pameladean | And make my seated heart knock at my ribs, against the use of nature

For those of you who know about this, this is news from last week, not a recurrence.

I am prone to occasional spells of tachycardia. I have been to the ER and the walk-in clinic for them, and the only thing anybody has ever been able to find wrong with me is dehydration. I accordingly drink a huge amount of water and, when I start to become aware of my heartbeat and am not running a marathon or dashing up and down the stairs or -- well, you get the idea -- I drink a bottle of Gatorade. I had one of these episodes on October 23. Gatorade more or less beat it back, but did not resolve it. I drank Gatorade intermittently all weekend, to no avail. On Sunday night my pulse rate was 116, which was unnerving me; and I was short of sleep, because it is hard to sleep when your heart is hammering. I take a beta blocker for hypertension, and this tends to dampen down such symptoms during the day. They wait to raise their tedious and annoying heads at bedtime, or wake me up in the wee hours. In any case, 116, while extremely noticeable, is below the emergency level.

Raphael offered to take me to the ER if I thought I should go, and would be able to do so up to perhaps four or five a.m. I was not really inclined to go, because I knew that I would waste four to six hours of very busy people's time, annoy the insurance company, and come home with a bruise on my arm but no more wisdom than before. I stuck it out til morning and called my clinic. To my increased annoyance, the nurse I talked to told me to go to the ER.

I accordingly did. Everybody was very nice, as they always are. My EKG was perfect, the heart monitor showed no problems, all my labs were gorgeous. They gave me two bags of intravenous fluids (ow) and sent me home in a record four hours. I felt fine, aside from not having had much sleep, until bedtime Monday, when the whole thing started up again. I drank Gatorade, I drank chamomile tea, I drank water, I paced around. At one point my pulse rate was 121, so Raphael got ready to take me in. I was getting dressed when I realized that I did not feel so frenzied. I checked my pulse. A hundred and five. I told Raphael not to hurry, and checked it again in 15 minutes. Ninety-three. I went back to bed. In the morning I called the clinic again, because it is a new thing that two bags of fluids have not vanquished whatever the heck this problem is. They made me a followup appointment with my regular doctor for November 5 and said I could go in to the Direct Care Clinic the next day if I liked. I said I would, bracing myself for another rocky night.

I had a delightful night, other than the part where I had to get up early to go to the clinic. I knew they wouldn't find anything, and they didn't. They kindly drew blood to check my thyroid, which the ER had not done; the results came back that afternoon and were normal.

Today I saw my doctor, and to my immense pleasure he took me off both the diuretics I have been taking for years and put me on a low dose of my old ACE inhibitor to compensate for the removal of the modest pressure-lowering effect of the diuretics. I have hated those things for years and I do so hope I won't have to go back to them, ever again. I also hope, of course, that this course stops the episodes of tachycardia once and for all.

My doctor told me that there were three possible ways to proceed: if I thought my episodes were caused by anxiety, he could give me Xanax or something like it that I could take when I started feeling anxious. However, I don't get anxious until my heart is really pounding away, so it is a result, not a cause, of the problem.

The second possibility would be to give me Clonidine or something like it, which reduces pulse rate by a different mechanism than the beta blocker, since I am maxed out on the latter. In my house, we always refer to this drug as "the evil drug Clonidine." I was on it briefly in 2002, and, frankly, I would rather go on having tachycardia. I indicated this.

The third possibility was the one we chose. I am really crossing my fingers here. These episodes seem benign enough, but I'm tired of them.

Oh, and in case anyone is wondering: No: no chest pain, no shortness of breath, no dizziness or light-headedness, no skipped heartbeats, no indigestion (other than that caused by too much Gatorade).

Pamela