Seeking advice re changes in my heart and energy

[Eva]

My energy level has been dropping these last two years more than before. I related this to the “unspecific A-Flutter“ in March 2019, the fall over 18-steep wooden steps end December 2019, A-Fib In March 2020 which required cardio version, some tension, etc.!
I’m able to run some errands, do necessary chores, and walk my cute dog every now and then. yet, when I do all or much in a row, I need a few days to recharge!
Last echo found “aortic root size is dilated. The proximal ascending aorta measures 42 mm”.
My left ejection fraction has dropped from 60-65 in 2019 to 50-55 in 2020.
My doctor is keeping “an eye”! Is one eye enough?!
Any advice will be appreciated!
May you stay healthy and safe.

 

[pellicle]

my advice is to try to remain active, while accepting that most of us don't get younger each year. I would be walking as much as possible and eating well.

Regular measurements are good and nothing about your measurements rings big red alarm bells to me. Changes in EF can be related as much to measurement differences as actual ones in my observations.

If I've done my sums right on your sig you're over 68 now ... so some amount of slowing down is normal. Are you sedentary or active? Unless mowing or cutting down trees, no gardening isn't activity its just hard on your knees and back.

 

[Eva]

my advice is to try to remain active, while accepting that most of us don't get younger each year. I would be walking as much as possible and eating well.

Regular measurements are good and nothing about your measurements rings big red alarm bells to me. Changes in EF can be related as much to measurement differences as actual ones in my observations.

If I've done my sums right on your sig you're over 68 now ... so some amount of slowing down is normal. Are you sedentary or active? Unless mowing or cutting down trees, no gardening isn't activity its just hard on your knees and back.

thank you, pellicle.
I read in one of your posts‘ inserts “Aortic Aneurysm | ANZSVS“
that: “In healthy people the aorta .... is usually about ... 20-25mm in diameter although this can vary with age and whether you are a man or a woman.”
Mine grew 2mm...it was 40 in March 2019.
I am 69. I’m moderately active, but maybe I need to force myself to exercise more. But I normally stop when I get short of breath.

 

[Brokenhip]

Eva,
Hoping you can get on top of your reduced energy levels as I have something similar currently. Interested to know about your AF in March & why it was treated with cardioversion rather than say medication or ablation.
I had an AF episode 2 weeks ago with an erratic pulse I could feel in the neck. Tried cycling the next morning, lasted 5 km as HR was much higher than normal and erratic. Off to the GP, did an ECG which was sent to my cardiologist & between the two practitioners they have put me on a beta blocker Sotalol (40mg twice a day) & an anti coagulant Pradaxa. The AF settled about 36 hours after it started, so not sure whether it was the meds or it would have corrected on its own.
Have continued cycling but finding it hard work as HR is maxing at around 90 bpm. Plan to see my GP on Friday & discuss a strategy to come off the Sotalol which the cardiologist is OK with & in the short term use a pill in a pocket, & see what transpires.
I am the same age as yourself with a bovine aortic valve & any input would be grateful. Did they put you on any beta blocker after the cardioversion & assume you are on AC therapy with your mechanical valves. I guess I could stay on the Pradaxa to help reduce the risk of throwing a clot & the subsequent consequences.
Anyone else with similar experience I would also like to hear from.

Peter.

 

[pellicle]

Hi

Mine grew 2mm...it was 40 in March 2019.

and indeed it goes on to say:

We know from two large studies in the USA and UK (Lederle FA et al, 2002) that aneurysms less than 5.5 cms

so still not at a stage where one would be concerned.

you write:

m moderately active, but maybe I need to force myself to exercise more. But I normally stop when I get short of breath.

and I'd say short of breath is a good point to stop. I can say that when cycling I know I can't charge up an incline as I could for as long, and so when my breath becomes the rate limiting factor I select a lower gear and slow down. I went out yesterday and did about 20km, it took me 45 minutes ... I'm sure it would have taken me less when I was 45, but now I'm 56.

I know I could be fitter than I am but somehow since coming back to Australia from Finland I cycle less and ski less too. Working from home has seen a reduction in activity as well.

I can only say "know yourself" and learn your limits and press gently outwards but not too hard. Sometimes using some tools like HR monitors (on these watches) helps to learn what's happening.

Best Wishes

 

[rich01]

My energy is very tied to my diet. Even though I know I shouldn't eat wheat, I keep going back to it because foods made from wheat are so convenient. I haven't had any for over a week and my mood and energy are starting to increase. Any foods that cause inflammation might affect your energy.

For exercise, I find if I don't exercise (walking) for several days, I lose muscle tone and get out of breath very quickly. Walking almost every day, even a short distance, is enough to prevent this from happening.

It could be a problem with the valve, but energy is a 3 legged stool - health, diet, exercise.

 

[Eva]

Eva,
Hoping you can get on top of your reduced energy levels as I have something similar currently. Interested to know about your AF in March & why it was treated with cardioversion rather than say medication or ablation.

Peter,
Thank you.
Electrophysiologist recommended cardio version since the 200 mg of Beta-blocker Metoprolol and the 200 mg anti-arrhythmic Amiodarone, he put me on for over a month, didn’t lower my heart rate enough! He thought the sooner my heart rate dropped, the better it was to spare it the pressure of the extra workload!
Last year he discussed ablation, but he didn’t this year, maybe this was faster and less risky because I have two mechanical valves!?

Now, I drink coffee occasionally and try not to binge on chocolate, as they are my triggers!

The AF settled about 36 hours after it started, so not sure whether it was the meds or it would have corrected on its own.
....Plan to see my GP on Friday & discuss a strategy to come off the Sotalol which the cardiologist .?

I believe your heart and the medication worked well together. Hope you stay so. But, if they keep you on a low dose of beta blocker, just embrace it!
(After my heart corrected on its own in March 2019 with the help of Amiodarone and Metoprolol, I was kept on 25 mg of Metoprolol! I wonder if it could have been better it I was kept on 75 mg?!)

Did they put you on any beta blocker after the cardioversion & assume you are on AC therapy with your mechanical valves. I guess I could stay on the Pradaxa to help reduce the risk of throwing a clot & the subsequent consequences.

Yes, I am on Warfarin singe my surgery.
Metoprolol was lowered after my cardio version from 200 mg to 100 and now I’m on 50 mg and will stay on it.

Anyone else with similar experience I would also like to hear from.

I would recommend you start a new thread. This will draw more members’ attention and responses to you particularly.
Good luck. Stay healthy

 

[Eva]

.......so still not at a stage where one would be concerned.
...I can only say "know yourself" and learn your limits and press gently outwards but not too hard. Sometimes using some tools like HR monitors (on these watches) helps to learn what's happening.
Best Wishes

Thank you, pellicle.
I read all the Article and I hope progression will be slow (Until l finish my mission )!
Yes and exactly! when I go off *my limits* is when I need to rest more! I have been trying hard to increase my activity a bit every week. I hope to continue so.
After my AFib, I and my Iwatch are keeping a cautious eye on my heart rate!
stay healthy.

 

[Eva]

My energy is very tied to my diet. Even though I know I shouldn't eat wheat, I keep going back to it because foods made from wheat are so convenient. I haven't had any for over a week and my mood and energy are starting to increase. Any foods that cause inflammation might affect your energy.

For exercise, I find if I don't exercise (walking) for several days, I lose muscle tone and get out of breath very quickly. Walking almost every day, even a short distance, is enough to prevent this from happening.

It could be a problem with the valve, but energy is a 3 legged stool - health, diet, exercise.

Thank you for sharing your experience!
Very interesting. I always thought of going to a nutritionist, but when my doctor tested me for allergies and I had non, I didn’t.
Maybe I’ll re-start keeping a log about what eat and how I’d feel!
And force myself to walk more often.
stay healthy.

 

[FredW]

Eve, everyone reacts differently to medication. Giving that, I found 5Omg of metoprolol limited my hearts ability to respond to strenuous activity. After cutting back to 25 mg a day, I found I could work harder with less impact. It might be the drugs that is limiting your activity.

 

[rich01]

Eve, everyone reacts differently to medication. Giving that, I found 5Omg of metoprolol limited my hearts ability to respond to strenuous activity. After cutting back to 25 mg a day, I found I could work harder with less impact. It might be the drugs that is limiting your activity.

That's a good point. Everyone needs to become their own detective and become aware of changes in how they feel and what may have caused the change. What makes it extra hard is we are all different. In addition to being normally different, I think many of us are probably outliers, so scientific studies may not always be the best guide for us.

 

[Eva]

Eve, everyone reacts differently to medication. Giving that, I found 5Omg of metoprolol limited my hearts ability to respond to strenuous activity. After cutting back to 25 mg a day, I found I could work harder with less impact. It might be the drugs that is limiting your activity.

FredW, thank you for responding.
I totally agree about medication’s effect on my energy, and this is why my doctor slowly lowered my dosage from 200 to 100 to 50 mg. My Electrophysiologist warned me that my A-fib could happen again and again, or may not!
So, honestly, I’m scared to push him to lower dosage though my heart rate drops below 50 a few seconds daily while at rest and while asleep. And he knows about this and that my BP is lower than before. He thinks that I’ll get used to the low BP and To the lower HR and will feel better with time (for which I’m still waiting and hoping the TIME will come!).
So, YES, my fatigue somehow was worse when I was on 200 mg.
Stay safe and healthy

That's a good point. Everyone needs to become their own detective and become aware of changes in how they feel and what may have caused the change. What makes it extra hard is we are all different. In addition to being normally different, I think many of us are probably outliers, so scientific studies may not always be the best guide for us.

Absolutely right, rich01.
stay healthy and thanks again.

 

[Brokenhip]

Peter,
Thank you.
Electrophysiologist recommended cardio version since the 200 mg of Beta-blocker Metoprolol and the 200 mg anti-arrhythmic Amiodarone, he put me on for over a month, didn’t lower my heart rate enough! He thought the sooner my heart rate dropped, the better it was to spare it the pressure of the extra workload!
Last year he discussed ablation, but he didn’t this year, maybe this was faster and less risky because I have two mechanical valves!?

Now, I drink coffee occasionally and try not to binge on chocolate, as they are my triggers!

I believe your heart and the medication worked well together. Hope you stay so. But, if they keep you on a low dose of beta blocker, just embrace it!
(After my heart corrected on its own in March 2019 with the help of Amiodarone and Metoprolol, I was kept on 25 mg of Metoprolol! I wonder if it could have been better it I was kept on 75 mg?!)

Yes, I am on Warfarin singe my surgery.
Metoprolol was lowered after my cardio version from 200 mg to 100 and now I’m on 50 mg and will stay on it.
I would recommend you start a new thread. This will draw more members’ attention and responses to you particularly.
Good luck. Stay healthy

Eva,
Thank you for that detailed response, excellent information and further food for thought.
Peter.

 

[KatherineA]

Yes, I completed agree, we have to be our own individual detectives and figure out what works for us. I’m prone to relying solely on yoga which is good. But not enough. To inspire walking, I finally got a Fitbit. I find it really does get me moving. I set the hourly reminders for 250 steps, whic isn’t much but does get me up and usually then I do some stairs, at least a trip or two and expand the walk to a minimum quarter mile (my driveway up and down 4 times ).
I like to compete with myself more than I thought I would too. I also like the sleep tracking feature.

I do disagree about gardening nor being “exercise”. I am currently pulling all dead stuff, tomatoes and stakes, covering every bed with wood chips from some recent tree work and a fresh layer of dirt. I had 5 yards of dirt delivered and have done a little over half of it with a shovel, rake, and wheelbarrow. The dirt pile and chip piles are both 100 feet from the garden beds. That’ll get get the heart rate up. I do 3-4 wheelbarrows full then rake it out as a “rest time”

 

[Eva]

Yes, I completed agree, we have to be our own individual detectives and figure out what works for us. I’m prone to relying solely on yoga which is good. But not enough. To inspire walking, I finally got a Fitbit. ...?
I like to compete with myself more than I thought I would too. I also like the sleep tracking feature.
...

I really miss my Fitbit! It saved my life twice! Unfortunately, hubby insisted on replacing my Fitbit with iwatch as it warns me when HR goes below or over limits I choose, and the EKG Application is really helpful!
keep on gardening...impressive work. Stay healthy

 

[Eva]

Eva,
Thank you for that detailed response, excellent information and further food for thought.
Peter.

You’re welcome. Best wishes to stay healthy.