AVR, low INR, and aniety/panic attacks

[worktheday]

***I KNOW THIS IS LONG, PLEASE TAKE THE TIME TO READ. AND THANK YOU IN ADVANCE***

Hello all,

I'll begin by giving a little background. Had AVR in '07, St. judes mechanical. Have had mostly succcesful INR therapy since. First in office, then home testing. Dating back to the age of about 26 I seemed to begin to develop an anxiety disorder what appeared to come out of nowhere. Since finding of the heart problem and the proceeding AVR it (the anxiety) has alway lingered.

I've gone through long stretches where it wasnt prevelant at all, months. Then out of the blue, an attack - or near attack. No apparent rhyme or reason.

I am and have been on medication for this for years. Prozac 10mg, xanax .5mg, and klonopin 1mg all daily (prozac and xanax in the morning, klonopin at night. Have been told mutliple times these are all relatively low dosages respectively). This seems to have kept me more or less at bay for the last few years.

There have been about 4 different instances over the last 4 years where i had a panic attack and because of my AVR, the first thing I'm always wondering is "is something wrong with my heart?!" Go to the ER, tests run, dismissed as an anxiety episode.

Its been a good 8-12 months since i have had any real issue with anxiety (still taking the meds) up until Friday before last. I was driving in my car and had what i thought was a bad attack coming on, worst in a long time. Thought i was going to faint, but didnt. drove myself to the hospital. was checked out. This is where my biggest fear over these last few years comes true. The Dr. comes back to tell me that my "Troponin" levels came back high, which is a front line indicator that I had some damage to the heart muscle and "it may have been a heart attack". What?!?! A heart attack??? I couldnt believe it! Again my worst fear, so many of the symptoms of an anxiety attack mimic identically that of a heart attack or heart issue. and to be told it could have been one?? There werent exactly sure seeing as my EKG was normal and they were going to admit me and I'd have to wait for the Cardio in the morning.

Well, I was admitted for the weekend, they also had me on hepparin because my INR was also low (I had just the weekbefore that had made a draastic diet change to completly healthy eating, seeing as I had put on about 40 pounds in the last year plus). They did an echo, as well as a cath (my first ever). Said everything looked really good, no issues. This was Monday morning. "Well then what the hell happened on Friday where you said i MAY have had a heart attack if everything is looking fine??". Well because all of my tests came back normal, including my EKG upon arrival at the ER and subsiquint EKG's, they said they couldn't give me a definite answer.

I was released from the hospital monday afternoon, told to follow my coumidin dosaging and go back in to see the doctor Tuesday. INR was 1.1, REAL low, and he upped my coumidin and told me to come bk thursday. Went bk on Thursday and INR was up to 1.5. In hindsight wondering why my cardio didnt put me on Lovenox till my INR was theraputic?? Just thought of this late last night, was never discussed. Have a follow up on Tuesday with an appointment with him and to get PT checked again (also have a at home coagchek xl machine, was at 2.0 this afternoon)

Finishing up, since leaving the hospital monday and beginning tuesday and happening every afternoon all week, at one point or another i feel as though im have a panic attack. Light headed, rapid heart beat, fuzzy feeling in my head, on the cusp of passing out but dont. Same exact feeling I had when I decided to go to the hospital the Friday before. I have just pushed through it. Mentioned this to my cardio on Thursday and he told me I shouldnt have anything to physically worry about, espicially with him doing the cath and everything looking good, "your not going to have a heart attack jay!" "oh really Doc, then what the hell happened last Friday that you cant figure out and how do I know every time I feel this that something isnt going on with my heart???"

Thats is how I feel and I'm just walking around nervous now. I know, direct indication of anxiety, but I dont know what to think.

I really appreciate anyone who took the time to read all of this!! I mean REALLY appreciate! I'm wondering if anyone has any similair situaitions, experiences that they could share, and maybe what they have done, talked to there doctors about directly, things they've practiced that have helped them in general, and also helped to get more answers. I feel as though I have a real good cardio and this is just "one of those things", but im one who needs more info as to what exactly is going on with me.

Thanks again and hope to get a few replies!

Jay

 

[Elcarim]

I've been there. And I know how scary it is.

What helped me was therapy. Seeing a psychologist and talking about my fears. I went for weeks where I was afraid that I would not live out the next half hour. I couldn't stand being on my own as I was terrified I would pass out and nobody would find me in time. I was afraid of dying at the wheel with my kids in the car. It was pure hell. I ended up in hospital twice, being told that it may have been a virus causing my symptoms, before one rather crabby doctor told me I was fine and offered me a sedative. If just one of those ER docs had gently suggested that I might have been having a panic attack I might have been able to get help sooner.

Another thing that helped was forcing myself out of my comfort zones, as well as the realisation that this was only fear and that I was not actually dying.

I also got into relaxation, meditation, brainwave therapies and the like.

The main thing that turned me around was meeting my now fiance. It was the distraction I needed to stop being scared all the time and start living my life again.

Google 'panic attacks' and read all those pages that tell you that what you are feeling is fear and your heart is actually fine. They will make you feel better. Talk to someone qualified to discuss your fears and how they affect you physically. It is a vicious cycle that you have to break. Medical doctors don't seem to realise the huge impact that OHS has on people, especially younger people, I guess because these operations are so routine to them.

You are young, Jay. You need to take your new body, grab life by the balls, and conquer the fear. There is still a lot of life out there for you. You can do it!

 

[worktheday]

Jodie,

Thanks for taking the time for reading my LONG post. And additionally thanks for your replies. I try to do some of the things you have mentioned (pushing through, telling myself im ok and its just a panic attack, etc), but my real issue now is the fact that I had what i once again thought was a panic attack,but this time it wasnt JUST a panic attack and i was told "something" had happened to my heart. "possibly a very minor heart attack". Again, just what everyone (well a lot of people) in the world is thinking while there having a "simple" panic attack. Terrifying now.

In addition, as I had begun to touch upon in my first post but didnt elaborate on, exactly seven days before I had quit drinking (i was drinking everyday about 2-5 drinks a day) and literally living on terrible food...fast food, pizza, wings, subs, etc. I had just taken my health for granted and went from being a VERY healthy 165 pound in shape, toned individual post surgery to a 210 pound slob (I'm only 5'8") who completely let themselves go in a number of ways. Exactly one week before my "episode", "mini heart attack", whatever it was, I had said enough is enough, quit the drinking and drastically changed my diet. I did discuss this with my docs also so they were/are aware. There wasnt a strong determination that this may had led to my episode, but not dismissed either.

Again, just a lot of what I consider "non answers", and thats the tough part for someone with my mental make up has trouble dealing with. I need to know, good or bad. Instead I feel like I'm walking around like a ticking timebomb. I want so badly to begin working out again, lightly at first of course. Brisk walks, then light jogs, then easing my way into light resistance training. Get back to what i used to do and be and feel like. But so scared that im going "to have a heart attack" now, even though my cardio says im fine to do so moving forward.

I have an appoinment tom morning with my therapist and am going to discuss all of this with him. I also have an appointment with my Carido tomorrow afternoon and am going to go through the whole thing again with him. So we'll see what comes of that.

Again thanks for reading out there, and still any replies or thoughts are welcome!

Thanks,

Jay

 

[Bina]

Jay, OHS is serious stuff, and some of us are more emotional and sensitive to the onslaught on our bodies.
My arrhythmias and frazzled nerves sent me to the ER a few times, where they would tell me that the heart
and valve were working just fine and try to ignore the minor skips and jumps....Yeah Right.....I also had a few
episodes where I had to call my husband to come home from work because I thought that I would pass out.

I don't remember ever being like this before surgery, but I kept my life very stable and without excess
stress. It seems that you are doing all that you can by seeing a therapist and taking the meds that they
prescribe, and talking to us here is always helpful Best wishes.

 

[Country]

Jay,

the way i see it.... your inr dropped so low because you quit drinking(your docs should have upped your dosage to address this)

I am on 200mg of metropal a day and many times through out the day my hr will be in the 90's, which makes my heart feel like it is going to beat out of my chest!
so i understand how you feel!

do you drink any caffine? did you stop drinking caffine all of a sudden? i know sometimes when i have a cup of coffee or pop then i will start to get a fluttering feeling?

all i can say for sure is just take it easy.... it may take a little time for your body to get use to your new diet. just stay positive and keep up with your inr testing(weekly)!

 

[worktheday]

Bina and Country,

Thanks for the supportive words. In reference to your questions Country, I dont drink caffeine ever. Stopped in my early twenties. Never had the taste for coffee, and stopped drinking soda and anything caffienated years ago (ice tea, etc.) I do drink green tea in the evenings, but decaf. Also, if I didnt mention this above, my doctor has and had upped my coumidin dosage, but i didnt alert them to my changes till a week after the changes i had made with the drinking and diet, thus the fast INR drop. So we have been moving forward from there. Just tested my INR earlier today and is up to 2.3. So I'm getting there.

You mentioned the metropol your on Country, They just started me on Toprol XL/25mg day a week ago. My blood pressure has come right down to normal range, and my resting heart rate which is usually in the high 80's/low 90's is now hovering around 70 (which is good). But I've done some reading and A LOT of people seem to hate the medication for a number of different reasons. I'm wondering if this may or may not have anything to do with my issues?? Again doctors apointments tomorrow and this will be brought up and questioned with both.

Thanks again for all of your time and replies. Any more, I'm listening

Jay

 

[WandaW]

Hey Jay, you could ask your cardio about going through Cardiac rehab again to establish the level of exercise that is good for your heart at this time, exercise is so good at decreasing anxiety. I too have had anxiety for the past 30 years and there are times it is such a struggle.

 

[worktheday]

Hi Wanda,

Yes, that exact thought has already crossed my mind. It may be something to pursue to get back up and running (forgive the pun) before getting into it soley on my own. But thanks for the advice!

Jay

 

[catwoman]

Also, if I didnt mention this above, my doctor has and had upped my coumidin dosage, but i didnt alert them to my changes till a week after the changes i had made with the drinking and diet, thus the fast INR drop. So we have been moving forward from there. Just tested my INR earlier today and is up to 2.3. So I'm getting there.

I have read numerous times that if you make changes in your diet or activity level to alert your doctor(s). Changes can require more frequent testing at the beginning until your INR levels out.
Hope your INR is getting there now.

 

[Country]

thats great that your body is responding so well to the tropol! and that your hr came down. i hope the doc had some answers for you! keep it together!!

 

[njean]

As others have said, OHS is a huge assault on your body and sometimes it takes months before things start getting back to semi-normal.

But just focus on one thing, and I say this because I've been there 3 times and on coumadin for over 30 years....your INR, diet, meds, activity, etc., will all start working cohesively and you will start feeling better and better as time goes by. Hang in there, enjoy your best days and go on with the business of living.

 

[pem]

Hey Jay, you could ask your cardio about going through Cardiac rehab again to establish the level of exercise that is good for your heart at this time, exercise is so good at decreasing anxiety. I too have had anxiety for the past 30 years and there are times it is such a struggle.

I agree completely with this recommendation!

 

[pem]

My GI doctor once said (with a twinkle in his eye) that GI problems generally won't kill you, they'll just make you wish you were dead. I would like to adapt that observation to anxiety.

Nobody, including me, will tell you that you absolutely didn't have a heart attack, but I think most people would agree that it's unlikely. I suspect that in our bodies, levels of things fluctuate outside the normal range all the time. Given the diagnostics they did (I'm not a medical professional), it sounds more likely that you are experiencing anxiety-based symptoms. And who knows, maybe anxiety can give rise to measurable changes that are suggestive of heart problems.

Take it from someone who does anxiety well, your best chance of relief both psychologically and physically would be to get better treatment for your anxiety (consider all aspects: practitioner, medicine, and method). At least if you get that under control, you'll be in a better place to assess your physical health, and in my opinion, better off physically.

To be clear, I do not mean to be at all dismissive of your health concerns, and if it were me, I would get a second opinion about why no heparin during your low INR and why you can rule out heart attack given the findings. But I would put managing your anxiety as a very high priority, because you will be able to do the rest more easily once you do.

Good luck!