Been doing good, then...: I had some... - Atrial Fibrillati...

Atrial Fibrillation Support

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Been doing good, then...

DesertDeuces profile image
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I had some weird experiences this week. First, Monday my nurse made a home visit and I felt I was doing so well that I could reduce the visits from twice to once a week. Next day, I saw the cardiologist after not having seen him for three months. He didn't like how rapidly my heart was beating and doubled my cardizem dosage, plus put me on digoxin. The meds weren't ready until Thursday night, but Thursday morning I went to work - I work only part time - and suddenly my heart started to painfully beat very fast. I went home and called my nurse. It's just too weird.

It kind of makes me wonder if the nurse is monitoring my afib properly. Question I have is: she takes a 30 second pulse, multiplies by 2 and says that's my true heart rate, rather than using the pulse oximeter. Doctor never checks my pulse that way. Can a 'true' heart rate be gotten by doing a pulse that way?

It just makes me wonder what the doctor found. Of course, he did have a new ekg to go by.

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CDreamer profile image
CDreamer

Hi - firstly if your AF is Paroxysmal then it could be you weren’t in AF when the nurse visited - you said you were doing and feeling well?

Secondly - Taking your pulse at your wrist is a very accurate way of taking your pulse, especially if you are experienced and probably if you were in AF, much more accurate than a BP monitor or Pulse Oximeter.

I think your cardiologist will have a lot more accurate information from the ECG than just a heart rate check.

I do hope your cardiologist explained clearly why he was changing your medication.

Best wishes CD

DesertDeuces profile image
DesertDeuces in reply to CDreamer

Hi CD, thank you for the reply. Doctor didn't go into too much of an explanation and I was so surprised by his finding that my heart was so fast that I was kind of dumbstruck. I used to work in hospitals and took pulses (old-time nurses aide), so I agree with you and Hoski about the accuracy of wrist pulse, and with Hoski about the 60 second pulse. However, since I have afib, I just question a 30-second pulse accuracy. And, I was just wondering how relevant it is with regard to afib.

I got a 170 pulse the day I had problems, and she got 88. Doesn't make sense to me in a situation where I'm having an 'episode'. I personally would prefer a 60 second pulse at least, in this case.

As it turned out, I had adverse reactions to Digoxin and decided not to call her about it. I just stopped the Digoxin until I call the cardiologist on Monday. In the meantime, I am taking double the cardizem, per doctor's orders, so I would like to see how effective that will be this weekend. So far, so good, I think. For the first time I can lay down in bed and not have fluttering heartbeats! Small but meaningful success, IMHO, I hope.

Here in the US it is common for nurses to take a 15 sec or 30 sec pulse. Being the “ old nurse in the group”, I always listened to the heart beat with my stethescope for a full minute because if the patient is having arrhythmia such as a fib, the weaker heart contractions dont always produce a detectible pulse to feel. The machinery like pulse ox, bp cuff dont always pick up the weaker beats in a fib. Having said that, most Dr offices here dont hire licensed nurses to do vital signs, usually its an aide who has minimal medical knowledge. Its the doctors job( especially cardiologist) to listen to the heart. He/ she is listening for murmurs, clicks etc that tells them how the valves are working and so on. I would have chronic a fib patients who were in and out of a fib all the time and they didnt know it. Sometimes their hearts were perfectly regular and often their hearts sounded like they were break dancing. Cool thing was the patient was unaware. I hope if my a fib ever returns and goes rogue, Im the type that is unaware and unaffected. 💜. Sorry this is soooo long

DesertDeuces profile image
DesertDeuces in reply to

Hi Hoski, I didn't think your post was too long! Thank you for the reply! By the way, I addressed a reply to you in the post above. (USA, too!)

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