AF Association

What’s happening?

I’ve been experiencing palpitations, dizziness and chronic fatigue for quite some time. I was previously diagnosed with B12 deficiency and so was given regular injections for over a year.

In June 2017, I underwent a gastric bypass to help me achieve permanent weight loss and all is going well apart from the chronic fatigue and palpitations.

Around August last year, I was referred to a cardiologist and had a 24hr tape, the results came through with a suspected 7 second pause of my heart, around 7am one morning however, we wasn’t too sure whether it was correct or whether the pads came disconnected from my chest briefly (which they did). Unfortunately, bad timing prevailed as I went through a break up and moved to another part of the country in September.

After registering with a new GP I was sent for a scan and last week, I had another 24 hour monitor attached. This time, more securely, there were no disconnection of the pads at all.

Yesterday, I received a call from the new cardiologist and he told me that there was more pauses, however, around 4 seconds appears to the previous 7 seconds and he said that he believes it warrants having a pacemaker fitted which will be done by the end of February.

Now, I’m not concerned about having a pacemaker fitted etc but...

1) I forgot to ask what the condition was called, I would like to research the condition so that I have a better understanding, I have requested a callback but still waiting in this. )I do know the cardiologist was in clinic so may come later today or even in the morning.

2) could these pauses be the cause of my chronic fatigue? I’m finding that I’m having to sleep a couple of times during the day or, could this be unrelated? I have made an appointment to discuss the fatigue with my GP but that’s not until next week.

From what I have said above, can anyone explain what the likely condition would be...more in terms of the pauses.

Thanks for reading.

APR

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ncbi.nlm.nih.gov/pmc/articl...

Pauses read up on heart block

Go to Casualty if you have a black out

Ring arrhythmia nurse in cardio dept

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Sick Sinus Syndrome maybe?

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Thank you for the responses. I have had a message left by the cardio who said the term is called sinus node disease which, I believe is the same as SSS?

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APR77

In that case, your cardio may already have made that diagnosis, in which case palpitations could signify rapid heart rhythms regular or irregular.

Sinus node disease sounds more acceptable even if not strictly a disease, essentially a wiring problem that is easily addressed. But yes the same thing I would imagine

So Buffafly has beaten your cardio to the punch 😉

Are you pleased with the results of your bypass? Weight loss is key in managing AF

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Hi Pilgrim3,

I guess I have a lot of reading up to do, make sure I'm fully 'equipped' to deal with this. I'm hoping that once I have the pacemaker fitted, it will alleviate the fatigue, that is what is getting me down the most.

I've had to defer both my modules with the Open University as I'm just too tired to study at the moment, chuck in a lot of confusion into the mix, it has become near on impossible to carry on. I've spoken to the OU and have agreed to defer to October where I can pick up where I left off.

I am pleased with the results so far, I did weigh 25st 7lb at my heaviest and now am 19st 11lb. I only had the op in June last year so just over 6 months ago. I have a long way to go yet to get to my ideal weight but due to the depression and anxiety, along with the fatigue, I haven't been getting much exercise. That is, until last Friday when I decided to get a dog. I needed a reason to get out and about so I have Loki, on a foster-adopt basis at the moment and I take him for walks at least 3 times a day.

This increase of my activity levels is what I call my phase 2 of my weight loss programme. Prior to getting Loki, I was doing around 500 steps a day which is dire! Only went out once a fortnight when I was running out of supplies so nipped into town for a bit of shopping so once a fortnight I was getting over 10k steps in. Now I have loki, I'm getting around 5-8k steps each day which is a massive increase, not quite the 10k but we are building up to that and once I have the pacemaker fitted I'm going to be aiming to 15-20k a day. Hoping to get a car soon so I can take Loki up to the Moors for long, peaceful walks :)

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APR77

6 stone in 6 months

That’s extraordinary but seems rather fast. Is your intake sufficient?

Blood count chem profile inc glucose and mineral profile can all be impacted. Hope Gastro are keeping a close eye ,

Did you open the monograph on gastric bypass I sent? good stuff in there

I,m not surprised you are fatigued, I would suggest slowing down a bit. The next few months will be challenging for you. It would be a pity to undo your progress by being over zealous.

Sounds like the Pacemaker is top of your agenda. A simple procedure normally but ideally needs a backdrop of metabolic stability.

Is a one off private gastro review an option., to get face time. Revert back to NHS for further tests as mega expensive unless insured.

You need a good GP to get your Cardio and Gastro together for shared management with the Cardio taking lead role.

It can be done, they need to see your potential to become a huge success story for all concerned. A case report for them and a potential book deal for you.

So that must be Loki. Looks like she/he is waiting to take you for a walk. Which moors?

Well done, hats off to you Sir!

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lots of good replies already- I would add that if you have pernicious anaemia - ( not absorbing Bit B12) you stay on injections for life

I have one every 3 months.

Extreme fatigue is also a sign of this so do have a blood test asap to see that yourB12 levels are OK. This should be done urgently just to be on the safe side as low Bit B12 has many effects which I won't go into as it may be unnecessarily worrying

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Hi rosyG, sorry, I forgot to say in my original post that I was stopped taking B12 injections at the time as my levels were well within normal limits, after having surgery though, I am again, starting 3 monthly injections, the last one was towards the end of December.

To be honest, I never found any benefit from having the injections, as I was able to self-administer at home, I took it upon myself to inject more often than recommended which was roughly once per month, sometimes twice so, even though I was having these injections, I was still very fatigued. I'd like to think I'm highly educated on the effects of B12 deficiency as when I was 'diagnosed' as being B12 deficient, I armed myself with as much information as possible including sources such as B12d.org and B12deficiency.info on Facebook. I fought every battle and jumped every hurdle I could to be able to self-administer as, at the time, I shared a car with my partner so made getting to my GP very difficult when he was at work. I'd have to get 2 busses each way which, in my state of health, wasn't easy to achieve.

Pilgrim3, 6 stone in 6 months is very fast however; prior to having the procedure patients have to follow a Liver Reduction Diet (LRD) which aims to, well, reduce the liver, so that surgery can be performed laproscopically. I had my procedure done privately with the Spire Group, their recommendations for the LRD was either to follow a very low carb diet (VLCD) or a 'Milk' diet (which consisted of only consuming 4 pints of milk, a day, for the duration of the LRD) or a combination of both. I opted to do a combination of both, I'd tend to do 2 days milk, 1 day VLCD. This was for 2 weeks before the procedure. Post-op, we were to follow another plan, again, the first two weeks after the op, it was a liquid diet only so, soups or liquidised stews etc. 2 weeks after, it was mushy food which would be a thicker consistency than the liquid stage, 2 weeks after that would be onto soft solid foods such as flaky fish and then back to 'normal' foods.

This is why there is such a dramatic weight loss in the first few months after surgery, I am taking in good nutrition, high protein meals. We have to prioritise protein over carbs and veg. As I now live alone, I do a lot of prepared meals, once a month or so, I'll cook stews, currys etc in a pressure cooker and also have batches of soups in trays in the freezer. I can't tolerate red meats as I did before unless they are cooked tenderly, hence prepping in a pressure cooker (fantastic invention!!)

As a result of the surgery, I am on life-long multi-vitamins and minerals with an additional 3 monthly injection and daily Calci chewD3 supplement which is calcium and D3. I have regular bloods taken and have monthly reviews with the dietitian and 6 monthly reviews with my surgeon.

I did open the link provided, very informative, indeed. I am seeing my GP next week, I initially was going to discuss with her, the possibility of having Chronic Fatigue Syndrome however; with what has come to light, I will discuss that with her (cardio have written to her which is sent electronically so should hopefully be reviewed by then) and will discuss asking her to write to cardio and gastro.

Out of curiosity, what would they have a case report on? The affects of bariatric surgery after having a pacemaker fitted? and a book deal? ha, that'd be the day :)

Yes, that is Loki as my avatar, he's a German Shepherd/Akita mix. Only had him 1 week and already are the best of pals!

Well, I live in West Yorkshire so we are quite spoilt for choice in places to walk, we have Saddleworth Moors, Yorkshire Dales, Ilkley Moor to name a few.

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Sounds as if you are getting everything sorted out. Be well

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Hi John,

I've not been diagnosed with having sleep apnea although one cardio suggested getting this checked out which I am seeing my GP for next week.

I've only just got Loki so not been on the Moors with him yet but will be Yorkshire Dales, Saddleworth Moors and Ilkley Moor (when I get a car) He's 2.5 years old. Fostering means taking the dog into your home on a temporary basis, to see if you both bond and get on with each other (which we are).

Dumping syndrome is where too much sugar goes from the stomach to bowels too quickly as a gastric bypass, re-routes your (new) stomach to directly to the lower intestines so you don't absorb all the calories or digest the food as you normally would.

No, I'm not PA, it was thought I was B12 deficient after a blood test so was on a course of B12 injections.

I've not checked for bariatrics on HU, I'm sure there will be. I only started using it yesterday when I was told about the condition.

Finally, no, I am male :)

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