Feeling grim after hospital stay for AF episode - advice please!

[CentreHalfMum]

Had particularly tenacious episode of AF which failed to respond to my usual Flecainide PIP. This led to hospital over the weekend. After a somewhat lengthy process I eventually returned to sinus rhythm with the help of more flecainide, more Bisoprolol and a new one for me, IV magnesium.

I was discharged last night and have appointment on 24 July for CT/angiogram as there were some new changes in my ECGs. Blood test in hospital showed thankfully no damage as far as can be judged.

Lovely to be home , but I’m feeling like I’ve been hit by a the worlds most enormous truck. Just exhausted , with a strange ‘can’t quite expand my chest properly’ feeling, almost like I cannot take a full deep breath. This isn’t painful, just a bit weird and uncomfortable. I remember having the same sensation for a week or so after 2 previous electrical cardioversions, but didn’t expect to feel it after a ‘chemical’ conversion. I have stayed in bed all day and cannot remember having to do that for years!

Is it normal to feel so wiped out after a particularly bad AF episode? Could it also be the drugs cocktail and the total lack of sleep in hospital? Because I am due to have further tests I’m panicking a bit thinking something very dreadful is wrong with my heart! Before this episode I was feeling great, walking for 2 hours every day, gardening, happy and active. Any advice would be most welcome. Have had to postpone looking after one of my beautiful granddaughters overnight this week too so feeling ‘proper miserable’!

[CDreamer]

Hi and good news is you are back to NSR!

Yes it is pretty normal to feel like that after AF episode, least was for me.

If you had to have Mag IV then I would look at your electrolytes maintenance. Do you take a supplement? It could well be that was the root cause. Keeping well hydrated and eating well to ensure you take in enough minerals is really important, especially in warmer weather.

It often took me 2-3 days to recover after a tenacious episode so listen to your body & get plenty of rest now.

Chemicals affect your body big time so no matter if electrical or chemical you cardioversion takes time to recover from.

Best wishes

[CentreHalfMum in reply to CDreamer]

Thank you for your kind reply CDreamer. It was an incredibly hot day on Friday and I may have become a bit dehydrated. Blood tests in hospital indicated that could be a possibility. However, once an AF episode starts, I wee gallons, every 5 minutes until back in NSR so that can add to any possible dehydration too. I eat a very good diet as we have bowel cancer in the family so have always been extra careful about it. I was reading about magnesium supplements on this site today. The Consultant in A&E described it as a ‘Miracle substance’ as he uses it for all sorts of conditions. However, when I asked him and the cardiology Consultant if it was worth taking a magnesium supplement they both said a firm no. I don’t quite get that as clearly people on this forum have been advised to take it. 🤷‍♀️

[CDreamer in reply to CentreHalfMum]

The trouble is that most doctors have very little training in nutrition. Also depends upon their speciality, ask an anaesthetist and they will often say yes to Magnesium supplementation. Ask a doctor with dual training in nutrition they will say definitely yes, as long as you understand the contraindications of which one is magnesium may enhance the affect of BP meds.

I have a condition called Myasthenia gravies - which is about the only condition for which oral Magnesium is a definitive NO! So I use Magnesium Oil as a topical spray. Magnesium is of course only one of the electrolytes but the one most often deficient in our foods mainly because of intensive farming.

Knowing symptoms of low magnesium is also helpful but if your serum magnesium is low - you know you are in serious trouble. Magnesium IV will only be affective for 20 mins and is usually given to treat or prevent serious Arrythmia which could be life threatening.

The great thing about Magnesium taken orally is that if you take too much the worst that happens normally is that you will be stuck on the toilet for a day or so! If you haven’t already found York Cardiology - Dr Gupta videos head over to YouTube and have a look at his video on taking Magnesium - he posts regularly here and what he advocates usually makes perfect sense.

You pee a lot - called micturition - when in AF because when your heart is in distress it releases an enzyme called BNP which tells your kidneys to dump sodium (another electrolyte) resulting in both dehydration and another electrolyte imbalance. The first line treatment for AF’ers admitted to A&E is often a saline drip - which will often help you to convert to NSR.

This is the sort of information that many doctors, especially in emergency departments sometimes do not seem to know and experienced AF’ers have learned through experience - which is why the forum is SO useful as we learn from each other.

The one caveat is that we all react very differently so what works for one, doesn’t for another hence you need to experiment a little with what helps you and ensure you know your medical history and your own body and research your topic thoroughly for yourself.

Hope that helps - Best wishes

[CentreHalfMum in reply to CDreamer]

Thank you so much for your kind, informative and insightful replies. This forum is indeed such a comfort and I’ve learned so much from it since being diagnosed with AF in 2019.

I did get IV fluids in A&E and you are right about the magnesium, even with an IV dose, in terms of an immediate effect in the bowel department! I had one IV course and then another nurse came along thinking I hadn’t yet had it and tried to put up another course. I did quickly tell her that I’d already had it and wasn’t due another. Although the staff were kind, it was quite stressful having to be on top of things with regard to medications, care, tests etc, as frequently over the 3 days I was proffered repeat/wrong medications, that I’d either just had or weren’t intended for me. I had a chest x-ray returned to the ward, then one very firm nurse insisted I hadn’t yet had the x-ray and tried to send me for the same test again. Even on CCU there seemed to be very little communication and joined up thinking between staff. I trained as a nurse many years ago so understood what was happening, but it could have been a bit dangerous for a a patient with zero medical knowledge.

[CDreamer in reply to CentreHalfMum]

I have learned to do the same and check everything medical as I've had SO much dud info. As you say, it really worries me when people accept 'doctor knows best' and really don't understand the medications they have been given or what they are for. Very stressful though as you do expect a modicum of communication and compentency when you are ill in hospital!

[Vonnegut in reply to CDreamer]

I tried to “like” your contribution but it seems it can’t manage to count above 4 as it went down to 3 so I made it return to 4 but really it should be 5 or more!!

[CDreamer in reply to CentreHalfMum]

However, when I asked him and the cardiology Consultant if it was worth taking a magnesium supplement they both said a firm no.

Always ask why in future? Sometimes there is a good reason.

[CentreHalfMum in reply to CDreamer]

They both sighted a lack of evidence that it was helpful, but that is true of a number of supplements patients find helpful. Many with bladder issues swear by Cranberry tablets and D-Mannose for example. Think I will watch Dr Gupta’s video and probably give magnesium a go. I’m still feeling completely wiped out again this morning and achey, strange ‘stiff’ feeling in chest remains. Sometimes I feel very relaxed in ‘AF is not going to take over my life’ mode - usually when I haven’t had any episode for weeks/months! As soon as an adverse event occurs I feel rather despondent all over again.

[CDreamer in reply to CentreHalfMum]

I'm afraid the emotional roller coaster goes with the AF territory.....

[OzJames in reply to CentreHalfMum]

I was given high dose magnesium IV when I presented to hospital back in 2017 with AF plus Metopropol and converted to sinus by morning. End of last year I was cardioverted after an AF episode and a month later saw my Cardiologist and asked if it was ok to take magnesium supplements and VitD3 and he said no problem. So far so good this year with no episodes. I am also on very low dose of metoprolol I think about 8mg morning and night. Due for appointment early August. I also started taking a few months ago CoQ10 and will see if he’s ok with that too

[CentreHalfMum in reply to OzJames]

It sounds like you have had reasonably good follow up after your AF hospital admissions. I’m sure that makes a big difference as so many are just given the diagnosis and then left to fend for themselves with no follow up. Or they’re told ‘your GP will care for you’ ….hmmmm we all know that rarely happens these days

[OzJames in reply to CentreHalfMum]

yes and am lucky I paid for hospital cover via Bupa, it makes a difference so the follow up is initially at 1 month then 6 months then 1 year if all goes well. I can also send an email with questions in between appointments to the Admin assistant in his Cardiology clinic. I’m fortunate to be able to afford that extra premium for this cover.

[CentreHalfMum in reply to OzJames]

Well it sounds like money very well spent, given the current state of the NHS. I actually had to pay privately fairly recently to see a bladder consultant. Can’t help thinking if the NHS trained consultants who do so much private work, just used that time for NHS we might not be in such a state. However that’s a whole different discussion for another time! It’s great that you are having good care though.

[OzJames in reply to CentreHalfMum]

our Public system is similar to yours. Our son is a Doctor/Registrar in emergency at one of the major hospitals in Sydney. As it’s under the Public Healthcare system he only gets paid $62 an hour. Compared to Private doctors it’s ridiculously low so I guess that’s why they venture into Private work. Clearly government trying to save money!

[CDreamer]

A few links you may find helpful

ancient-minerals.com/magnes...

ancient-minerals.com/magnes...

For me the tell tale is cramping in my feet and legs at night with insomnia - I head straight for the Magnesium spray and stops within minutes and I sleep like a baby.

youtu.be/Ckdcr-cp9w8(Not working as expected?)

[Vonnegut in reply to CDreamer]

Thanks for that- about the magnesium spray - I experienced unexpected cold feet yesterday and do have some magnesium spray so will know what to do now should it ever happen again ( and I remember your advice!)

[Fullofheart]

Probably a mix of all the things you say CHM. Sounds like you need to listen to your body and rest up for a wee while. 🌸

[CentreHalfMum in reply to Fullofheart]

aah thank you for your advice. I will indeed rest up. Unfortunately just not very good at it but currently body is not giving me the choice ! The flower emoji has cheered me

[Ppiman]

I have a theory that arrhythmias can affect the left chest area itself extending beyond just the heart itself, including the diaphragm area, causing some discomfort and an odd a sensation of a need to breathe in more deeply now and then. This is my current experience and was especially so in the time after my ablation.

IV magnesium is not given because you had a deficiency, by the way. Given directly into the bloodstream, it has a rate lowering effect on the ventricles and some centres I gather use it with antiarrhythmic drugs where tachycardia is problematic. From what I have read, its action remains unclear, and its use is still debated. It is not, in any way, the same as oral magnesium which is absorbed only in a tiny amount and has no antiarrhythmic or other heart effects. That said, low doses of magnesium are safe and some here report helpful so may be worth a try.

Steve

[CentreHalfMum in reply to Ppiman]

Thank you Steve, that’s exactly it re funny feeling in diaphragm and a strange need to breath more deeply but feeling it’s not quite happening. Sorry I can’t quite describe the sensation accurately enough, but it’s a relief that others have found the same, though wouldn’t wish it on anyone. Psychologically I find that sensation hard to deal with, keep thinking it’s a sign of something grim. When looking back I seem to get low and teary after a ‘big’ AF event but eventually perk up once that weird chest/breathing sensation goes. However, every time it happens I panic and forget it has happened before and I will feel better.

[Ppiman in reply to CentreHalfMum]

It’s the same as I have, I feel sure now, from what you’ve written. I take tablets for acid reflux, too, so I sometimes feel that there might be a link.

Left-sided under-rib ”spasm” feelings are often a part of my heart troubles, with the “breathiness” you describe and sometimes left sided upper back discomfort too. This happens without AF, showing on my ECG monitor only as palpitations and a slightly fast heart (85-90 maybe). I get AF only very irregularly.

Steve

[secondtry]

You may want to get a Red Cell magnesium level test (nb this is different and evidently more accurate than the normal GP surgery test which almost always shows a normal level) as this would be a base point to work on and help identify any improvements from supplements.

You will likely have to do this through an Alternative Practitioner (my London Naturopath suggested this in my case), simple blood test and post off to a lab for results. Cost around £100.

[CentreHalfMum in reply to secondtry]

That’s very interesting, thank you for the suggestion

[Jetcat]

Sounds normal to me. Iv had Afib episodes that has also wiped me out for days.!! Get some rest and feet up time and keep hydrated. Hope you’re feeling better soon.👍

[CentreHalfMum in reply to Jetcat]

Thank you for your kind words Jetcat. It’s reassuring to hear from others that feeling so wiped out is normal

[Jetcat in reply to CentreHalfMum]

it’s not only physically draining it’s mentally draining as well.

[CentreHalfMum in reply to Jetcat]

You are SO right. Very aware there are far worse things to have and that I sound like a right old misery guts but I just feel awful. Just keep feeling full of doom and gloom, crying and in mourning for my old self. Must pull myself together and crack on, but difficult when you feel so physically awful that even a trip up and downstairs feels daunting. The AF episodes I have had since 2020 have all been fairly brief and resolved at home with staying calm and flecainide PIP. The flecainide ( which I only take as a PIP not daily) always made me feel a bit knackered the following day but then felt absolutely fine day after. I suppose this is the first ‘big’ AF event that has required hospital since 2020 and it’s come as a nasty shock. It feels like I’ve gone right back to how it felt when originally diagnosed in hospital after major episode in 2019. Sorry for the moan, but this forum is so vital because people who don’t have AF just don’t get it.

[Jetcat]

first of all you’re not moaning. You’re not in a good place at the moment central. Afib and its effects are very good at getting the anxiety, fear, dread, despair feelings going through the roof every waking moment of the day.? Always wondering when the next episode will arrive and how long will it last etc etc,? is it going to ruin my life,? Am I always going to be like this.?

You may not think it now but things will get better.( probably not in my case you’re saying) Iv had palpitations since late teens. Then afib since 42 years of age.? Finally got it caught on hospital ECG at 44 years of age. Saw cardiologist who prescribed different drugs which stopped the episodes coming as often.! But in this early time I was becoming a different person.? A petrified wreck who’s life was over.? I was either going to drop down dead because afib or end up just existing with this awful affliction.? I was referred to a EP (electrophysiologist) who arranged an ablation procedure. 6 months waiting list.!!!!! He booked me in for some cognitive therapy until my ablation appointment came through probably to try keeping me sane.?😜

After the first ablation things were better but not perfect but that’s usually the norm. So I had 2 more. I’m now in a totally different place.? Mentally and physically. Yes I still get the odd episode but I know it’s not going to kill me and I know my QOL is brilliant compared to start of this journey.👍 I’m now 55 and still working,still going on holidays,still running around with my grandkids, still doing my hobbies and living life. You will end up the same centrel. The beginning of this journey is always the worst and you’ll get through it but it will take time for you to realise and believe it yourself. Yes go for therapy or read stories but as time goes on you’ll realise yourself that things and life is improving. 👍

Best wishes centrel

Ron.x

[CentreHalfMum in reply to Jetcat]

Thank you so much for taking your time to write such a lovely, comforting reply. I think what’s preying on my mind is that this time around they saw changes from 3 years ago on ECG. I have a CT scan booked so they can investigate further. They kept saying they needed to check incase my arteries were blocked. Having spent 4 years dealing with AF, the thought of having something else potentially wrong with my heart has scared me witless. So I think the usual AF event anxiety has been doubled. However at least they are being thorough. As you say, I will get over this. Thank you again for your kind reply. All the responses have been so helpful, what a great site this is!

[Jetcat in reply to CentreHalfMum]

they will check and give you a full MOT centrel. Echos, scans, X-rays etc, It gives them all the info they need to get you sorted. We lucky to have these great people looking after us.! Your in good hands and know how to get back to a better life.👍

[CentreHalfMum in reply to Jetcat]

Thank you - I’m going to bed in much more optimistic mood 😃

[DawnTX]

good news bad news the good news is that is normal you could have it for a few days. If you happen to get a Pericarditis, which is an inflammation, that’s also unfortunately somewhat normal. They are very treatable. I just took Tylenol for the pain you are failing right now, if you have pericarditis hopefully they will give you something for that like I had. One pill for 30 days that was it and you start feeling relief within days. I had forgotten about the pain you are feeling when I had my AV node ablated for my pacemaker. Thank heavens for everyone out here because yes, of course I wrote and I was told, but I’m telling you about after an ablation. No matter what they give you one for or what else you have done it’s is traumatizing to the body. I had all kinds of aches and pains, because first my pacemaker was put in and two weeks later the AV node ablation. I also had the incision, etc. nothing dramatic I guess we forget some of the pain sometimes. My doctor said my body has had enough especially over the last year and a half. I will tell you now I’m feeling great.

There are times that twinges and other things pop up. Also not everything can be blamed on a fib. For the most part, my doctor has told me anything else now could be other things. I started having shortness of breath again a few weeks back. And was exhausted as well as pain in my chest so of course I blamed it on a fib. He told me it was anxiety I do suffer from it at times. I had just changed meds and the new one did not take affect yet. Long story short it was anxiety I’m pretty sure And I had just had a seriously traumatic situation where my two kittens were out front of the porch and killed by dogs. The babies were only a couple months old. I just had it again two weeks ago because we had another cat killed. I have no doubt it’s anxiety and neither did the doctor. That being said , he did order a chemical stress test. I don’t have the results yet but other than the nuclear medication side effects it was not anything like the first one when I was diagnosed.

It’s necessary to keep an open mind

[Stonk007]

That can happen if you are taking too much flecainide. It happened to me a couple of weeks ago. I felt like a walking zombie

[CentreHalfMum in reply to Stonk007]

Thank you so much for your reply - it’s a relief to know others have had similar experiences. Well 17 days after my original post /hospitalisation for AF episode I can report that it’s only today that I have started to feel more ‘normal ‘. I have also felt like a ‘walking zombie’ and unable to walk any distance or do anything like gardening etc. The strange tight, weird, uncomfortable feeling in chest has persisted. I had CT angiogram last Monday and the Consultant radiologist supervising the test looked most put out when I asked him when I might get the results. Fancy a patient wanting to know the results of their test!! ? He rather snootily replied “ in due course you can ring your Consultant”. Hmmm, cannot imagine many people are successful in ringing a Consultant Cardiologist but will try to find out secretary’s number. Honestly, why do we put up with being treated so casually at times in the NHS? Please don’t get me wrong, I am grateful for any care /treatment received, but I just don’t know why it seemed to be regarded as unreasonable that I wanted to know when and how I might receive the results of the scan. I had an MRI scan in 2005 and after trying to chase up that result for 6 months, unsuccessfully, I finally gave up. I have never received the result of that scan and have presumed no news is good news all these years. However, I just don’t want a repeat of that. I speak as an ex nurse and ex Senior Tutor in a Medical School, so if I can’t successfully navigate my way through ‘the system ‘ who the heck can?

Anyway…..I think possibly the huge amounts of flecanide in hospital took its toll. Also, have long wondered if Bisoprolol 2.5mg, although a relatively low dose, is too strong a dose for me and contributing to the zombie feeling? For the first time in months I forgot to take my dose this morning and feeling in chest and total lethargy is much improved. Since returning from hospital pulse has been late 40s to late 50s. I have never felt my normal self since starting Bisoprolol 2.5mg when first diagnosed with AF in 2019.