Treating PVCS on a virtual ward

[Norfolk_spaniel]

I have posted on here a number of times about the burden of persistent PVCs. Anyway, after 5 days of feeling very dizzy and nauseous, I went to see my GP. She sent me straight to my local hospital which is a big teaching hospital. I was seen in the Same Day Emergency Medicine unit who were thorough and brilliant. I was admitted for 1 night, querying a stroke, but diagnosed with acute vestibular neuritis. I was sent home on the virtual ward which is a brilliant concept and is working very well. My palpitations have been very bad. My cardiologist wanted to start me on beta blockers but my GP wouldn't do it as my resting heart rate is around 60 and I am mildly asthmatic. Hower, being on a virtual ward is a perfect opportunity. I have started on 1.25mg bisoprolol today and because I am on the virtual ward will be checked every 15 minutes. I so hope it will reduce the palpitations to a level that I can live with. Very pleased to see that the NHS can still be brilliant.

[CDreamer]

That is the way medicine is going but not everyone views it as progress. I am assuming you are wearing a monitor of some sort which communicates directly with the hospital?

When I had COVID in 2021 and my o2 Sats were low I was put on a virtual ward for monitoring for 7 days.

[jeanjeannie50]

A virtual ward, that sounds a great idea. How do they operate that?

[Norfolk_spaniel in reply to jeanjeannie50]

I was sent home with a prpreprogrammed tablet, a monitor which I strap to my arm and a blood pressure monitor and cuff. The tablet gives me a list of what I have to do and when each day such as blood pressure readings. It also has a chat facility so the nurse can ask me for extra blood pressure readings for example. The nurse phones me at least once a day usually on my mobile but there is also a video phone facility. Yesterday, I started off by describing my awful heart palpitations in the chat facility on the tablet. I then had phone calls from the nurse, cardiologist and pharmacist. Only downside is that medication has to be collected from the hospital pharmacy. My obs are being taken every 15 minutes. I'm in my own bed with lots of peace and quiet.

[Norfolk_spaniel in reply to Norfolk_spaniel]

Meant to add that I'm under the Norfolk and Norwich University hospital.

[jeanjeannie50 in reply to Norfolk_spaniel]

Wow, that's a great scheme and it's so lovely to be in your own bed at home. Hope this catches on and is offered by all hospitals. It's even more important now to stay internet savvy!

[Tigger_2 in reply to jeanjeannie50]

Yes, and pity those who aren't.

To just get by, I have to use e-Consult, Anima, TPP, Systmonline, Airmid, NHS online and Patients Know Best.

I do repeat prescriptions through Airmid and can view and update my medical record.

Appointments and other letters are notified by PKB, I go to another URL to view and download a pdf (portable document format).

This doesn't include downloading BP measurements, recording blood glucose in Excel 365 somewhere in OneDrive, uploading MyCareLink etc.,

God only knows where I would be without three PCs, one running Linux and one laptop with Win 11. Not to mention all the apps on the phone.

If anyone thinks that retirement is putting your feet up, a nasty shock is on its way.

[jeanjeannie50 in reply to Tigger_2]

Nothing is easy these days is it.

I was sat in the doctors surgery waiting room a few days ago and I heard a receptionist questioning an elderly lady. What year were you born she asked and the lady replied 1931 and I sat there trying to work out how old she was = in her 90's. Still all the cross questioning came and I wondered why that dear lady had to stand there and go through all the questioning that took so long. I had to bite my tongue to stop myself from saying anything. Imagine feeling ill when you're in your 90's and you have to stand and be cross questioned.

This world has gone truly mad!!!

Jean

[Dudtbin]

i was on a virtual ward when first diagnosed with af and heart failure, it was a bit like this forum very reassuring and comforting - i was bereft when i was well and they took it away 😂

[Ppiman]

I have taken 1.25mg bisoprolol since just before a minor op last March. It has so far kept my AF in check, but my ectopic beats have continued although, perhaps at a much more tolerable level with occasional flare ups.

Steve

[Cundara1234 in reply to Ppiman]

Could you please describe your ectopias? How do you feel about them? I have them too, and they bother me a lot. I drink Bisoprolol 2.5 mg × 1. Therapy doesn't help me, it just calms my heart, but I still have the ectopias.

[Ppiman in reply to Cundara1234]

Hi Cundara

The ectopics are, in themselves, something that I cope well enough with, except they do cause anxiety about my heart in general. In themselves, they feel like a "thump" and I can have them every few beats at their worst and sometimes in runs of 2 - 3 at a time. Often, like today, they are accompanied by a mild discomfort under my left rib, which goes through to my back. I used to think this was a gastric problem as I have a small hiatus hernia with reflux acid, but now, I tend towards thinking it's heart related although it's more like diaphragm / stitch at times. It can go on for hours, so, I suppose is not the heart itself - but I doubt I shall ever know. They make it difficult to do strenuous things like carrying my grandson, today. Why? I don't know. I get tired very easily and, I suppose, I fear something will happen to my heart like setting off AF or worse! As I say, anxiety is the worst aspect.

Steve

[Tigger_2]

Interesting.

Pleased to hear that you are being well monitored, but it does show up the differences in care around the UK.

Like you, I have been having PVCs, which coupled with the pacemaker, have had me on the floor at least 4 times. On average, 100 PVCs per hour.

8 months I've putup with this with minimal input from the cardiologists.

To be fair, they did take me off Atenolol 50-mg daily and swapped it for 1.25-mg Bisoprolol daily.

For general information, they said 5-mg Bisoprolol was equivalent to 50-mg Atenolol.

That was rapidly raised to 2.5, then 5.0 then 10-mg daily.

A cardiologist friend said don't do it, the GP said she couldn't see the sense of it, but what do you do as a patient?

Fortunately, I'm tolerating BS at maximum dose and because of the many changes in dose, mistakenly took 20-mg one day without ill effects.

The worst symptoms of the PVCs do seem to have improved.

However, not once has anyone checked how I'm doing and you are just left to get on with it.

A GP is phoning me next week, no idea why, then in six weeks time, I get to see a cardiologist.

Virtual Ward? I should be so lucky. Virtual Device Clinic once a year for all that does.

[Gertsen]

I take 3.75 bisoprolol in the morning and 1.25 in the evening I am doing ok on it get a bit tired now and again but not too bad.

[Cundara1234]

Excuse me, I'm wondering if that dose reduces your PVCs, and if a smaller dose didn't give you results. I drink 2.5 mg of Bisoprolol. , maybe even 5 mg wouldn't help me. That's why I'm asking you, did the lower dose not help you, so you increased the dose and now that dose is helping you?