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  #1 (permalink)  
Old 08-21-2010, 12:24 PM
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Join Date: Aug 2010
Location: Michigan
Posts: 166
COPD2 is on a distinguished road
Chucked The 30 Day Event Monitor at 21 Days

Anyone also have Chronic Obstructive Pulmonary Disease (COPD) as well as A Fib??

This A Fib bit is new to me. First event I was aware of was 07 March 2010. Strong, erratic heartbeat whilst sitting at the 'puter. I have a Nonin Onyx oximeter which also reports pulse rate (PR). It was wild for about a 1/2 hour if I remember correctly. Anywhere from 54 to 247 bpm jumping in 8-12 beats at a time. Again 22 April, 27 May and 10 June 2010.

My family doctor scripted a 30 day event monitor and set up an appointment at our local hospital's cardiology department. Then I got a phone call from the hospital that they no longer do them where I had been told to go and they would call me back w/further info. Except they never called back and since I expected them to call I forgot about it.

Then 23 July I had a doozie! No where near such drastic fluctuations, but lasting longer than any of the others, the longest of which was the original on 07 March. I ended up calling 911 and being transported to ER, probably a good 2 hours from the start of the event to arrival at ER. 100 to 160 bpm during the ambulance ride and ER visit. Two Troponin blood draws 4 hours apart and FINALLY released! This happened on a Friday evening, of course.

So Monday I see my family doctor, he still doesn't have an event monitor report. Of course not! I haven't been given one yet!!! Ooopsie! It seems I got lost in the shuffle in the middle of the hospital discontinuing doing their own event monitors and sub-contracting them out to eCardio in Houston, TX. (We're in MI).

I got a phone call Monday afternoon from the hospital apologizing and telling me I would be receiving information and event monitor setup yet that afternoon. Later that afternoon eCardio called, explained they would overnight an event monitor to me and I should call when I receive it and they would handwalk me thru using it. The next MORNING, 27 July, before noon!! the eCardio eVolution event monitor arrived.

Mind you, given the length of time between events I was aware of, always when at rest, reading, at the 'puter, on the phone, watching TV, I didn't expect much and was pretty sure this was just a waste of time and money.

Ha! 28 Jul from 10:15 to 11:30 an event!!! At least this wasn't a waste after all! eCardio calls to ask what I was doing when I pushed the button, just sitting at the 'puter. Then a cardiologist I never heard of called, wanted me to go to ER. I had my Nonin oximeter on and was monitoring my PR myself and things were slowing down so I declined.

Last edited by COPD2; 08-21-2010 at 02:19 PM.
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Old 08-21-2010, 02:28 PM
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Location: Michigan
Posts: 166
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Hey, this cardiologist's office "ain't" so bad after all. They never even blinked an eye or gave me any guff when I requested a copy of the inch and a half thick eCardio report! They made the copies whilst I waited. Now THAT is the kind of response I APPRECIATE from a doctor and office staff!!!! (No charge for the copies either! 141 single side pages!)

28 July 10 - 11:15 AM - Sinus tachycardia > Atrial Fibrillation RVR Rapid ventricular response.
11:24 AM - Atrial Fibrillation RVR w/PVC Premature Ventricular Contractions
11:28 AM - Atriall Fibrillation RVR
11:30 AM - Atrial Fibrillation RVR/Sinus Rhythm
11:32 AM - Sinus rhythm w/Intermittent Atrial Fibrillation
12:33 AM - Sinus Tachycardia w/Lead loss
30 July 10 - 4:04 PM - Sinus Tachycardia w/PAC/Artifact Premature Atrial Contractions
11:17 PM - Sinus tachycardia/Sinus rhythem w/Artifact
31 July 10 - 9:52 PM - Sinus rhythm/sinus tachycardia w/PAC
10:26 PM - Sinus rhythm/sinus tachycardia w/PSVT Paroxysmal supraventricular tachycardia
01 Aug 10 - 12:59 PM - Sinus tachycardia w/PACs/artifact
7:50 PM - Sinus rhythm w/PSVT
02 Aug 10 - 12:22 AM - Sinus tachycardia w/PSVT/artifact
03 Aug 10 - 10:47 PM - Sinus rhythm w/Intermittent Atrial Fibrillation RVR
04 Aug 10 - 10:59 PM - Sinus rhythm w/PAC
2:27 PM - Sinus tachycardia / PAC / sinus rhythm
9:52 PM - Sinus rhythm w/PAC
05 Aug 10 - 5:56 PM - Atrial Fibrillation RVR w/PVC
06 Aug 10 - 6:29 AM - Sinus rhythm/sinus arrhythmia
07 Aug 10 - :11:14 AM - Sinus arrythmia/sinus rhythm
08 Aug 10 - 6:29 AM - Sinus rhythm w/PAC
6:29 PM - Sinus arrhythmia/sins rhythm
08 Aug 10 - 9:48 PM - Sinus tachycardia w/PAS
09 Aug 10 - 6:29 PM - Sinus tachycardia w/PAC - Sinus rhythm w/PACs
10 Aug 10 - 8:56 PM - Sinus rhythm w/PACs
12 Aug 10 - 8:55 AM - Sinus tachycardia
13 Aug 10 - 8:55 AM - Sinus rhythm w/PACs
3:06 PM - Sinus rhythm w/PSVT
14 Aug 10 - 8:55 PM - Sinus rhythm w/PACs/Artifact
15 Aug 10 - 7:23 PM - Sinus rhythm onset > atrial fibrillation RVR
7:31 PM - Atrial fibrillation RVR
7:30 PM - Atrial fibrillation RVR - Sinus rhythm w/PVC/PAC
7:35 PM - Atrial Fibrillation RVR w/PVC - Sinus rhythm w/triplet PACs
7:47 PM - Sinus tachycardia w/PAC
18 Aug 10 - 9:21 AM - Sinus rhythm

It looks to me like I need to use my 02 more often thru out the day, thus reducing the episodes of shortness of breath (SOB) and that would drastially reduce these reported "events".

If the locals had kept me in the loop once a week we could have used those last 9 days on the event monitor that I terminated w/my using 02 all wake hours. What a waste!

Last edited by COPD2; 08-21-2010 at 02:37 PM.
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  #3 (permalink)  
Old 08-08-2011, 10:23 AM
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Join Date: Aug 2010
Location: Michigan
Posts: 166
COPD2 is on a distinguished road
Was in to see the cardiologist for my 6 month "well visit". So far as I can tell I've not had an event since the third day of Rythmol. I never did increase the dosage of the Rythmol or the Toprol. He's okay w/that.

We are STILL playing around w/the coumadin dosage. Three times this past year I've been able to go 2 weeks between draws and once even was able to go a full month between doors. Other than that it has been weekly draws. *sigh*

He'll see me again in six months. A month before our appointment he will schedule another event monitor to check things out.

He asked when I had my last stress test and I told him I would NOT go back to that facility and I could NOT do that type of stress test again. I can NOT keep my arms above my shoulders long enough for two scans. He said it can be done w/me prone instead of supine so that my arms are hanging instead of above my head and we will do another stress test in six months too. AND I don't have to go back to that facility we will do it at the hospital.

We had a good talk about my "type" of A fib being "chronic" despite so infrequent. And that it will get more frequent due to the COPD. And eventually more severe as the COPD progresses. So - so much for my goal of a "pill in a pocket" for the Rythmol and no more Toprol.

I also asked about what I'd read that Rythmol needed a second med rather than being the lone med. He said Rythmol is "just" to hopefully keep the heart in good rhythm, something else (Toprol in my case) is needed to slow the heart rate down. *sigh*

He sure has a way of explaining things that make sense to me and get me to "behave" and pretty much do as he suggests. *sigh*

He's okay w/my staying at the lower dose of Toprol rather than the doubled dosage he had scripted. I'm doing well w/this dosage so WHY bother to double it to the more common dosage when it doesn't appear to be needed.

The ECG script they ran looked "perfect". No suprise to me. Never have had an ECG strip other than normal as events just don't happen that often. (See above). Like they will ever catch them w/a just plain ECG.

ECG or EKG? Just the electrical activity of the heart, not the one w/ultrasound.
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  #4 (permalink)  
Old 08-14-2011, 10:35 AM
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Join Date: Aug 2010
Location: Michigan
Posts: 166
COPD2 is on a distinguished road
Due to my COPD I can no longer "do" the walking stress test. I have to "do" the chemical stress test.

Has anyone ever done a chemical stress test W/O having to go in on an empty stomach, then eat some high fat junk food and drink lots of cold water as part of the test???

My understanding is that the cold water tends to encourage the high fat to congeal in the veins and arteries and thus aid in the imaging. (Rough explanation).

Either way, THAT is a nightmare for me to have to do. #1] those high fat foods on an empty tummy do NOT sit well and #2] the volume of liquid we are told to drink stretches the capacity of my tummy and I get NAUSEOUS to the point of barfing and #3] the cold water quickly makes me cold (and the imaging department is always so cold anyway).

Twice I've had this type of chemical stress test, both times it happened, I REFUSE to do it again if I have to do the empty tummy high fat eating and cold drinking.

Twice I've had a chemical stress test where I didn't have to "do" the high fat eating bit so we shall see when it gets closer to having it scheduled what they will try to require.

Sounds like the first of the year is going to be a "fun" time. I wonder what next year's annual deductable is going to be?? *sigh*
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Old 02-19-2012, 11:19 AM
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Location: Michigan
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Ha! What a bunch of horsepuckies about the need to drink all that cold water on top of eating all that high fat junk as the cold water tends to encourage the high fat to congeal in the veins and arteries and thus aid in the imaging. That's the line fed when I explained to the cardiologist why I wouldn't/couldn't do this test again.

Was just talking to my new cardiologist the other day and mentioned I just couldn't do that type of test again and he said that it wasn't true, that by the time the cold water hits my stomach it is body temperature and has no influence on the high fat congealing to any degree.
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Old 02-22-2012, 07:09 AM
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Location: Michigan
Posts: 166
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Okay. My office EKG was "beautiful" and just what my cardiologist wanted to see. No need for the stress test after all, maybe at my next follow up in August.

We did the 21 day event monitor to verify how I was responding to the Toprol and Rythmol. This time around it was the CardioNet MCOT instead of the eCardio ER920W. I didn't like it as much but that is a whole other subject I posted that I have to get back to and update.

Anyway, the MCOT reported normal sinus rhythm thru out the 21 days. His nurse made copies of the entire report(s) and mailed them out to me yesterday. Last year I would have had them today but USPS has close our local postal processing facility and all mail for this area, including in-town mail, is being trucked to the main processing center in the state and then shipped back to our area for delivery - in delivery point sequence even. (i.e. machine sorted in delivery sequence rather than sorted by the letter carrier).
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