Just setting the scene here: I have Crohn's, GERD, short bowel syndrome (aka
intestinal failure), mild heart failure, etc. I am female, 48 years old,
1.62 m at 54 kg. I am very ill, was severely, deathly ill in 2005 and it
took 8 months of dithering by my doctors to get a diagnosis of short bowel
syndrome at a specialist clinic where I spent 3 weeks. Twenty months of
incorrect treatment then led to Crohn's anorexia (involuntary anorexia) with
the associated heart problems (due to nutritional particularly mineral
deficiencies - think Karen Carpenter here) and I have been on disability for
nearly 4 years now.
Firstly, you should check that you have implemented all the GERD lifestyle
changes: http://www.gicare.com/Diseases/GERD.aspx including sleeping in a
raised bed, not eating 3-4 hours prior to bedtime and no fast foods, sweets,
chocolate, coffee, cocoa, milk, ice cream (except joghurt), sodas, fizzy
mineral water, black tea, alcohol, peppermint, chewing gum, etc. GERD pains
normally occur after exercise or on bending or stomach crunches. Ginger,
aniseed or nettle tea might help here - they speed up the gut somewhat
especially the ginger. GERD can cause heart pains as the inflamed oesophagus
presses against the heart and irritates it. In order to eliminate GERD as
the source of your heart pains you need to make sure that your GERD is under
control.
You should have been checked for the presence of a hiatal hernia, which is
sometimes the cause of/contributes to GERD symptoms
http://www.medicinenet.com/hiatal_hernia/page3.htm#5howdoes.
Your BMI
http://www.healthyyounaturally.com/services/bmi_calculator_chart.htm 88.9 kg
(196 lbs or 14 stone) at 1.78 m (5'10") is 28.12, which is too high
especially for someone who has heart symptoms. You should aim for under 25,
which means losing over 10 kg to target at the most 78.8 kg, obviously a BMI
of 22 (under 70 kg) would be better for your GERD and your general health
particularly your heart. So, you are either 10 kg or nearly 20 kg overweight
depending on your doctor's point of few - I suspect that he/she would go for
the 20 kg overweight. Do not go on a crash diet, but just change your diet
and stick to it and the weight will slowly come off - losing more than 6 lbs
a week can be very dangerous.
I am just musing out aloud here in response to your post, which because of
its length gives the reader a good idea of the extent of the problem and
allows a comprehensive reply. Please discuss all suggestions with your
doctors before making any medical treatment changes.
Things that sprang to mind when reading your post:
- Exercise-induced angina pectoris
- Chronic infection
- Hormone imbalance/underactive thyroid
- Your doctors are either not telling you everything or they have not done
all the diagnostics they should have done based on your symptoms
- Ideally you should be referred to a cardiologist, urologist, and
nutritionist to address all issues.
Angina pectoris http://www.netdoctor.co.uk/diseases/facts/angina.htm
Firstly, very well done for giving up the smoking and boozing.
The chest pains sound to me to be exercise-induced angina pectoris (AP). AP
is generally associated with atherosclerosis due to year long poor lifestyle
choices: high fat and sugar diet, immoderate consumption of alcohol,
smoking, etc. The pathologically high cholesterol you have can be a sign of
a extremely poor diet - fat intake over 60 g per day or disease of the
liver - the liver, stores fats, regulates blood cholesterol levels and
synthesises cholesterol. Too high fat intake can cause liver damage (watch
Supersize Me) as can chronic alcohol intake. Keep a close eye on your fat
intake and eat low cholesterol (google low cholesterol foods).
http://www.webmd.com/cholesterol-management/features/checklist-your-low-cholesterol-diet
If you have atherosclerosis then this can be hopefully addressed with a
radical change in diet - throw away the frying pans, increase the vegetables
(vegetarians have the lowest cholesterol levels) and decreasing fat intake
to below 30 g per day and ensuring that these are in the form of good
quality oils - olive oil for cooking, walnut oil or linseed oil (refrigerate
the latter two) for salad dressings. No empty calorie snacks: crisps,
biscuits, butter, cakes; no fast foods or deep fried foods, etc. No sodas or
colas or ice cream, etc. Go mediterranean. Reduce salt intake - instead of
salting boiled potatoes use lemon juice in the water. A snack should be a
piece of fruit or soup with bread or some olives or raw carrots/celery/etc.
with a yoghurt and herb dip. It might be very worth your while getting a
referral to a nutritionist. Drinking a glass of water and eating an apple
prior to every meal will reduce the hunger and smaller portions will be
eaten.
Caveat: chronic smoking results in long-term damage to blood vessels (loss
of elasticity) and the formation of atherosclerotic plaques is inevitable.
Here's hoping that you can reverse the process somewhat, although some
degree of damage will remain.
It is noteworthy that young children especially the overweight and obese
kids have atherosclerosis due to very poor diet and the longevity of the
next generation looks as though it is going to be a lot lower than our
generation. I know when I was studying in Scotland aeons ago I used to
shudder when I cycled past the little fat children going to school with a
bag of crisps in one hand and a can of coke in the other - obviously their
breakfast.
You should have had ultrasound of the heart carried out by a cardiologist to
check the state of the arteries and valves. Forget the ECG.
It might be that your doctors have not discussed everything with you and
that atherosclerosis is indeed present together with, for example, hormonal
imbalance or thyroid insufficiency or something else. I advise you to
request all of your medical notes and to go through them several times until
you understand what is going on. Doctors frequently do tests and then don't
address the results or discuss them with patients due to high workload, etc.
The greyness and the general state you were in in Thailand and post-Thailand
reminded me of my dad when he came home one day after climbing up a post
office antenna mast (part of his job) and collapsed into bed. He was 38 at
the time, but lasted another 20 years or so - he was a heavy drinker and
smoker.
Pain is a warning signal and heart pain is a warning signal that your heart
is distressed. You need to adapt your exercise regime to prevent the heart
pains.
I do not think that pain medication is a good idea prior to exercise - you
are masking the warning signals that the heart is sending to you to indicate
that it is in distress. This will likely result in you having a massive
heart attack, because there will be no warning signals as the pain will be
masked. You would be better off sticking to (light power) walking, jogging
(only if no pain), cycling or swimming and no pain killers until your
doctors have given you a diagnosis and the appropriate treatment and you
have done your bit.
You must be careful on Buscopan - it is contraindicated with (severe)
ulcerative colitis due to the risk of intestinal bleeding. If your UC flares
severely you should not use Buscopan. Don't take your Nexium and Buscopan
together - leave at least 3 hours between them
http://www.drugs.com/cons/buscopan.html
Nexium can cause stomach pain, joint and muscle pain, and tightness of the
chest http://www.drugs.com/cons/buscopan.html I had to stop Nexium and move
on to Pantaprazole and then, due to my new doctor's budget constraints,
Omeprazole because the side-effects were so bad.
Look up the side-effects of Propranolol (aka Bedranol) here:
http://www.drugs.com/pdr/propranolol-hydrochloride.html It would appear to
be contraindicated with your low blood pressure and pulse. However, the
latter might stabilise if you drink enough and it will do virtually the same
job as the Valium, but it is more geared up to heart problems. If your
doctor wants to prescribe you heart medication then it sounds to me as
though you do have a heart problem - ask for copies of your medical files.
I though that my pulse was low at 60. Are you drinking enough? You should be
drinking at least 2 litres water/herbal per day, excluding coffee and black
tea - herbal teas will help the mineral balance in the body. Dehydration can
cause AP.
I have had angina twice - once in hospital due to post-anaesthesia oedema
and once in the middle of the night due to severe dehydration. I was also
very ill with Crohn's in 1992-1994 where the doctors did not give me the
correct treatment. I now have insufficiency of the mitral, tricuspid and
aortal valves as a result of the chronic infection - massive abdominal
abscess, which took two major operations to get rid of. Full anesthesia
causes heart fibrillation and discomfort because of the heart failure, and
because I am chemically supersensitive. The anaesthetist, warned of this,
just send me straight to the intensive care station and hook me up - ready
for the crash team to come running. Nearly everyone over 40 has some degree
of atherosclerosis - I have some on my damaged heart valves.
Have you been checked for aortic or other aneurysm? An aneurysm is unlikely,
but if you do have a detectable aneurysm you should not be exercising at
all. http://www.nhlbi.nih.gov/health/dci/Diseases/arm/arm_signs.html
Infection
Have you had some sort of pericarditis in the past (Thailand?) due to an
infection - food poisoning? Please note that, if your teeth are in bad shape
any (chronic) infection in the mouth can potentially lead to pericarditis.
Fibromyalgia and co. are thought to start off with an infection. Chronic
infection can cause a myriad of problems and it might be that a virus rather
than a bacterium the cause of the problem because viruses can transport
themselves easily in the nervous system and are more difficult to test for.
A definite diagnosis of fibromyalgia is usually given by a rheumatologist.
However, fatigue, malaise and abdominal discomfort/pains are associated with
Gilbert's Syndrome
http://www.mayoclinic.com/print/gilberts-syndrome/DS00743/METHOD=print&DSECTION=all
http://www.gilbertssyndrome.org.uk/What%20is%20Gilbert%27s%20Syndrome.html
Herpes Zoster (chickenpox) can cause severe gastrointestinal problems and
tingling within the body due to infection of nerve cells as can many other
infections.
Have you a history of Herpes simplex infection or another STD? You don't
need to answer that ;-) But, it might be something you need to consider and
address because many STDs can infect silently and cause chronic inflammation
and pain. http://www.arthritis-treatment-and-relief.com/std-joint-pain.html
Hormone imbalance
The prostrate problems could be causing a homone imbalance and this could be
the reason for the poor temperature control. However, night shivers could
also be indicative of ongoing infection or thyroid problems. I suggest a
trip to your urologist and ask him to check your hormone levels. I suggest
that your thyroid should also be checked. BUT, low temperature has also been
associated with Gilbert's syndrome http://www.gilbertssyndrome.com/
However, the only way to measure your internal temperature is rectally or
using the high-tech ear gadget at the doc's and under the tongue will always
read lower. Mine is also around 35.5 even when I have my menopausal hot
flashes.
Communicating with doctors
Firstly, get your hands on all of your medical notes and take over the
management of your health - don't leave everything to the doctors - believe
you me it does not work.
Another tip is to prepare for the doctors' appointments by writing down your
current symptoms, current medication and any OTC (over the counter)
self-treatments including supplements. Use bullet points and tick each item
as you have discussed it. I have incorporated everything into a health CV -
with a chronology of illnesses with date, symptoms, diagnosis/es, in or
outpatient, operations (numbered 1 to 9 in my case) at the end - it is now 4
pages, but it means I have everything with me including health insurance
details, diagnoses, allergies/intolerances, blood group, and who to contact
in an emergency, etc. Use the pain scale where 0 is none and 10 is
excrutiating, morphine-requiring pain to convince the doctors of the
severity of the pain. Doctors respond well to numbers and paper - they then
don't need to try and get sense out of patients who can't articulate because
they are too ill.
Keeping a patient pain/food/medication/activities diary (plenty of examples
on the internet:
http://office.microsoft.com/en-us/templates/TC060894201033.aspx
http://www.balancedweightmanagement.com/DiaryTemplates.htm ) can be a good
tool to keep tabs on what is happening to you and whether or not certain
foods or activities are making you feel worse. Start calorie counting and
reduce the fat in your diet.
If you are scientifically inclined you could start plotting your:
minimum/maximum daily pain levels, hours of exercise, BMI, cholesterol
levels, calorie intake, etc., in Excel. Doctors really love this kind of
thing and it is good for the patient too - helps compliance and tracks
achievement leading to incremental success stories. Set yourself realistic
targets and stick to them. I tabulated and plotted all my blood results in
various Excel graphs (organ based: liver, blood, kidneys, hormones, etc.)
and proved to my doctor that the long-term chemotherapy was just making me
very sick - after one year chronic drug-induced hepatitis, acute
pancreatitis, suspected multiple infections and finally after two years
leukopaenia - and not addressing my Crohn's disease, which is why I stopped
the treatment in December and rang the practice to let them know that I had
done so and then set up an appointment with my internist (also my GP) to
discuss my long-term blood values. He requested that I gave him the Excel
table to look through - my printouts were not very good - I reckon he wanted
to see how I had done it, but I was very pleased that he was interested and
he took my point that the medication was not working for me.
You have some serious work ahead of you to squeeze a diagnosis out of the
doctors. In the meantime I have highlighted above lots of basic lifestyle
changes you can make to reduce your symptoms and improve your health.
When you have eliminated GERD as a cause of your heart symptoms then, one
can safely say that you have a serious health condition with multimorbidity
(multiple diseases). If this is the case then you are at high risk of a
massive heart attack especially if you continue to do high stress/impact
sport using pain killers to mask the heart pains that you have. Changing
your diet radically, counting calories, modifying your sport's regime to a
gentler one until the doctors have given you a diagnosis with appropriate
medication, and losing 10 to 20 kg over the next six months or so will
improve your chances considerably.
Use the internet to do more research and get a handle on what is happening
to you. Some good sources of literature include: www.webmd.com ,
www.pubmed.com , www.medscape.com
For side-effects of medication and drug interactions see www.drugs.com and
www.rxlist.com
Good luck.
Vanny
Post by PaulgregoryHi, I am male, 48yrs old 14 stone 5"10. A few years ago I started with
severe sharp chest pains.I had a endoscopy and it was put down to Acid
Reflux for which I take Nexium daily.(I have never had burning
sensations!) I used to run 2 miles every other day.I passed no problem a
ECG stress test. In January last year on my 5th week in Thailand after too
much smoking,boozing and dancing (I had just finished some really hard
dancing and was wet through with sweat and started with sharp severe chest
pains). Mainly at the sternum and and just to the right of the left nipple
and a pain under the left armpit muscle like I was being squeezed with
pliers
Back in England I quit smoking and drinking for good.The pains continued
and I became very ill to the point that I was so fatiuged that I could not
talk without being out of breath and going grey.I could not climb the
stairs to go to the toilet.Severe pain hit me just about everywhere in my
body, severe symptoms of IBS clay coloured stools, diahorea, constipation
etc. I had Ultrasound scan in the gallbladder area, chest xray to no avail
other than blood tests showed I had inflamation in my body (Creactive
Protein) and my cholesterol was high. Total cholesterol was 6.4 and good
cholesterol 0.85.I have lost count of the number of times I have been in a
ambulance to A and E with severe chest pains.
I have had numerous ECG's all ok. Fibromalgia and Chronic Fatigue Syndrome
was mentioned quite a lot.
Since that time I have slowly got better.
The current situation is that after nearly a year of vegatating on the
couch (I was frightened of doing anything physical that brought the pain
back, which it did) I have now decided to bite the bullet and get my body
back.
Everday for the last week I have power walked for two miles in 30
minutes.(I used to run the same strech)
I take 30 mg codeine 45 mins before I start to dull the chest pains.
I hope that the exercise will sort things out and the pains will go away.
The other problem is that a few months ago I started experiencing what can
only be described as a heart shivering/vibration.
Like a cat purring in your chest, or a tens machine turned upto to full
stuck in your chest. it has now progressed to my left leg. 2 Buscapan four
times a day used to sort it out but the vibration got worse to the point
that the Buscapan was not working, so now I know when the vibration starts
as I become aware of feeling ill and then I realise the vibration is there
in my heart area.I take 5mg of valium and that sorts it.
If it does not, then I take another 5mg which tends to do the trick.
This happens twice a day
My doctor prescribed Thiamin (B1) and strong B vitamin complex. It does
not make a difference.
The doctor now wants me to take bedranol SR 80mg per day but if as he says
my heart is fine why should I take them.
My doctor can not explain the vibration. I have scoured the internet and
found quite a lot of people with this vibration problem, but no one has a
clue as to what causes it.
I have tried to ride the vibration out but I end up getting pains in the
upper back and the vibration gets so strong in the heart area it feels
dangerous to let it continue.Turbulence in the heart area is one way of
describing the vibration.
I have even tried drinking a full bottle of wine to stop the vibration
just in case it was stress but it did not make a difference.
Sorry about the length of this email but I am at my wits end now and need
to sort it all out
I have Gilberts Syndrome, Ulcerative Collitis and Benign Prostate Growth.
I take no medication for the above as I suffer no ill effects from the
above.
I was thinking of paying private for a echo cardiograph to put my mind at
rest as I understand that ECG only check the electrical systems of the
heart. If the vibration was somewhere else there would be no problem but
It freaks me out with it being in the heart area along with the chest pain
My resting blood pressure is 112/73
Pulse 54
The only thing that I have noticed is that my teperature seems to be on
the low side
I woke up shivering at 6am last week and my temp was 34.1
during the day its about 35
Any advice suggestions.
Thanks in advance.