Delayed stress response: I was just struck... - AF Association

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Delayed stress response

Eatsalottie
Eatsalottie

I was just struck when reading CDreamer's post that so many of us find stress to be the biggest trigger. I was wondering if anyone else has what I have: this weird thing where after something stressful, almost exactly a week later I will go into AF during the night. I have no idea why that should be...

Sometimes I go into AF almost immediately, if the stress is big enough - like in March this year when we had to have our beloved old dog put to sleep. That night I went straight into AF. But normally it has this odd pattern - I had AF the night before last, and a week ago I had to go to the dentist for a filling, so I was worrying both about the filling and getting there as it's quite a long drive for me.

Plus afterwards, not so usually, this last time I was left feeling quite sick. I was just wondering if anyone else got these strange things happening?

61 Replies
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BobD
BobDVolunteer

This is quite interesting in that I always found the biggest problem happened AFTER the stress. I used to hate holidays as by day four I would be knocked down by bad headaches, feel jittery and generally unwell. I put this down to going cold turkey on adrenaline . It is a very individual thing but we all need some stress to keep us interested in life and functioning normally. You know the old saying. " If you want something done give it to a busy person." The problem is when it becomes distress.

Eatsalottie
Eatsalottie
in reply to BobD

Thanks Bob, that would make perfect sense - you get the adrenalin boost to help you through the actual stressful situation, but then at some point that wears off and you get hit by the real stress reaction. And yes, I know exactly what you mean about stress and distress. If I juggled any more things to do I would definitely drop one!

Yes, I read somewhere the danger time for AF is 3 days after the stressful event.

My take on this is it is you parasympathetic system needs calming back to normal which I suggest could take a couple of years at least of changed lifestyle - because of prolonged stressful lives many of us lead, the system does not adjust back to normal properly any more i.e. the result is it is still trying to calm us down long after it should ( the stressful peak) resulting in the main heart beat being unnecessarily subdued and letting the AF 'little drummers' out of the bag.

I probably haven't explained this too well (party last night and only 4 hours sleep!) but following my own hunch I have taken the last 4 years reducing stress on all fronts in the hope that my parasympathetic system will rebalance itself naturally and reduce AF susceptibility.

Oh, how interesting! I am definitely going to try to reduce my stress, then...

Hidden
Hidden
in reply to BobD

Yes distress is the right word, we need to de- stress

I suspect (but don’t know) that it’s all part of a heightening of blood pressure and general angst when things you cannot control go wrong. It puts an enormous amount of pressure on the heart forming part of a viscous circle potentially resulting in an attack of Afib. It has happened to me in the past and what I try to do is ask myself if this is something I’m still likely to be worried about in a months time. If it is, then I got no chance, but fortunately more often, it isn’t......🤞

CDreamer
CDreamer
in reply to FlapJack

I can see that but my usual response is a rapid decrease in BP. We all react slightly differently.

I am sure it's something properly physical, a response of some kind... Interesting that you get a decrease in BP, CDreamer! Weird how our bodies react to stuff, isn't it?

I so agree.....

I think Bob is right - I used to say that stress is useful until it becomes distress. Withdrawal from a passion is a bit like addiction withdrawal.

Although my heart had been bumpy all day, the AF started about 10 minutes after a talk with my sister - I was on the listening to her stress end. One of the reasons I had to give up work - I think I also react to other people’s stress - my body rather than my mind.

I do wishes I could be a worrier or an outwardly emotional person but I am always the calm one and people often see me as that. I can also relate to the sick feelings but I get that more when the Mg flares.

I'm sure you and Bob are absolutely right - stress can be good right up to the point where it tips over into distress. And yes, sometimes other people's stress is actually harder to deal with than your own! Both of our daughters are going through hugely stressful situations and I'm sure that doesn't help. And yes, I'm the outwardly calm one of the family too - I think someone has to! I didn't know about Mg flares, tell me more...

I was diagnosed with something called Myasthenia gravis - which literally means extreme muscle weakness. It is pretty well controlled now but the first 2 years were pretty awful. A flare is when the immune system flares in a response to inflammation which is the body’s natural response to infection, invasion etc.

For me, and other Myasthenics, when that happens, our immune system goes into overdrive and produces antibodies which eat up and destroy the neurotransmitter AChr - Acetycholine, which transmits the signal between the nerve ending and the muscle - which means the muscles just don’t work. It’s a very odd sensation. It affects my eyes, face, bulbar muscles ie swallowing/breathing, neck and arms mostly. AF can trigger a flare but the main antagonists are stress & emotional responses, extremes of temperature - my range seems to be 0C-24-5C, infections - which are difficult to manage anyway because I need to take heavy duty immune suppressants to keep the antibody response under control so I am much more prone.

Add all that lot to AF and it gets complicated because so many drugs are contraindicated for Mg - sedatives, anaesthesia drug’s, most things which begin with ‘anti’ - anti histamines, anti- malaria etc, beta-blockers, rythm drugs, quinine (sadly no more gin and tonics), Magnesium supplements, some anti-biotics and one in particular which is known to kill.

Severity of symptoms are incredibly variable from person to person but also from moment to moment, one day you look and are perfectly normal, the next moment you fall down, can’t open your eyes, can’t chew, can’t swallow and in a myasthenic crisis - cant breath so need intubation. This means I can’t have sedation for the Pace & Ablate and need an Anaethetist & Neurologist on call during the procedures - so not exactly looking forward to that!

It’s a fairly rare disease but not one to mess around with or be uninformed about. Unfortunately most hospitals, A&E, paramedics and GPs have never seen someone with a Myasthenia (there are 4 types) and are ignorant of what to do - eg: if I struggle with breathing they will measure my sats and say ‘oh they are fine, so you are ok’. But what happens with Myasthenia is that because our muscles go very weak we can’t breath out properly - so CO2 builds up in our system to dangerous levels. Most medics and info on the website will say that it is manageable and most people ‘live a normal life’ - well not everyone with AF will live a ‘normal’ life will they so I think you can imagine what most Myasthenics say about that! Most are unable to hold down a job - because of the variability. I could go on - but I’ve probably bored you enough!

I’ve been fairly stable now for about 12 months - last Blue Light ride was last August so just hoping that the pace-maker will improve my QOL as there is some evidence that heart muscle can be affected by Mg.

Thanks for asking and hope you haven’t now lost the will to live but just writing all that has helped. xx

Oh my goodness, I am so shocked - what a terrible disease! It puts my AF in perspective, that's for sure (and apologies to those who suffer greatly, of course). I can't even imagine - this sounds like the most dreadful, debilitating thing to have! I'm so glad you've been stable for a year now, though I guess if there's one thing AF has taught me it's not to say 'oh, good, well that's over then...'

I had heard the term, but I had no idea it was anything like this. I'm stunned. I think you're amazing to be able to deal with it so matter-of-factly, I'd be climbing the walls I think! I sincerely hope your future life is blessed with medics who understand the gravity of the condition and know how to deal with it! And very best of luck for the pace and ablate xx.

Lis

Thanks Lis x

Hidden
Hidden
in reply to CDreamer

Good luck and wishing you an easy recovery with your 'pace and ablate'. I had one in 2016 and am doing well. I named my pacemaker Seymour. Take care xx irina

I can't add anything to your comment so going with 💜💜💜

Aprilbday
Aprilbday
in reply to CDreamer

🤞pace maker

Hidden
Hidden
in reply to CDreamer

Im the same way . All the years I worked in oncology took a toll. I was a " great" nurse but wasnt aware that I might have been taking everyones pain in too deep. Being retired has been liberating in many ways

Hidden
Hidden
in reply to Hidden

For me, too. After I retired (40 years as a nurse). someone asked in my senior community would I like to volunteer using my nursing skills. I felt guilty for a while saying No, but now it's time to care for myself. Many of us (nurses and other caregivers) are notoriously bad at taking care of ourselves. Don't remember the author but years ago tripped over a book "I'm dying to take care of you." The literal title was on target and helped me gain some insight about small daily ways we ignore our needs at work.

Hidden
Hidden
in reply to Hidden

I will look for that book. I worked 44 yr full time, loved nursing and people but I was in too deep, looking back. Now, almost a year in to retirement, friends are trying to push me in to volunteering and I happily say no. Im totally enjoying being lazy, spending time with my hubby, grandkids and our collection of dogs and horses. This last christmas was so freeing, first holiday season since I was 18, that I could do what I wanted, was not on call, etc. Other than missing the $$, Im not missing nursing, which really suprises me.

Hidden
Hidden
in reply to Hidden

In my senior building there are about 10-15 retired nurses. Some of us have had conversations about boundary setting. It's hard when people stop you in the elevator on your way to get your mail to show you their rash. I've let other residents know-esp on my floor- that if they have a true emergency please come and knock on my door otherwise, pull your cord that rings in the office. When I first moved in I soon learned the things people stop to tell you about are not true emergencies: (their bathroom habits, their stomachache because they just ate too much pizza at 10PM-I'm sure you've been here too.) There are some residents with really severe medical issues and they seem to be the ones that hardly ever complain.) Oncology has to have been especially draining. One of the biggest challenges I would think would be all the mental energy you absorb from the family dynamics swirling around when a patient is dying. I think it must be very hard for families to understand one of the best gifts they can give a dying relative is to let them die in peace.

Hidden
Hidden
in reply to Hidden

If I ever do volunteer, I would do hospice as even when I was young, I was drawn toward end of life matters. I always thpught there isnt alot of difference between birth and death. We are entering and leaving different places, sometimes easy, sometimes hard transitions💜

Hidden
Hidden
in reply to Hidden

This is a subject that interests me very much as I have definite ideas about end-of-life care I do and do not want. A few months ago I ordered a book after seeing the author's video on Public Television during a fundraising weeK. You might enjoy checking it out online. The title is "I'll Have It My Way" by Hattie Bryant. She offers a lot of up-to- date info about clearly defining legally what you consider your quality of life and taking control of your last days. It is not about euthanasia or assisted death but clarifies how your last wishes must be legally claified to avoid having hospitals doing more and taking more control because without knowing your wishes in detail their hands are tied. I was interested to learn of new terminology such as 'AND' (Allow Natural Death,) and 'DNH' (Do not hospitalize). The old 'DNR' (do not resuscitate) that we grew up with seems too vague and meaningless in todays high tech medical world. It a fairly easy read and I found it very helpful. I really do not want to languish away in some of the nursing home environments (US) it has NOT been my privilege to witness.

CDreamer
CDreamer
in reply to Hidden

Dear Irina & Hoski - I helped lead a group from our local U3A into end of life study group. One of the books we loved was Atul Gwande - Being Mortal - Medicine and What matters in the End.

He is an American of Indian origin and still has family in India so has a foot in 2 cultures regarding medicine and family. He lectures world wide and is a very influential figure in surgery and end of life care.

As a result - we managed to get one of our leading Consultants in End of Life care for the Elderly to visit and talk to us and what resulted was a significant change in policy locally. We also got to talk to medical students who were studying this subject,

What he says is inspirational and certainly if you have an interest in this area - a must read!

He is very highly respected US surgeon and wrote a protocol which revolutionized surgery protocols which improved outcomes.

Hidden
Hidden
in reply to CDreamer

Thank you, CD. Will look it up this morning. I want to have all the info available to help me complete my final wishes document. I've seen too many patients and families stick their heads in the sand when the 'D' word is mentioned (dying). I believe part of the process needs to be experiencing (by our own definition) a good death. Whatever that involves for each of us.) I was able to have my mother at home to die and I will always feel good about this. She was old and this was in the 1970's when it was a real battle to keep her out of the hospital. She didn't like hospitals and wanted to be at home. It wasn't easy fighting the established standards of care at that time but I did and she had a very peaceful death in her own bed. This doctor's cultural background is probably more helpful to Americans as , in my opinion, many other cultures offer dying patients much more comfortable 'last days' than we do. Take care. irina

Hidden
Hidden
in reply to CDreamer

P,S. I just pulled up his website <atulgawande.com> and will definitely get this book. On his website are three twitter quotes-one from June 30 about our horrendous recent immigration (US) decisions. He seems to not only be very qualified medically but also has his spiritual and philosophical ducks in a row. I am interested in reading more of his works. Anyone interested I would say google his website. It is much different than the book I recommended as his involves moral and spiritual insights. My book is more of a how to about getting our wishes into an airtight legal document so the healthcare system has to honor them. Also important in our litigious society. irina

Hidden
Hidden
in reply to Hidden

CDreamer Hi CD. Just went back to Dr Gawande's website and read a little about some of his other books. Two caught my eye. 1) What doctors feel. I realized that what I need for myself when choosing a doctor is that their feelings about medical care and life in general mesh as well as possible with mine. They may have all the knowledge I need but if their philosophy is too much at odds with my own our professional relationship will not work and I should move on. And 2) The Mindful Way through Depression. I am having some difficulty right now with depression. It's solvable and I have thought about (and scheduled an appt) to talk to a psychiatrist to hear myself think and work through how I should handle some issues. But I am also afraid they are going to push meds on me. I've done this in the past and do not want to travel the psych medcation path again. Dr Gawande

s book title makes me think he uses Eastern philosophy to help western depression and I am interested in seeing what this approach is about. I know often medication is helpful and necessary for mental issues but I think it is greatly overused here in the US and is too often the first choice for treatment. I want to try less invasive things first.

CDreamer
CDreamer
in reply to Hidden

He writes from the heart and his books always move me. I first became aware of his work about 4 years ago as he was the guest speaker for a series of lectures that the BBC broadcast every year. They choose people who they believe are world leaders in their field - called the series is called ?The Reith Lectures. I don’t know if you are able to access them Outside of the UK - they are on BBC iPlayer but they are always amazing.

I am pretty sure I have seen him also talk on the Ted Talks - YouTube.

Best wishes CD.

Hidden
Hidden
in reply to CDreamer

I found many of his talks an d interviews on youtube yesterday afternoon and spent about 3 hours watching them. He's the only person I have heard who 'gets" why seniors don't like senior living,assisted living, and nursing homes in the US. As my past posts have said I really dislike senior living and I am figuring out how to afford a more positive move before too long. His quote sums up everything I dislike about them. They are all about safety at the expense of enjoying the time we have left as defined by ourselves-not family, not society. His quote which was repeated by him in several videos is "SAFETY IS WHAT WE WANT FOR OUR LOVED ONES. AUTONOMY IS WHAT WE WANT FOR OURSELVES." This one statement made my goals crystal clear and is helping me plan what I want - not what family and friends think I should have. I ordered 3 books: Being Mortal. What Doctors Feel. and The Mindful Way Through Depression. Thanks again for bringing Dr Gawande to my attention. irina

Hidden
Hidden
in reply to Hidden

You know I don't miss it either. I still like to help people but I am VERY glad not to have to deal with our current healthcare system (US) with all its foibles which often contribute nothing to good patient care. Nursing was very different when we started! Our job was to provide good care not worry that we were changing sheets too often and running up the laundry bill!

Hidden
Hidden
in reply to Hidden

Yes, and people got real baths, back rubs, etc

Hidden
Hidden
in reply to Hidden

Yes, they did, AND without rubber gloves because, God forbid, we might catch something giving a back rub.

Hidden
Hidden
in reply to Hidden

I know I have the title correct. Can probably pull up on amazon.

Eatsalottie
Eatsalottie
in reply to Hidden

Sounds interesting to me too! Nurses in particular need to look after themselves, I know. One of our daughters was training as a nurse and I know it's a tough, totally immersing job. Huge kudos to all who take it on. A very well-deserved retirement, Hoski!

Hidden
Hidden
in reply to Eatsalottie

Thankyou! Im now trying to practice what I used to preach🤣

Hidden
Hidden
in reply to Eatsalottie

Thank you. 😊

Aprilbday
Aprilbday
in reply to CDreamer

CDreamer-I bet you limit your exposure to the News. Frightening things in it every single day it seems. News these days probably affect everyone’s “hearts”.

CDreamer
CDreamer
in reply to Aprilbday

My rule is - no news on whilst eating - we need rest and digest mode for nutritional absorption - likewise just before bed, I don’t read newspapers or magazines - with the exception of Time magazine. So yes, I do limit my exposure.

Otherwise I do follow the news online or radio or TV but I try not to get immersed in it - as many people seem to. I have a lot of friends who get very hot under the collar about politics and one who was making herself ill - she wanted to take up art but thought she would the have the time to go on marches and do art so she asked me which she should choose - after listening to my advice and choosing art - she is now happier and healthier.

Art has to be better than politics for sure. I do feel I let myself get too upset by events I can do absolutely nothing about. Perhaps my stress levels are higher than I think!

My step-granddaughter is on the organising team for this event - today at the National

theartnewspaper.com/blog/an...

Now that sort of politics I can cope with!

Hidden
Hidden
in reply to CDreamer

Great article about the brick wall! Thanks.😊

Hidden
Hidden
in reply to Eatsalottie

There is an american doctor who began to write books about eating and living healthy in the 80's. Very ahead of his time. I have read his books and tried to follow some of his advice for years. He is very much into holistic medicine and has a lot of credibility as he was a Harvard-trained mainstream physician. Worth googling if interested. His name is Andrew Weil, MD and the one thing I learned from him probably 20 years ago was this. Don't watch the news before going to bed. In fact, take the television out of your bedroom. I did this and it has been one of the best things I have done. Have not had a tv in my bedroom since the 90's. At the time the O.J. Simpson murder trial was all over the television ad nauseum and everyday at work that was all people talked about. I was sick of the whole story anyway and was reading one of Dr. Weil's paperbacks someone left in the nurses lounge. I am no longer a news junkie. I figure if something is important enough someone will tell me about it. I read the abbreviated news on my phone each morning for a quick view and that's it. I've gone back to newspapers because I can pick and choose and don't have to watch and listen to a lot of talking heads arguing with each other and telling me what to think.

Hmm, interesting. I know stress can take me into AF right away. As when I was in my scruffs painting the bottom part of a wall when my brother and his wife rang to say. We're in the area and coming to see you. My, did my heart hammer!! The house was a mess and I had no make up on, but all was presentable in 45 minutes when they arrived and my heart eventually calmed. Same when going to my daughters wedding, where my ex would be with his new wife. Grrrr, I dislike them both so much - It's a long story.

Would be a good idea for everyone to check and see if their AF follows a pattern like yours.

Jean

Oh goodness, well yes, I'm not surprised your heart did the tango with all of that! I've had AF brought on by exactly the same thing (not an ex, but someone coming and having to clear up in a hurry!).

I'd also be really interested if people were to keep track not just of what's happened immediately before the AF but up to a week before as well, just to see if it happens a lot.

Lis

Cricky I just got anxiety colouring my hair lol No AF though Been a while since I did it xMy work involves so much stress every day I think eventually it catches up with us all My middle girl has schysophrenia also so my life seems full of stress Emergany situations I can deal with calmely until after then the heart pounds

Yes, I think some of us are great copers, we are calm for the sake of others while things are actually going on and then it all catches up afterwards. With you re the hair lol.

Ohh my hair lol Well I seem to be breathing normal lol

Hidden
Hidden
in reply to Eatsalottie

Like when our brains keep going like hamster wheels. I call this having a party in my head.

Eatsalottie
Eatsalottie
in reply to Hidden

Yeah except not enough wine lol

Hidden
Hidden
in reply to Eatsalottie

🐱

Hidden
Hidden
in reply to Eatsalottie

You know, I just realized something that affects me still. Of course, when we're working or in other tense, chaotic situations, at times we have to project a calm image. And I could do that-look calm and in control on the outside. But the more I looked capable externally, many times the more turmoil I was feeling inside.

CDreamer
CDreamer
in reply to Hidden

That so resonates with me......

Eatsalottie
Eatsalottie
in reply to Hidden

And with me!

I noticed I often have an episode after stretching over head for some time, usually the next day but once it was straight after looking through the high White Stuff sale rail! My first diagnosed episode was when my husband was waiting for a very serious operation that needed to be done ASAP. I was also recovering from a respiratory virus and had been putting up a display in school so triple whammy really.

Oh yes, my first episode was also after a combination of things - I guess that first one needs to be tripped by something fairly major but after that, well, as you say, looking at the sale rails can do it! I wonder if stretching overhead is somehow upsetting the vagus nerve? Weird stuff, AF, really!

Hidden
Hidden

A few weeks ago we were nearly in a bad car wreck, scariest event in my life! I was afraid it would trigger a fib but didnt. My last a fib event( 2 in 1 wk) was march when my hubby was going thru chest pain, heart tests( came out ok) but I believe my worry about him triggered the ticker to dance around.

Now hubby is waiting on a biopsy report and Im being more proactive with prayer, meditation, exercise to try and convince my heart Im not stressing. Will get results next week.

Eatsalottie
Eatsalottie
in reply to Hidden

Now that is interesting, because I've thought that before, there have been times when something shocking has happened and I haven't gone into AF and been really surprised. And yet something like worry about a loved one can do it. I think it just goes to show how hard it is to understand what really does cause us the sort of stress that triggers AF. Best of luck to your husband with the results, I shall keep my fingers tightly crossed!

Hidden
Hidden
in reply to Eatsalottie

Thankyou so much💜

I was hospitalised with my first case of Atrial Flutter a week after our 17 year old dog died. That was tough on the whole family, especially one daughter who has autism. I have always been the ‘rock’ who supports everyone. My DC cardioversion lasted 10 weeks when I read a distressing email and I went straight into AFib and was hospitalised again. Looks like I might need a stress free life.

Eatsalottie
Eatsalottie
in reply to Kaz747

I think so many of us have to be rocks for others around us, and often forget to be there for ourselves... It's so tough losing a well-loved pet! I went straight into AF after a nasty phone call once, so there is definitely a 'short, sharp' stress response that can do it. I would love a stress free life too, maybe we can all buy an island somewhere lol.

Kaz747
Kaz747
in reply to Eatsalottie

Sounds like a plan ... as soon as we win the lottery 😉

Hidden
Hidden

Stress is my biggest trigger for so many facets of my life and also the hardest to get a handle on. I could write a book about all the 'what ifs?' I find to worry about.

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