that can be corrected overnight though, it will take months of recovery, but it's 100% possible.

    If there was anything wrong with your heart, it would absolutely have been picked up and with your age, lifestyle and historic exercise regime your risk factors are incredibly low. You must listen to your doctors when they say it's 'just' anxiety. I too used to be in the same place where any movement would spike my heart rate, especially at night. But if your heart rate spikes, it ain't gonna harm you. I developed a massive obsession with my heart rate, and it becomes a self sustaining issue. With anxiety, increased heart rates and PVC's just aren't dangerous. My Doctor told me they are 'medically insignificant', and this is something you need to keep repeating to yourself over and over again.

    You need to get out of the mental cycle of 'nobody is listening to me', because they are. There's just nothing they can do. Try and remember that panic and anxiety ARE part of the human condition, it's an autonomic response to danger and cannot be switched off. The issue here is that you have developed a panic disorder, the panic response is firing when not appropriate. This is not a medical issue as much as a holistic self care issue.

    In the short term you need to stop exercising, it's too stressful. The only exercise you can really get away with at this point is walking, and preferably at a heart rate of around 100bpm. You don't want to provide your body any reason to think that stress is happening. As Js2019 said, watch your diet. It sounds like you do anyway, but this is not just about calories. You need to eat fresh, whole food. Not cardboard boxed crap and diet sodas. Good quality meats (if you do) and vegetables. Meditate every single day, meditation was my absolute magic bullet saviour, and this is coming from somebody who couldn't put the bins out 3 years ago because I feared ANY kind of heart activation at all.

    This IS fixable, but your fiance isn't really qualified to lay claim to this being somatic or not. Psychotherapists aren't really trained to guide in the more physical nature of anxiety, rather they deal with mental conflict and emotion. The kind of anxiety you are experiencing is now firmly in the 'feedback loop' stage. I know, because I've been there. The good news is, you are absolutely in control of this IF you put the effort in. Ultimately what you need to do (and again, JS2019 has nailed the solution) is practice calming yourself physically and mentally. This is a slow process, but it works. You need to practice not reacting to what you perceive is a heart problem, because it's not. It's a heart reaction, not a heart problem. Your heart is naturally reacting to what it perceives to be danger, led by what your mind (especially your subconscious) is telling it is an immediate danger. It's not an immediate danger, it's an imaginary one.

  4. #4

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

    Thank you both so much for such reassuring and meaningful responses! I wish you all the best in your journeys, and I apologize for taking this long to write back. Things have been hectic, but I am a little closer to understanding everything better now.

    After my initial post, I ended up back in the ER twice. Both times were from tachy episodes waking me up from sleep (which seems to be a trend). Long story short, they tried putting me on Propranolol for the anxiety symptoms. It worked great for a day, until these horrible side effects began. It's been days since I've taken the drug, but I'm still having strange headaches, chest pains, pains in my extremities, and a very bizarre dizziness that has brought me to the brink of a total meltdown twice. I have stopped the Xanax as well. I just don't think pumping me full of drugs is for the best while my system is in such shock. That being said, I met with both my cardiologist again and electrophysiologist. The cardio ran blood work for adrenal issues and I'm currently awaiting results. The EP told me that he's convinced this is all from the flu. Since I'm in sinus rhythm during these episodes (save for PACs), he thinks my heart is okay but did ask I get another, more formal echo. He told me the massive shift in my normal routine really messed with me (suddenly stopping intense cardio for weeks, 2 viruses, etc.) - heart rate and BP included. He instructed me to take it easy too for a while, and start with 15 minute workouts and daily chores to build myself back up. He claimed the after effects of the flu on my heart could last 6-12 weeks. He also said to drink lots and lots of water and make sure I have enough sodium intake, as I was losing a bit of weight from all the trauma (loss of appetite) and lost a lot of electrolytes over the course of the illness. Part of me finds this hard to believe, as it feels like it happened too long ago to have such a profound effect on my system still, but I'm going with his professional opinion and trusting his word.

    On the bright side, though I'm scared out of my mind to do so, raising my pulse actually seems to help. When it comes back down, my BP and resting rate actually level off. Maybe my heart is just starved for exercise. I'm slowly trying to integrate activity and not fear the pounding in my chest or chest pains if they hit. Showers still make me crazy, but I'm learning to slowly overcome the fear of that again. Sleep still is rough. I'm finding myself waking up with palpitations but my heart rate is completely normal (like a horrible pounding but not racing) - it's all very strange and unsettling to someone like me (or all of us here it seems lol). It would be a miracle to see a day where I don't feel sick again. Today I barely could function from the dizziness. My family is supportive, but I think their tolerance is running low. My fiance doesn't want me to go anywhere near something like inpatient treatment. But my mother is broken and extremely mad at me for not being able to "just fight the fear and get better." I don't know if I'll ever be 100 percent, but a life where I can do some basic shopping and groom myself without crying would be ideal lol.

    I'm supposed to go to Disney World to get married in the Spring. I have NO IDEA how I'm going to conquer that. Right now, it really seems utterly IMPOSSIBLE. I used to handle going just because I loved it so much, but last time (as I got more acute), the trip was literally torture towards the end. The plane especially. Oh well, here's to praying something works out.

    The fear of death will destroy us if we let it - ironically, it will "kill" us even before take our last breath. That's what's happening to me. That's what anxiety does. I'm just constantly waiting for his shadow to appear.

    But hearing your thoughts, your concerns. That just makes me see all the more how hope isn't gone and we all have shared this experience together somehow. People do and can understand this pain which is silent, invisible, and to many, something that seems ridiculous. It's anything but.

    God bless and all my love,

    Jon

  5. #5
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    Re: Long Story About A Crazy Heart (Bear With Me) -PACs, PVCs, and more...

    You need to listen to the medical professionals here, but also decide yourself whether you want to over medicate your bodies normal function. This seems to be especially prevalent in the USA

    The flu WILL raise your heart rate, quite a lot. I have a cold right now (fever, chills, not a particularly bad one) and my heart rate is hovering just under 100bpm. I know it's fine, so I just went to sleep. You talk about 'waking up with tachycardia', but this is incredibly common with illness and anxiety. I went through a period of about 18 months where I would wake up 2-3 times a night with a heart rate approaching 140bpm. Ultimately I realised that panicking about it was just part of the feedback loop so I would get up, have a pee, get myself some water and just lay back down again. It passed soon enough.

    You are also catastrophising imaginary worst case 'what if' scenario's instead of focusing on recovery. What you described matches almost exactly some of the experiences that I have had in the last 5 years, and in a lot of respects your Mother is correct here in saying 'just fight it'. Of course her frustration doesn't help, and it's easier to say it than actually do it in the position you are in right now.

    The ONE thing you should focus on right now is not reacting to what you perceive as dangerous heart symptoms. They are simply not dangerous. Your heart is doing exactly what it's designed to do (and is perfectly safe for it to do) in the face of perceived danger. You are making assumptions about where your heart rate and quality should be, and you are wrong.

    So you wake up and your heart is pounding, or it's fast....so what? I'm telling it's no problem, your doctors are telling you it's no problem....so what is actually the problem....it's you. And everybody else who goes through this...including me.

    You've been instructed to take it easy for a while and start with small exercise. I would even suggest just walking for the first month. We don't HAVE to push to the max with exercise to stay healthy, and doing so only increases stress on the nervous system. You were told 6-12 weeks, so use that time practising the idea that your body is doing what it's designed to do, it's your mind creating a problem out of nothing that's really the issue here. Perception.

  6. #6

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

    Dear all,

    Just wanted to thank you again (and a first time to Joe) for giving me some feedback and support. Joe, I definitely agree with what you're saying. I also wish I could say I hadn't gotten quite as upset these past few days and ended up having 3 more episodes, one of which landed me in the ER.

    On Friday, I tried exercise for a mere 15 minutes - some light aerobics mixed with jogging in place. My heart rate would not go down below 100 for over an hour afterwards. Worse yet, my EKG registered an unclassified rhythm which was later confirmed to be sinus arrhythmia upon EMS arrival. Now I'm told this particular "arrhythmia" isn't even one at all, but rather a suggestion of high vagal tone which shows the heartbeat fall in sync with one's breathing. I've NEVER had this before on ANY EKG, at home or otherwise, in my entire life. I'm scared, despite them saying I should ignore it (the paramedics were nervous and kept saying I was "somewhat irregular" when they got here that night). The ER didn't seem to think anything was wrong and sent me home. I notified my doctors, and tomorrow they have scheduled me for a stat stress echo to see why these events keep happening.

    Just this morning, I awoke from my sleep with a heart rate of 145 BPM. It took about half an hour and .25 mg of Xanax to bring it back down into the 70s. I feel like I got off easy - thank God I didn't have to go back yet again to the ER. My heart rate has been much higher today too than it was even yesterday. I was almost in the mid 60s-low 70s all day with a BP of 105/70! Feel like I shouldn't have counted my chickens before they hatched.

    I'm starting to wonder if there really MIGHT be an electrical issue that has reared its ugly head as a result of the flu over a month ago. The doctors are suggesting there may be a correlation, but until proven true, this is all anxiety. It most likely will end up being 75 percent or more anxiety in any such case. Being nervous definitely doesn't help the heart slow down.

    Showering really is terrible still. I can't seem to get a grip on that. It just skyrockets so quickly and I feel extremely sick. This has to be the most invasive part. Takes me hours to get ready now. Absolutely a nuisance.

    Anyways, I'll keep everyone updated. Here's to hoping I don't get that nauseous, gonna pass out, dizzy, "body shock/brain stopping" feeling I get when I go out to the cardio's tomorrow.

    Jon

  7. #7
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    Re: Long Story About A Crazy Heart (Bear With Me) -PACs, PVCs, and more...

    Jon, thank you for the update! I was worried about you and you have been in my thoughts. I am sorry that you ended back in the ER. They would not send you home if there really was a problem. The fact that the Xanax calms you down and sends your heart rate back into normal limits really makes me feel like it’s an anxiety Issue as well. As for the shower...well that shower was kind of like my work. Let me explain. I used to get panic attacks at work all the time. It felt like I would only get them at work. I would get dizzy my heart rate would shoot up randomly and I would feel like I was going to pass out. The thought of work would even send me into a panic. I associated it with panic. Maybe that’s how the shower is for you. Since you associate it with panic it is giving you panic attacks. Maybe slowly ease yourself into it, and breathe slowly. When you realize that it is a mental thing it will improve. I can go to work now no problem. When I have a panic attack I just go into the bathroom and breathe slowly. Since starting lexapro my anxiety and depression has improved immensely

  8. #8
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    Re: Long Story About A Crazy Heart (Bear With Me) -PACs, PVCs, and more...

    Quote Originally Posted by Jon1821 View Post
    Dear all,

    Just wanted to thank you again (and a first time to Joe) for giving me some feedback and support. Joe, I definitely agree with what you're saying. I also wish I could say I hadn't gotten quite as upset these past few days and ended up having 3 more episodes, one of which landed me in the ER.

    On Friday, I tried exercise for a mere 15 minutes - some light aerobics mixed with jogging in place. My heart rate would not go down below 100 for over an hour afterwards. Worse yet, my EKG registered an unclassified rhythm which was later confirmed to be sinus arrhythmia upon EMS arrival. Now I'm told this particular "arrhythmia" isn't even one at all, but rather a suggestion of high vagal tone which shows the heartbeat fall in sync with one's breathing. I've NEVER had this before on ANY EKG, at home or otherwise, in my entire life. I'm scared, despite them saying I should ignore it (the paramedics were nervous and kept saying I was "somewhat irregular" when they got here that night). The ER didn't seem to think anything was wrong and sent me home. I notified my doctors, and tomorrow they have scheduled me for a stat stress echo to see why these events keep happening.

    Just this morning, I awoke from my sleep with a heart rate of 145 BPM. It took about half an hour and .25 mg of Xanax to bring it back down into the 70s. I feel like I got off easy - thank God I didn't have to go back yet again to the ER. My heart rate has been much higher today too than it was even yesterday. I was almost in the mid 60s-low 70s all day with a BP of 105/70! Feel like I shouldn't have counted my chickens before they hatched.

    I'm starting to wonder if there really MIGHT be an electrical issue that has reared its ugly head as a result of the flu over a month ago. The doctors are suggesting there may be a correlation, but until proven true, this is all anxiety. It most likely will end up being 75 percent or more anxiety in any such case. Being nervous definitely doesn't help the heart slow down.

    Showering really is terrible still. I can't seem to get a grip on that. It just skyrockets so quickly and I feel extremely sick. This has to be the most invasive part. Takes me hours to get ready now. Absolutely a nuisance.

    Anyways, I'll keep everyone updated. Here's to hoping I don't get that nauseous, gonna pass out, dizzy, "body shock/brain stopping" feeling I get when I go out to the cardio's tomorrow.

    Jon
    I'm not trying to sound dismissive, but you're making a much bigger deal out of all of this than you need to.

    I have experienced everything you have mentioned here, over a much longer time frame. Your focus on the minute to minute heart rate is causing you anxiety, and that alone can keep your heart rate high permanently. By your own admission you are stressed, have recently had a significant illness AND you have anxiety, so your heart rate staying high after exercise is normal. Waking up with a heart rate of 145bpm is normal (I have experienced this literally hundreds - if not thousands of times). You don't need to take a benzo for this, it will create a problem down the line. If you wake up with your heart rate this high just get up, go for a pee, get yourself some water, sit on the edge of the bed and breath slowly whilst sipping the water. It will take 5-10 minutes for the HR to start coming down again.

    And.....having a resting heart rate in the 60-70s is just simply not worth even wasting any thought on.

    You don't need to keep going to ER for this either. Arrhythmia and all sorts of things can be picked up on a stressed system (and you are stressed). I have been in A&E(ER) half a dozen times over the last 10 years for what turned out to be nothing. Some days I went there because my heart rate was stuck over 120bpm (stayed there for 36 hours or more). Each time I was hooked up to an ECG for at least 24 hours and Doctors would explain to me that they could see hundreds of little 'blips', but this is to be expected with somebody in my state, with my history of anxiety. I don't think this message is as easily portrayed in the USA, where it seems more likely that they want to eradicate these blips with medication. And this, in my opinion is a dangerous road to go down.

    Fundamentally, there is nothing wrong with you apart from stress and anxiety, and stress and anxiety is causing everything you are experiencing. You are macro analysing every single heart reaction to everything you do, and forming fear reactions based on where you perceive your heart rate should be, and what it should be doing at any given moment. And your heart doesn't work like that. Your heart will be all over the place simply by having low grade background anxiety switched on all the time. And this is compounded by you checking your heart rate every 5 minutes. This creates a feedback loop as you consciously perceive fear (my heart rate is 5bpm more than I expected!!!), which makes it spike another 10-15bpm for another 2-3 minutes.

    Having the flu and suffering from anxiety means you have a long road of self restraint ahead of you. This mostly means allowing your heart to do what it wants to do WITHOUT reacting to it. Next time you wake up at 145bpm, just let it be (YOU WILL BE FIIIIIIINE ).....allow yourself to experience it coming down again without panic swallowing a benzo. Why are you trying to bully a natural bodily process into submission.

    The best thing you can do is accept what's happening right now, because nothing you're experiencing is dangerous, in any way.

  9. #9
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    Re: Long Story About A Crazy Heart (Bear With Me) -PACs, PVCs, and more...

    Jon, I'm sorry you're having such a rough time right now. I get palpitations on a regular basis, and while they don't frighten me, I do sometimes find them distracting/annoying.

    Further to what Joe has said (and yes, Joe is totally the man when it comes to situations like this and I wish I had half his self-discipline), have you thought about starting to meditate. There are plenty of simple, free resources to help you get started, and once you have a little practice the results can be nothing short of miraculous. Until I met a really good therapist who tuned me in to some really brilliant coping strategies I always thought I didn't have the focus to meditate, but it's actually less about focus and more about awareness and reminding yourself of good habits.

    Please try to stop running to the ER? All you're doing by that is reinforcing your anxiety.
    __________________
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    Sometimes, it's better to light a flamethrower than curse the darkness. - Terry Pratchett

  10. #10
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    Re: Long Story About A Crazy Heart (Bear With Me) -PACs, PVCs, and more...

    The self discipline is only practice. I have a long history of having no self discipline at all. It's not innate.

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