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Atrial Fibrillation Support

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seeking more info with yet more questions

gbn_ profile image
gbn_
42 Replies

Hello. As I begin to write this it's 5:45 in the morning here. Trying to get at least some type of sleep. Still having loads of anxiety but trying to calm myself down to at least write this. Glancing over once in a while to check oxymeter, heart rate ranging from 92 to 104, oxygen steady at 96-97. When I see the doc in a few days i've mentioned i'm going to ask questions about metoprolol and anxiety to see if there may possibly be any connection with it. And, if there is to maybe try and find out why, such as possibly by it altering a certain brain chemical which would cause it to produce the anxiety. In the meantime I'll try to search this possible issue to maybe find out. Maybe it would be a simple fix to introduce or change something which would correct the issue. Also still taking my furosemide and xarelto. Yes, I've had anxiety issues before in my life, but with this, at age 69, it's almost unbearable to contend with. As I've mentioned in earlier posts, it magnifies other issues with you as well.

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Rainfern profile image
Rainfern

Unfortunately there is no quick fix for anxiety, whatever the cause. When body chemistry shifts from the acute “fight or flight” mode to the more chronic, ongoing response then different chemicals come into play that hang around longer. Please be patient with yourself because the body will need time, more than anything else, to get back in balance. Even if it doesn’t feel like the self-help stuff is working, keep at it. Remember both anxiety and depression have a habit of making people feel like they’ll never get better, but we know that’s not true. You will get through this and out the other side. Hopefully the doctor will have some answers about medication and triggers, but meanwhile take it easy as you can and know you can’t force an end with chronic anxiety, you just give it, and yourself, breathing space.

Aegean56 profile image
Aegean56 in reply toRainfern

Agree there are no quick fixes but CBT (cognitive behavior therapy) might be helpful. I am a firm believer in the Buddhist phrase "we are what we think". CBT can help you alter your thinking and teach you tools to deal with the breakthrough episodes. There are plenty of apps that can assist you if you aren't keen on face to face or if there are financial constraints. Finally anxiety begets anxiety that begets A fib that begets A fib. I would strongly urge you to stop checking everything so often . Set the alerts and let that guide you and your action.

Wishing you all the best .

Shopgal67 profile image
Shopgal67 in reply toAegean56

I would second the recommendation for CBT , it’s really amazing for health anxiety which I have .

jeanjeannie50 profile image
jeanjeannie50

I would have thought that Metoprolol being a beta blocker would more likely sooth attacks of anxiety. What dose are you taking?

Jean

gbn_ profile image
gbn_ in reply tojeanjeannie50

Hi Jean. When I was in the hospital in November they had me on 50 mgs. twice a day. Then had my first follow-up visit with the nurse who works with the doctors at their office. I guess after the ekg along with blood pressure and heart rate things must have still been elevated, and me being somewhat nervous with just being there probably didn't help much. So she instructed me to take one and a half pills twice a day which is 75mgs. twice a day. Yes, I've read that beta blockers are sometimes prescribed for anxiety symptoms, but they don't really help the actual cause of it, but supposidly the symptoms of it. Sometimes propranolol is prescribed also for the same reason.

jeanjeannie50 profile image
jeanjeannie50 in reply togbn_

I see that you are in the U.S. I have a feeling that the Metoprolol you take may be a little different to ours in the U.K. I take 25mg of Metoprolol Tartrate twice daily.

Once when in hospital with a high rate of AF I was given a hefty dose of Metoprolol in an attempt to bring my heart rate down. The result was I got out of bed and collapsed. My cardiologist came running later with a stream of paper that had been recorded by my heart monitor, he was saying, 'Look what your heart is doing'. Well the stream of paper he was waving meant nothing to me. My AF nurse told me I must never take more than 25mg of Metoprolol or it could kill me.

Years later I took a larger dose of Metoprolol by accident. I'd gone shopping with a friend and it made me feel totally worn out.

At the moment I'm wondering whether to try something a little different. I did try Bisoprolol which made me feel wonderful and full of life, but unfortunately it made my legs ache.

Sorry I cant help more.

Jean

gbn_ profile image
gbn_ in reply tojeanjeannie50

Hi jeanjeannie50. Thank you so much for your response. The metoprolol is the same as yours, Tartrate. Well, honestly that cardiologist who came running with your readout papers would have been quite upsetting with me with making me nervous and worried because I would have asked just how much did I take to give me this problem. I would have wanted to know promptly. Do you remember what that larger dose was that you took by accident when you felt worn out when you went shopping with your friend? The only thing I can do at this point is to ask questions with the current medication and amount of it. Are you still feeling worn out on your current dose for you to possibly change to something else? Also, I just took notice a few hours ago that the swelling has returned to my left foot and ankle, but not as bad as it was at the start of all this, and I'm wondering if this latest bout of anxiety or lack of sleep has brought it on again. I will post with any updates and info from my next visit with docs. I'm just going to hate to have to go through the side effects (if there is any) of trying out any new meds that might be prescribed until I find a right combination. Thanks so much again.

jeanjeannie50 profile image
jeanjeannie50 in reply togbn_

I think I may have been given 2 x 50mg tablets of Metoprolol. Having an anxiety attack can certainly cause AF, the sad thing is anxiety is like fuel to AF and keeps it going. I know this from my own experience. After having had AF for 19 years I really don't give much thought to what my heart does now. The more you can distract yourself from it the quicker your heart will go back to it's normal rhythm. Not easy to do I know.

Jean

gbn_ profile image
gbn_ in reply tojeanjeannie50

Hello jeanjeannie50. So true. It will eventually get to that point and I'll just accept this. It might take a little more time though only because it's new to me and any symptoms that come up I'll have to deal with it at the time.

gbn_ profile image
gbn_ in reply tojeanjeannie50

Hi jeanjeannie50. Forgot to mention this here, along with the AF diagnosis, diastolic heart failure was diagnosed along with it also hence the probable uptick with the anxiety along with possible med issues. Hospital told me that is the cause of my leg swelling.

Buffafly profile image
Buffafly

Maybe you are reassuring yourself you are ok by checking your ‘vitals’ (see, I occasionally watch US tv!) but on the other hand you could be feeding your anxiety. When my grandfather didn’t like his AF medication (digoxin) he announced he was going to ‘throw it in the Duzi’ (local river). As it was the only thing available for AF at the time I assume he had no other treatment and died quickly and peacefully from a stroke at 81. My father had permanent AF from his mid fifties, likewise didn’t tolerate meds but it was emphysema that got him. Are you dizzy, faint, breathless, in pain? If no, you are ok! Your brain is just confused by your heart’s actions but in time you will distinguish ‘physical anxiety’ from mental and you’ll feel a lot better ❤️‍🩹

gbn_ profile image
gbn_ in reply toBuffafly

Hi Buffafly. Thank you much for your response. It's understood the difference between physical and mental anxieties, and it's a good way to look at it, but honestly when it hits, it hits really hard. The anxiety itself can bring on those physical symptoms you mention. I guess it's just knowing that something just isn't quite right, in actuality knowing I have AF honestly doesn't give me the anxiety for the moment, I just feel that there must be a different cause bringing on the symptoms of it and the cause is what I'm trying to find out. It could very well be from the AF itself, but I'm leaning towards the medication for it for the time being. And there's the rub, I'm not really into procedures, but trying to rely on these very medications to see me through. I'm sure there will be med changes for me possibly when I meet the actual AF doctor, and not the nurse that I have seen for the pre-doctor visit. And it's sometimes the long wait in between visits when more questions arise that can cause unnecessary worry or over concern.

Singwell profile image
Singwell in reply togbn_

Just chipping in here as I recognise something you said- you're worrying about the anxiety itself if I've understood you. Wondering what's set it off. In my experience that's part of the anxiety - it's a mean condition that preys on itself. I do hope you get your appointment soon and also check put side effects of meds. I've given a longer response further down the thread.

Buffafly profile image
Buffafly in reply togbn_

In that case it’s more of a panic attack and as Rainfern says the ‘self-help stuff’ is the way to go. I’m sure ‘box breathing’ has been suggested and the advice from Singwell is great. We’ll look forward to hearing if a change of medication is helpful ❤️‍🩹

gbn_ profile image
gbn_ in reply toBuffafly

Hi Buffafly, thanks again. It was sort of a panic attack, but with taking my current daily doseage of metoprolol it possibly kept it under semi-control without it going into a full-fledged type of panic (which I have experienced many times many years ago).

Buffafly profile image
Buffafly in reply togbn_

Not wanting to sound like an amateur psychiatrist but do you know what set off the original run of panic attacks?

gbn_ profile image
gbn_ in reply toBuffafly

Hi Buffafly. Well, probably a few things. I have mentioned a few times that with anxiety, many other things could get magnified by it as far as troubles and worry. I live by myself, but every day I go over to my ex-wife's house to help her with different things and we still go shopping at stores together and things like that. Even though we are divorced we remained friends through the years. My daughter lives there with her and there are 2 grand children, as for me, I live in a kind of bad part of town here and when I'm out of the house doing things with her I feel usually better just to get out more and away, but I always have to come back home later and from being out coming back to an empty house is sometimes the absolute pits, in other words I like to do things with her and be out and about and it's usually depressing for me to come back home at night. There are other factors that could be included with my anxiety triggers, such as dealing with these symptoms of my AF, I also suffer from sinus and ear issues which can sometimes set things off with me also, but, one of my biggest fears, and I've been thinking about it more and more lately (probably because we're getting older) is the thought of something happening to her (we were married for 25 years, and have remained friends for another almost 25 years later now), that's a long time. If that were to happen, I know I'd be totally lost. She currently has some health issues but nothing real bad. So, that along with living here where I do and probably just the usual everyday situations that pop up as you can see can sometimes be stressful.

pusillanimous profile image
pusillanimous

I too have suffered from anxiety all my life, and it gets worse as you get older. I saw my GP yesterday for a review of my medication and mentioned to her about my increased anxiety especially about driving since some idiot cut the corner on a bend and took off my wing mirror. Just sitting in my car now starts me shaking, I calm down if I play some soothing music I've downloaded from Spotify - Mozart works best. However, yesterday by the time I got to her I was a nervous wreck, BP up, HR up. She's been my GP for 15 years and knows me. We reviewed my meds. and she asked would I like something for the nerves (I have alzam - but it no longer works well and I don't want to increase my intake). She has prescribed a little blue pill (not Viagra !), and explained that it can part of aging in my personality type (I'm 80). I have never taken metoprolol, but have taken bisoprolol, of which I take 1.25 mg for rate control (cardiologist prescribed) very effective at its job, but I find even the low dose horrible. Yesterday we decided to try and replace it with verapamil, which I have had before. as part of my BP med. before AF was diagnosed.

gbn_ profile image
gbn_ in reply topusillanimous

Hi pusillanimous. That would have shaken me up also, I just can't believe some of the driving blunders that I see on a daily basis here where I live. I have just taken notice now that the swelling in my leg, ankle, and foot has returned, but not as bad as it was when first diagnosed in November, and I'm wondering if yesterday's bout of the anxiety has brought it on, I just hope it settles down before my next doctor visit in a week. My current prescriptions of metoprolol, furosemide, and xarelto might be helping from it getting worse.

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

Have a 24-hr Heart Monitor. Its important as Metorolol gave me pauses at night and that could ultimately give you subconscious feelings of the start of ANXIETY.

Metoprolol has proved to be the wrong med for AF.

Metoprolol to Bisoprolol.

In fact research is questioning giving any AF patient a Beta Blocker which both the above are.

As Frusermide takes away elements that you need like potassium and magnesium even that shuld be closely monitored.

Every morning start with real lemon, glucose, a tiny salt shake. Keep hydrated.

Luckily my story profile made me grateful that the stroke put me in hospital only to discover the thyroid cancer and its removal in time to prevent spread.

B12 level for your age 700-800. Don't bother with Dr saying you are above 175 normal. That is very low for an older. person.

TSH for thyroid should 1.5-4.2. Over hypo and under .5 hyper.

More levo .. if higher than 4.2

More difficult lower than .5 You are in suppression with toxic thyroid.

Look forward to something that should arrange ahead.

First time overseas from stroke in 2019, I've booked JAPAN.

cheri JOY. 74 (NZ)

secondtry profile image
secondtry

Where I have found the most success in reducing anxiety: learn here until you go squinty eyed, close interaction with Nature (not just a countryside walk) & prayer. Also a new hobby has helped, in my case a sport - walking basketball at 70!

Singwell profile image
Singwell

I sympathise. I'd always been a worrier, looking back, but when I developed AF it turned into anxiety. A couple of frightening visits to A and E during the pandemic and I was definitely in the anxiety habit! And yes - it is crippling. As others have said, it takes time to combat it. But our brains do have nueoroplasticity and are capable of changing patterns. You may appreciate a podcast with Dr Chattaerjee where he interviews are neuropsychologist called Dr Caroline Leaf. It was an eye-opener for me to hear her explain how many mental health conditions manifest because of negative experiences that are mapped in the brain and cause proteins in the brain to be 'misfolded'. So I'd think a response to medication might cause that effect in your own brain. Just as medication can damp down that response. Dr Caroline gives advice and steps that people can take to help change those brain patterns. That gave me hope - because I didn't want to feel like that for the rest of my life. I use some of those techniques still to manage anxiety when it visits.

Another forum member recommended a book to me, which I also used - see image. And I have some 'somatic' and 'vagus stimulation' strategies that help.

For the somatic work I might focus my attention on what I can physically FEEL - the bedclothes, the pillow, my hot water bottle, feet, hands, head, hair, air coming in and out of my nose etc. Or I might focus on what I can HEAR. some people focus on what they can SEE -;very close, further away, far distance etc. All of these techniques bring us into the present and help calm the anxiety- because anxiety is always in the future if you think about it.

For the vagus nerve I do loud humming- like a chant. I was a singer so my breath control is still quite good but it doesn't matter if you've never sung - put on a slow piece of music and hum along loud and slow. This isn't woo - there's science behind it. And for me - more than once - it's seen off an episode of AF. Not always though.

Hope some of this helps.

Book on self help for anxiety
gbn_ profile image
gbn_ in reply toSingwell

Singwell, thank you so much for this info, I will surely try some of these suggestions. I have suffered with anxiety issues a good part of my life, It has been told to me many times to try and distract the anxious thoughts, but sometimes the patience just isn't there and many look for a quicker way out or just plow through the thoughts as they hit us because of the swiftness that anxiety thoughts sometimes come about. To be able to master your thoughts away as you have mentioned would be so welcomed.

Singwell profile image
Singwell in reply togbn_

I absolutely relate to that sense of being walloped by anxiety. It's horrible. What drew me to the book was a kind response to a post of mine a couple of years ago. She replied that what worked for her was 'cosying up' with the sensations of anxiety - rather than fighting them. I tried it - curling up shaking and sometimes.crying and at the same time clocking the feelings without judgement. This is described in the book. What I found was that by feeling the sensations, they didn't last as long.

Peony4575 profile image
Peony4575

sorry you are suffering . My brain adapts very quickly to things . I got sky high anxiety as a withdrawal symptom of stopping beta blockers not the short time I was on them but we are al different. I had no trouble stopping aspirin but the first clue I had forgotten my anti coagulant one day was the most awful anxiety . There must be something in the excipient of the tablet my brain has latched onto . I hope I never have to stop them for an operation or something . Will the doctor believe your tablets are causing anxiety, probably not . Have you googled to see if others had the same problem? Large numbers suffer trying to stop bisoprolol . Some people are unfortunately very sensitive to things

gbn_ profile image
gbn_ in reply toPeony4575

Hi Peony4575. Was it just the actual thought of stopping the beta blockers ( which ones were you on that might have caused the biggest problems for you with stopping them?) or was it like an actual withdraw type symptom because of the chemical composition of them? It seems like you suffered because of knowing you were going to stop the beta blockers and forgetting to take your anti coagulant that might have frightened you into the anxiety.

Peony4575 profile image
Peony4575 in reply togbn_

Definitely not the thought of stopping them. I hate taking all drugs and resisted to the point that when the loving cardiologist at the hospital sent me out on them I made a private appointment with another cardiologist who said I should stop them and gave me the standard taper . My heart rhythm went haywire as soon as I started reducing , tachycardias and ectopics waking me up all night and sky high anxiety . The second cardiologist supported me through it at no charge because he said the problem had been caused by his hospital . I used to email him some of the wonkiest ecgs from my Kardia . It’s in my notes that I must not be given beta blockers , so no , not in my mind actual physical withdrawal which is more common than you might think

Peony4575 profile image
Peony4575 in reply togbn_

BTW. Super patronising comment you don’t know me from Adam

gbn_ profile image
gbn_ in reply toPeony4575

Hi Peony4575. Forgive me if anything sounded out of place. What you have mentioned about withdrawal was something that I've never even thought of, had no idea that this could happen with heart meds. It is something else that I'll now need to watch out for and I greatly appreciate the info.

Peony4575 profile image
Peony4575 in reply togbn_

It can happen with any med. sometimes it isn’t even the active ingredient in the med but one of the excipients ( fillers ) in the tablet. For example I had no problem stopping aspirin abruptly after decades . But a big problem with the anticoagulant . Fortunately I am not the norm am just very unlucky in being so sensitive .

gbn_ profile image
gbn_ in reply toPeony4575

Hi Peony4575. Again, thank you so much for this info. It actually scares me now that this could happen only because of me wanting to see if I might be able to switch to something else when I see the doc this Thursday with possibly being put on something different from the metoprolol I'm currently on or at least maybe lowering the amount of it that I'm currently taking. I am taking a total of 150 mgs. of it a day, which is 75 mgs. morning and evening and I'm thinking that this amount just might be causing some of my anxiety issues.

Peony4575 profile image
Peony4575 in reply togbn_

Mention your concerns to your doctor

Ppiman profile image
Ppiman

Temporary relief from intense anxiety is only really available with a tablet such as alprazolam or diazepam. These can be, in a few people, problematic and habit forming, so need great care. Also, they are not especially effective as no drug works truly well for anxiety.

In my own experience, a way out of anxiety completely is not really possible. It is the way the brain functions in some people. No chemical as such can be altered to fix it so far as I know. What always helps me is reassurance that tomorrow, next week, next year will come and all will still be well. You will not die from AF itself, need a heart transplant, have a cardiac arrest, nor become ill or go crazy. Life goes on for people with heart arrhythmias.

A queue of tens of thousands of people suffering with heart arrhythmias could be formed with each person assuring you that your worries are groundless and all will be well. And yet, you would still you will find reason to separate yourself out from those tens of thousands as somehow different and deserving those worries. Of course, if there's more than AF, then that would be different.

I find that only a medically trained person can offer the level of reassurance required, supported by tests. In the case of heart issues, this needs to be a scan of some sort, echo or MRI. Have you had these?

Steve

gbn_ profile image
gbn_ in reply toPpiman

Hi Steve. Sorry for the late reply. This AF is all new to me, and while knowing I now have the condition which doesn't really cause me to worry, it's the effects of it that causes concern. I'm hopeful that the right combination of meds will be found for me because I don't like procedures which I think are risky. I had a major heart attack back in 2009 where I actually died while they worked on me, and because of that I was told by the cardio doc that a top portion of my heart muscle died as a result. So now, after getting checked out in November for leg swelling that wouldn't go away I was told that I have developed AF, which was the reason for the swelling. I went in to emergency on my own to get the leg looked at on November 5th. After running an x-ray and blood work I was promptly admitted. 5 days later, they discharged me with instructions for follow-up care with cardiologist. I don't think my worries are groundless for this, while in the hospital I had many tests done, including a failed cardioversion. So yes, I have had the scans and tests done, and out of it all was the diagnosis of not only AF, but also systolic heart failure as well, that is what concerns me the most with this condition. It is because of the bottom chambers of my heart being somewhat stretched out of shape a bit that is causing the heart to not pump out all the blood like it should which is what is causing the swelling in the leg, the current medications that I'm currently on are keeping alot of that at bay, but I believe they might be contributing to my current anxiety issues. All of the medically trained doctors at least for the time being, gave me no reassurance, it was all serious stuff.

Ppiman profile image
Ppiman in reply togbn_

Hi again. I am sorry but I must have missed reading any of that extra information about your condition when I replied. Was this in the thread of messages? I should have read these, but didn't - my apologies again, if so. From what you now write, I have gained a different picture and there are clearly other complicating factors in your condition.

I think when the heart muscle itself is affected, then it is more difficult for a doctor to offer the reassurance that often seems to be possible when only the electrical side of the heart is affected. I do hope that you find a mix of medications that help to relieve the health problems you are facing. It must be really difficult for you and surely your anxiety is entirely natural. people cope differently with this. I am poor at doing and easily struggle with health fears.

Steve

gbn_ profile image
gbn_ in reply toPpiman

Hi Steve, thanks so much for the reply, no need to apologize here. Since my AF diagnosis, I have posted a few questions in different threads on the AF site, I have mentioned the heart failure in these postings that might be found on my information by clicking on the name of mine. I realized I was talking about my anxieties in this question blog that I posted, and realized that maybe I should inject the information towards the beginning which I should have done, there was no way for you to know and actually I am the one who is sorry for that. Actually I made a mistake, it's not "systolic', it's "diastolic" type heart failure they say. Systolic is where the actual heart valves don't work properly, but with my type, the valves still work relatively good, but the shape of the lower heart chambers are a bit distorted which is what causes the particular problems. Again Steve, my fault entirely--------------Mike

Ppiman profile image
Ppiman in reply togbn_

Hi Mike

Forums are always difficult to post to, I find. With regards to heart failure, I should think many of us here live in fear of it, to be honest. From the little I know, though, yours is the kind to have if such a thing can be said of it, and with medication, I’ve just read, can be properly treated. What have your doctors said? And did they work out what caused the earlier heart attack?

Steve

gbn_ profile image
gbn_ in reply toPpiman

Hi Steve, your words are very reassuring to me. I have an appointment with the doctors nurse one more time this Thursday before I see my actual doctor on the 22nd. of this month. I will post with any and all up-dates but I hope I can keep the appointment because of snow being forecast, it's really cold here right now. Well, the heart attack I had back in 2009 was one of the worst types, it's called a "widow maker". Instant 100% blockage in LAD, they told me less than 2 percent of people survive this. I was "gone" for 20 minutes while a crew of 2 worked on me, it happened at work.

Ppiman profile image
Ppiman in reply togbn_

Well - you survived to tell the tale! Let's hope this current issue gets sorted soon. Anxiety is not an easy thing to cope with or treat, but I hope your doctor can find ways to reassure you. My own experience of it is that it diminishes greatly with reassurance and as time proves the fears were groundless. Of course, it's there to raise its ugly head again always given the chance!

You and I are a similar age and I think, whatever the media say about 70 being the new 50 and other such nonsense, even though I think I am young for my age, I often do feel it and oh so wish I could be 50 again!

I hope the weather keeps on your side. I have a friend in OK city and even there it's c-c-c-old!

Steve

Vonnegut profile image
Vonnegut

Gentle breathing exercises might be helpful. Michael Mosely suggests in through nose for count of 4, hold for count of four and then out through mouth for count of four.

Westknoxgirl profile image
Westknoxgirl

I’ve had afib for 5 years now and have learned that only hospital-grade pulse oximeters will work if you have afib. As for the anxiety, I had horrible anxiety when I started having a fib and finally asked my dr if I could take something for it. I’m 70 years old and have never been on any type of anxiety medication and was a little apprehensive about taking it. My doctor put me on Alprazolam 0.5 which is a low dose . I take it as needed, especially at night to help me sleep. After taking it for 2 years now I have no more palpations and I sleep better. I also take Metoprolol 100mgs a day, 50 in the morning and 50 at night about 30 minutes before I go to bed. It helps me sleep better. I feel your pain and hope your doctor can help you!

Desertflowerchild profile image
Desertflowerchild

I used very low dose propranolol prn to calm anxiety for specific situations such as public speaking. It was utterly amazing. Since I had this medication in my medicine cabinet, I would also use it (at my own discretion) to bring the heart rate down when in afib.

My cardiologist recently prescribed metoprolol prn for rate control when afib shows up. What I noticed is that, for me, the metoprolol did not have the same calming effect on anxiety as propranolol. I can't say for sure that it contributed to my anxiety, but it certainly lacked the calming effect I experience with propranolol.

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