BRAINS - is this treatment for me? - Atrial Fibrillati...

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BRAINS - is this treatment for me?

beardy_chris profile image
25 Replies

Lots of people ask about treatments here - which is probably not the best place to ask because most of us are not medics. I came across a useful acronym in a group on Facebook: BRAINS.

First ask if it’s a medical emergency. If no, then BRAINS:

B - what are the Benefits of this treatment? Why is it suggested and necessary?

R - what are the Risks of this treatment? Now and long term (if applicable).

A - what are the Alternatives? (And as it’s not an emergency I have time to wait for you to look into it).

I - intuition. Listen to your gut.

N - What happens if we do Nothing?

S - smile. This one is an optional extra, but the idea is to remember to enter a discussion and not a confrontation, because that’s not usually helpful in achieving the aim.

The doctors have spend a long time training, sacrifice family and social life for their vocation (or profession). They are not wanting to cause trauma, or even “just” bad experiences, but there can be a mismatch between what they want to do and the actual outcome and experience for the patient. The usefulness of BRAINS is that it’s appealing to the medic’s intellect. It’s not telling them they’ve wasted their lives and know nothing. That doesn’t elicit a great response from anybody.

(with apologies to Anna Hagenaar from whom I pinched it and edited it slightly! She attributes it to midwives and doulas)

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beardy_chris profile image
beardy_chris
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25 Replies
10gingercats profile image
10gingercats

This is very interesting and practical information. so thank you. Most people here do say they are not medics when responding to others with problems.Even our vulunteers are cautious. Some people are desparate and alone and most people on this site do whatever we can to try and ressure them .Mostly it what I think we are here for?

dani777 profile image
dani777 in reply to 10gingercats

Sometimes I think people would feel more reassured from someone who is suffering the same thing, rather than a doctor. I recently asked my own GP if he suffered palpitations and he said "thankfully, no." It's like anything. If you know that person doesn't have first hand experience with palps, even if they are a doc, you're still probably going to want to hear from people who have been there. Hence forums like these x

Buffafly profile image
Buffafly

Brilliant! Since reading another article about how to get the best from your GP appointment I have found I feel much more satisfied with my consultations, although even more annoyed if I have prepared well and the doctor isn't really listening. When I had a consultation with a specialist physiotherapist he asked what I hoped to get out of my appointment. Luckily I had prepared that (had to jump through so many hoops to see him I didn't want to waste the opportunity) and I got just what I wanted, though being realistic helped.

Thank you.

beardy_chris profile image
beardy_chris in reply to Buffafly

Jumping through hoops can be really good physiotherapy! :)

Buffafly profile image
Buffafly in reply to beardy_chris

😂😂😂

BobD profile image
BobDVolunteer

Love this Chris. So true.

wilsond profile image
wilsond

I like that thanks!!

Suzy1954 profile image
Suzy1954

Very helpful thanks. I’ve taken a screenshot and will take it with me when I go to my next medication review 👍

Buffafly profile image
Buffafly

Re the smile - my friend was delighted she got the 'pleasant lady' comment on her letter. We are convinced this is a code of some sort - she thinks you may get quicker treatment if you come in the 'pleasant' category, I wonder if it's the standard opening assuming you didn't take the doctor by the throat and snarl?

heartmatters1 profile image
heartmatters1 in reply to Buffafly

🤣

JaneFinn profile image
JaneFinn in reply to Buffafly

That made me laugh!

I never thought of code - but I’ve always seen it as a badge of honour to get ‘pleasant lady’ on my letters! Once I got ‘delightful lady’ and it made my week 😁

Recently I had a difficult appt with a neurologist, and his letter simply referred to me as ‘this lady’.

I’m pretty sure he privately added the adjectives ‘bloody annoying’! 😂

10gingercats profile image
10gingercats in reply to JaneFinn

Yes! I once had in a letter from a consultant "this well informed person".Probably also a 'beware' to the next consultant who got too 'bossy'!

Auriculaire profile image
Auriculaire in reply to 10gingercats

Before moving to France my GP gave me my dossier to read - stupidly you are not allowed to take it with you;it just moves to some records storage place and then gets destroyed after 10 years. A letter from an ENT consultant to my previous GP described me as "this bizarre young woman" . I assume this was because when he had proposed cutting a bit out of my nose to fix my recurrent sinusitis ( which had started after moving to Brum and was possibly caused by air pollution) I had declined and said I would see how the sessions of acupuncture that I had just started went before going for the op. The acupuncture was very unpleasant for this as the needles go in your face but it worked. When I told the GP I would not be having the op she said she had had the same op and six months later her sinusitis had returned! It is now 30 years since my acupuncture treament and mine has not returned (though to be fair for the last 18 I have been breathing relatively unpolluted air). I decided to change GP.

sotolol profile image
sotolol in reply to JaneFinn

Years ago I got a tall thin lady.

Not any more I’m still tall and thin now I’m old not a good look. I wonder if they ever put short and fat...

Stinky1953 profile image
Stinky1953 in reply to Buffafly

I too was wondering about the "pleasant lady/pleasant gentlemen" comment and thought it might be a code. My wife being a bit of a cynic thought it was perhaps a warning to others meaning "beware - this one asks too many questions".

Buffafly profile image
Buffafly in reply to Stinky1953

More the other way maybe, a compliant patient? On the other hand the secretary may have a set letter and just fills in the dictation afterwards which is a slightly disappointing thought.

JaneFinn profile image
JaneFinn

Thank you, Chris, this is really helpful :)

100h profile image
100h

My letter from my cardiologist to mu EP said complex lady 🤣🤣

SingingT profile image
SingingT

Nice one! It brings together all the loose ends I have when trying to make sense of my treatment for PAF. Thank you Chris.

dani777 profile image
dani777

We need a pic of Brains from Thunderbirds

Buffafly profile image
Buffafly in reply to dani777

😀

Stinky1953 profile image
Stinky1953

Thank you Chris. Very useful and I will use it every time I see someone from now on.

My next appointment is to see someone about possible pulmonary hypertension. Would love to hear from anyone who has any experience of this. It was picked up not by cardiology but by my oncologist on a routine scan.

Not sure if anyone remembers but I was diagnosed last summer with pancreatic cancer. I am now 4 months post chemo and so far all is good. But I had to stop my chemo early as the treatment was setting off my AF and I had three cardioversions.

While I'm here I'd just like to say a big thank you to all for the wise words and advice on this forum, in particular people like Bob. Most of what I know about my AF I've learnt here and it still amazes me why new patients are not immediately put in touch with this site when first diagnosed. It would have saved me years of worry had I known about it sooner. Thank you all.

Rosemaryb1349 profile image
Rosemaryb1349

Loving the "BRAINS" thing. Will keep a copy in my phone. After a visit to my cardiologist very early on in my Afib journey , armed with suitable questions, all gleaned from this wonderful forum, I saw his letter of referral to an EP. I was described as "this very pleasant, switched-on lady" !!! Possibly code for "caution, don't mess with her" 🤣🤣🤣

cycleman73 profile image
cycleman73

Excellent, thank you !!

If you are having heart skips, you might want to try this:

-------------------------------------

After 9 years of trying different foods and logging EVERYTHING I ate, I found sugar (and to a lesser degree, salt – i.e. dehydration) was triggering my Afib. Doctors don't want to hear this - there is no money in telling patients to eat less sugar. Each person has a different sugar threshold - and it changes as you get older, so you need to count every gram of sugar you eat every day (including natural sugars in fruits, etc.). My tolerance level was 190 grams of sugar per day 8 years ago, 85 grams a year and a half ago, and 60 grams today, so AFIB episodes are more frequent and last longer. If you keep your intake of sugar below your threshold level your AFIB will not happen again (easier said than done of course). It's not the food - it's the sugar (or salt - see below) IN the food that's causing your problems. Try it and you will see - should only take you 1 or 2 months of trial-and-error to find your threshold level. And for the record - ALL sugars are treated the same (honey, refined, agave, natural sugars in fruits, etc.). I successfully triggered AFIB by eating a bunch of plums and peaches one day just to test it out. In addition, I have noticed that moderate exercise (7-mile bike ride or 5-mile hike in the park) often puts my Afib heart back in to normal rhythm a couple hours later. Don’t know why – perhaps you burn off the excess sugars in your blood/muscles or sweat out excess salt??

Also, in addition to sugar, if you are dehydrated - this will trigger AFIB as well. It seems (but I have no proof of this) that a little uptick of salt in your blood is being treated the same as an uptick of sugar - both cause AFIB episodes. (I’m not a doctor – it may be the sugar in your muscles/organs and not in your blood, don’t know). In any case you have to keep hydrated, and not eat too much salt. The root problem is that our bodies are not processing sugar/salt properly and no doctor knows why, but the AFIB seems to be a symptom of this and not the primary problem, but medicine is not advanced enough to know the core reason that causes AFIB at this time. You can have a healthy heart and still have Afib – something inside us is triggering it when we eat too much sugar or get (even a little) dehydrated. Find out the core reason for this and you will be a millionaire and make the cover of Time Magazine! Good luck! - Rick Hyer

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