My new autonomic cardiologist wants to hospitalize me for tests!!!

Gingergrrl

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@Kati I get the sense that our symptoms and illnesses are very similar and I also take a low dose of Atenolol which has been very helpful for me.

Believe it or not, I almost left the hospital AMA tonight after having a horrible reaction to Midodrine and calling the nurses station for over half hour for help but no one came. My HR was 124 on my HR monitor and I felt hot, facial flushing, prickly, and thought I could fall if I went to bathroom on my own.

The nurse dismissed my reaction and told me that I needed to take the second Midodrine or I would be discharged by Dr C. He had however told me that if I had a bad reaction, we would talk about it and it is ultimately my choice.

The nurse then came back and told me I could take a Xanax. I declined and told her that I did not need a Xanax and that it would in fact be dangerous to mix Xanax with the sleep meds that I already took. I don't know why this nurse so intensely disliked me and the nurse I have tonight is lovely and told me it was good that I advocated for myself.

I realized if I left AMA then nothing would be covered by my insurance so I stuck it out but I was fuming and I wish there was a way she could have understood how truly ill I am and how taxing it has been to have all these invasive tests back to back with little sleep or food. The ACTH stim test was stimulating for me and then taking Midodrine back to back was to much for my system.
 
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Gingergrrl

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@Aileen that's what I thought but it turned out not to be the case. Patients have rights no matter how ill they are and I learned from the awesome night nurse that the day nurse had written that I refused a pulmonary test which was blatantly untrue! I guess there is always one bad apple in the bunch and I can't let it detour me but I was really close :mad:.
 

Kati

Patient in training
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Sleep well @Gingergrrl , I am crossing my fingers and toes for a better day tomorrow.
(If it's too noisy, ask for earplugs they should have them.)
 

MeSci

ME/CFS since 1995; activity level 6?
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One feels so vulnerable in hospital - isolated, often tired and hungry, and at the mercy of people who often wield their authority in unacceptable ways.

I liked the message about your cardio asking if you were still friends! That demonstrated some humility, compassion and self-awareness which is often lacking in health staff. He had probably been upset by something else not related to you. Maybe one of his patients had died - this upsets health staff.

Hospitals can be horribly noisy. I included reference to unnecessary and unbearable noise in a long complaint about my last hospital stay. There were multiple different bleeps/alarms all going off at the same time, sometimes one stopping and another starting, and I was in an isolation room where they were especially loud. I sometimes had to open my door and stand outside the room, and actually felt like throwing myself out of the window as the experience was amounting to torture. I seriously felt like discharging myself before I went mad. I heard a patient in another ward complaining and she told me that one of the alarms was on a TV, and I later found that one was on my bed - it went off every time I tried to adjust it! I asked for earplugs but was told they didn't stock them...I tried burying my head in pillows but they stank of artificial perfume, to which I am very sensitive.

Hang on in there - not long to go!
 

zzz

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Ah @Gingergrrl, you manage to cram more into a day than I do into an entire week. And I bet it feels that way, too, even on a "quiet" day.

You write very well, though. You should at least write a book and make some money from all this. You'd help publicize the cause in the process.
@zzz I just wanted to clarify that I am not having an angiogram or heart biopsy or anything like that and I think my former posts must have been unclear!

No; looking back, your posts were quite clear. But their clarity didn't manage to penetrate my brain fog.

I knew you had mentioned an angiogram on a number of occasions. But when I went back and looked, it was always a CT angiogram! That makes perfect sense, of course, as that's far simpler than a traditional angiogram, and completely noninvasive. But that means that your CFS doctor's request for an endomyocardial biopsy would have required a separate procedure, including catheterization. That would explain why your cardiologist was so opposed to it.
I've seen a couple of references to viruses in the conduction system, but these references were describing how the viruses used the conduction system to get to the heart muscle, where they made their home. I've seen no reports of viruses causing trouble in the conduction system itself.

Viruses are a well known trigger for POTS, which of cause is a type of dysautonomia in which body has trouble controling things like heart and other essential functions.

This is true, but these functions are controlled by the hypothalamus, which would make a viral infection of the brain more likely in such cases. Unfortunately, even once the virus is eradicated, the dysautonomia may remain. At least it can be treated.
My cardio promised me I could take my own meds, I could start with low doses, I would have a chance to ask questions and none of this turned out to be true. He promises anything in the moment but then never confers with the nurses and then they blame me.

I think that part of the problem may be that as your cardiologist is the top cardio doc at the hospital, he often gets called to emergencies, urgent meetings, etc. I would guess that he fully intended to talk with the nurses but that something unexpected came up, and he didn't get a chance.
He was abrupt with me this morning (maybe the nurses said I was a bad patient)

More likely, he had other problems coming up in other areas, and these may have affected his mood. This would also explain why he didn't have much time to talk with you at this point.
I tried to ask questions re: Midodrine b/c I thought it was one option of many but he was adamant that this was the plan and got frustrated with me.

Midodrine was a very reasonable drug to try, and he knew that; that was extremely basic for him. But it sounds like he just didn't have the time to discuss everything with you, especially with something that was so obvious to him.
He had promised to speak with Dr K but now doesn't seem interested.

Now that I understand that you had your angiogram done as part of your CT scan, I can see why he would not want to do that biopsy. He seems to be clearly running short on time here due to his other duties, and I can see why he would think that there wasn't any real point in talking to Dr. K, at least now. It wasn't going to change anything, and he just didn't have the time.
I felt really coerced into taking Midodrine and I know some of you guys take it and are fine but I didn't like feeling coerced. I had such a life altering reaction to Levaquin that it is very hard for me to trust doctors. I feel like I am now labeled as the crazy & difficult CFS patient here and just want to go home. :cry:

Levaquin is an unusually toxic drug. Midodrine is rather benign; about the worst reaction you get from it (assuming you take the prescribed dose) is what you experienced. Even the two people known to have taken major overdoses of it were treated and were fine the next day.

But how do you know that? As you found out with Levaquin, you can't trust your doctor to always tell you the side effects, or even to know what they are. (For an example of how a clueless doctor recently may have almost killed a forum member (who fortunately didn't follow her advice), see the thread Antibiotics: complete the round or stop?)

As I have a lot of drug sensitivities, I found out long ago that the only way to make completely sure that a drug was safe for me was to check it out myself. This also had the advantage that I didn't have to bother the doctors or other medical staff. In the old days, I would just look up the drug in the PDR. These days, I just type the drug name followed by the phrase "prescribing information" into Google. Either the manufacturer of the drug will have a link to the prescribing information, often ending up at a PDF file, or else (especially for older drugs) you'll end up at Drugs.com, which has this information as well. It's important not to get sidetracked by the patient information, as this is incomplete. And if you're asked whether you're a patient or a medical professional, you need to choose "medical professional" - otherwise you'll get the patient info.

I think that this could be helpful for many ME/CFS patients to do. It means learning enough medicine to read the prescribing information, but based on the medical knowledge I see on this forum, that shouldn't be a problem. It also means learning what type of side effects you tend to be sensitive to, and what type you don't. And if you have any questions, then you ask your doctor. But this should save you and him (or her) a lot of time, and make taking new medications a lot less risky.

You can even do this when you have no source of data available. For example, once I ended up in an ER for the second time in a few days with the same case of drug-resistant pneumonia that kept getting worse. When I walked in the door, they took one look at me, put me in a wheelchair, rushed me through admitting, and into a patient room. It's the only time I've seen ER staff look worried. They started getting the IV ready, and I asked what antibiotic they were going to use. They told me the name, and I recognized it as a cephalosporin, but I had never taken a cephalosporin, and I'm very sensitive to antibiotics. So I asked for a PDR.

They looked puzzled for a moment, but then they produced a PDR. I spent a couple of minutes finding the drug and reading its description (which was a little difficult with a fever of 103). It looked quite reasonable, so I closed the book, looked up at them, and said, "OK, let's go!" And we did, and I was fine.
My cardio does not prescribe mag shots or use Taurine. He prefers mag IV's and said I will get another saline/mag IV today and they take 5-6 hours (not sure why?!!!). I am going to ask my ND if she does those shots. It turns out my mag & potassium are really low even though I already supplement with both!

Yes, under the circumstances, going through your naturopath seems the best thing to do. Either that, or asking Dr. K, as @Sushi suggested. For best results, you should do these shots daily for at least the first few weeks. Then you can try backing off to a few times a week, and see if that's OK, or whether you prefer it on a daily basis.
You could ask Dr. K for a prescription? It isn't an unusual thing for ME/CFS patient to get these shots. I think Dr. Cheney prescribed them routinely for his patients.

Yes; the schedule I mentioned above is what Dr. Cheney used. Drs. Myhill and Enlander also recommend these injections routinely. Dr. Myhill has explained that most people can't get enough magnesium from supplements because magnesium does not penetrate the gut very well. I know that I had a severe magnesium deficiency even while taking a lot of supplements. Magnesium and potassium are linked, so @Gingergrrl, your low magnesium drags down your potassium levels. Once you start getting magnesium injections, your body will be able to use your supplemental potassium (which it will need).

Dr. Cheney's formula for the injections seems to be the best tolerated (i.e., the most painless) from what I've heard. I've posted it before, but for convenience, I'll post it here again:
Many patients benefit from magnesium injections, which are virtually painless with the addition of taurine. The Magnesium used by most is Magnesium Sulfate—standard 50% solution—1/2 cc drawn into the syringe first, followed by 1 1/2 cc's of Taurine. The Taurine is compounded at 50 mg/cc. The taurine makes the injection virtually painless and the ratio eliminates the hard knots many are familiar with. The injection is intramuscular, given in upper, outer quadrant of either buttock. Both require scripts from a doctor.

Dr. Myhill mentions that you can also give yourself this injection subQ, generally in the abdominal area, or the side of your thigh. If you do, it's important to massage the injection site afterwards a bit so that the solution gets distributed around somewhat.
I also got agitated from the ACTH stuff that they injected into my IV although not to the level of the over methylation incident. My body just does not process things well that normal adults can process.

Low to moderate side effects from this injection are common.
I definitely have tons of trauma from past physicians which clouds my current interactions (as I know everyone on this board has, too.). My cardio came back and took my hand and said jokingly, "Are we still friends?" and I said, "of course" and then we were able to talk about the Midodrine a bit more.

I agree with @MeSci that this is a very good sign. These guys are under tremendous pressure, especially cardiologists, as they routinely deal with life and death issues. So it's really doubtful that his original reaction had to do with you.
Hi @Gingergrrl the symptoms you are describing are very similar (if not exactly like) what I have experienced in the early years of my illness. Occasionally I will have SOB, but It's unusual, possibly because I have learnt to avoid the offending activities, and possibly due to the low dose atenolol I have been on.

The same goes for me too. I had much more SOB in the early years than I do now. I remember once staggering into my doctor's office,on the second floor sitting down, and huffing and puffing for about 20 minutes. I thought, "Wow! That one flight of stairs was way too much!"

Then I remembered I had taken the elevator.

But those were the early days; it's never that bad now. There are several simple things you can do to relieve dyspnea symptoms; I'll get to them in another post, as it's getting late here.

Many specialists think that this illness goes through stages over the years. That seems to be my experience.
Believe it or not, I almost left the hospital AMA tonight after having a horrible reaction to Midodrine and calling the nurses station for over half hour for help but no one came. My HR was 124 on my HR monitor and I felt hot, facial flushing, prickly, and thought I could fall if I went to bathroom on my own.

The nurse dismissed my reaction and told me that I needed to take the second Midodrine or I would be discharged by Dr C.

This is crazy. You don't need to be a medical professional to know that if someone's having a bad drug reaction, you don't give them more of that same drug.

That's one dangerous nurse.
I realized if I left AMA then nothing would be covered by my insurance...

That's one of those widely-believed myths that just isn't true. See this article for details.

However, leaving AMA could easily have damaged your relationship with your cardiologist. Remember what he had to go through to get you into the place? So I'm glad you stuck it out.

Soon you'll be home, and I'm sure you'll be very glad to be there. Take care, and rest up well.
 

xchocoholic

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Yikes. Sorry to hear you had a bad reaction to Midodrine. I didn't realize they wanted you to start the Midodrine right away.
I thought you said you were going to start that on Monday.

I'm not a doctor but I have problems with meds and chemicals and that doesn't sound safe to me based on everything else you've had over the last couple of days.

My bp has been lower than that many times and salt loading brought it up. I actually have to salt load daily to keep mine up. Any salt works for me.

To bring it up quickly I allow salt to slowly dissolve on my tongue and drink water after it's dissolved. Going too fast upsets my stomach. 1/4 tsp has 5-600 mg of sodium. I slowly ingest appr 1/8 tsp at a time up to 1 tsp until I feel better. It takes me about 20-30 minutes to get a full tsp. If you do this go very slow. I've been doing this since 2007, so I know how I react but you may react differently.

Good to hear the pushy obnoxious nurse left and you got one who cares about you. Makes you wonder what drugs she's on. I was conned into giving my pain meds to a drug addicted nurse once. Duh ! I'd be sure to report her behavior to your doctor. So far from what I've seen head nurses aren't interested in hearing feedback from patients.

Good to hear you're thinking clearly enough to advocate for yourself. Hang in there. X
 
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taniaaust1

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@WillowJ I definitely do not have asthma and have been assessed for this before. I have zero coughing, wheezing, congestion, etc. when I say "short of breath" it is a feeling of breathlessness as if I had run up several flights of stairs and it takes a good ten minutes at least to catch my breath back.

The worst is when I am walking and carrying something at the same time or when I lift my arms over my head such as to use a hair dryer or get a plate from the cabinet. .

Ive heard many people with POTS say stairs are bad causing breathlessness (of cause they are bad too with ME weakness and balance issues). Lifting arms above the head causing symptoms, is actually one of the common POTS triggers. I still wonder if your test also showed POTS as well. I hope you get a report on what your test showed.

If POTS did show up too, the most commonly drug for that is florinef . Florinef helps by increasing blood volume (it can have a side affect of raising blood pressure) but in your case that wouldn't have been prescribed for you due to your low potassium as florinef can commonly lower potassium so needs to be watched with this. So that is one drug your doctors wont be using for your case.

Somewhere online there is a great list of all the drugs used for the various forms of dysautonomia. If I come across it again, I'll give you the link as by that info you probably will understand more why your doctor suggested trialing the Midodrine over others.

I hope things sort out for you soon. Your hospital experience is unfortunately all too common in ME/cfs... I sooo hate having to go to hospital as the chances I'll hit a bad nurse, a bad doctor or a bad ambulance person, I rate at about 90% based on my many hospitals experiences.
A good hospital experience for those with this illness, is a rare thing
 
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xchocoholic

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Arm weakness is a common feature of gluten ataxia. I used to have to rest my arms several times when washing my hair. Heavy legs are too. I don't understand it but Dr Hadjivassiliou explains this. Tc .. x
 

MeSci

ME/CFS since 1995; activity level 6?
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Arm weakness is a common feature of gluten ataxia. I used to have to rest my arms several times when washing my hair. Heavy legs are too. I don't understand it but Dr Hadjivassiliou explains this. Tc .. x

That's interesting. Arm weakness was one of my first symptoms, but I don't get it much at all now, having given up gluten over 2 years ago.
 

Valentijn

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@Gingergrrl - Most of my experiences with nurses have been very positive, but that's here in the Netherlands where they aren't over-worked and actually enjoy their jobs. Some nurses can be quite sociopathic, however. I think a couple years ago there was a "Nurse K" from a major hospital in Montana who was posting absolutely horrible things about fibromyalgia and CFS patients on her blog, with a lot of encouragement from several other anonymous nurses.

Basically there are some nurses who think anyone with an "invisible" chronic disease is a drug-seeking melodramatic attention whore, and treats them accordingly. They seem to divide patients into those who are deserving of treatment and those who aren't. But that divide is based 100% on their own prejudices and ignorance, and has nothing to do with the reality of whatever is afflicting the patient.

That nurse sounds like she was a bad apple, and I'm glad the other nurses are being nice.
 

Sushi

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zzz said:

Midodrine is rather benign; about the worst reaction you get from it (assuming you take the prescribed dose) is what you experienced. Even the two people known to have taken major overdoses of it were treated and were fine the next day.

From my experience, I can't quite agree with that. I used to spend a lot of time on dysautonomia boards and a number of people had life-threatening reactions to midodrine--including me. It is very safe for most but then for those who react to it, it is quite unsafe.

BTW @Gingergrrl, after two weeks of taking midodrine with no problems, I felt dizzy after my morning dose, but didn't connect to to midodrine, so took my second dose (I was on a very low dose, twice a day). The next 6 or 8 hours were really hell until it was out of my system. I had the phone in my hand the whole time debating: "Should I call 911?" At that time ER's = very bad experiences in my mind, so I didn't make the call. Nowadays, I would.

My autonomic doc told me to never take it again. I don't know if the nurse was trying to get you to take a second dose while you were still reacting to the first, but if so, good going for refusing.

Sushi
 

Gingergrrl

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@Sushi I can't type much now b/c I have an IV in my right hand and hard to bend it. After some drama w/ the nurse from hell all is resolved and I still love my cardio and the other nurses.

I am trying Midodrine again today in the hospital and was curious what dose you took? I am attempting to do 2.5 mg 2/x day. So far my BP is 90/52 so it hasn't raised it too much!

What symptoms did you have when you almost called 911? You mentioned dizziness but curious what else? Yesterday about 2-3 hours after dose, my entire body felt hot and face flushed, I got shaky and my HR went up to 124. I felt very uncomfortable and agitated.

I can deal with just about any side effect but tachycardia and agitation. My BP was still low so that was not the issue.

Would love to hear more about your experience! Did you feel a prickly sensation like things crawling on your skin and scalp?

ETA: two of my best friends are coming to visit me later this afternoon in hospital so hoping I am okay from the Midodrine at that point! They do not have CFS but both deal with chronic illness as one has epilepsy and the other has Lupus and very compassionate & understanding.
 
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Sushi

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@Sushi
I am trying Midodrine again today in the hospital and was curious what dose you took? I am attempting to do 2.5 mg 2/x day. So far my BP is 90/52 so it hasn't raised it too much!

What symptoms did you have when you almost called 911? You mentioned dizziness but curious what else? Yesterday about 2-3 hours after dose, my entire body felt hot and face flushed, I got shaky and my HR went up to 124. I felt very uncomfortable and agitated....
Would love to hear more about your experience! Did you feel a prickly sensation like things crawling on your skin and scalp?
...

Prickly bugs crawling on your scalp is a typical midodrine reaction--most everyone gets it and it never goes away. You get used to it! :oops:

I was taking 2.5 mg twice a day. My midodrine experience was in 2006 so some of the details are fuzzy, but yes, extremely agitated, flushed, felt like my head was about to explode (I didn't have a BP monitor then but I'd guess this was high BP), chest pain.... I don't remember what my pulse did. Basically I felt like I was about to keel over and die. It is hard to describe after so many years. I knew what the half-life was, so I decided to wait it out. But I did keep the door unlocked in case I decided to call 911.

Midodrine has a relatively short half life so it wouldn't be affecting your BP this long after taking it. As I remember it takes about an hour to kick in so they try to time the doses so that the next one kicks in before that last one wears off. You are not supposed to lie down (so they say:cool:) while on midodrine, so if you are taking it in a hospital bed, try to sit up and move around as much as you can--could you try walking?

The weird thing was that I had taken it for 2 weeks with good results--I could walk almost normally. So it was a disappointment that I couldn't take it. My doc did find another drug that worked wonderfully though, and after the initial bumpy run-in period, gave me no side effects.

While the TTT can point to certain drugs as likely candidates, but we all respond differently so there is a lot of "try and see" with most experiments not going too well. My autonomic doc also favored a low-dose cocktail of several meds rather than a higher dose of one med.

Hope today's experiment goes better! :)

Sushi
 

Gingergrrl

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@Sushi thank you and so far I am tolerating the Midodrine today. I cannot leave the bed b/c I am attached to an IV but I have the bed propped up to sit instead of lie down. Unless something changes I am supposed to go home tomorrow (Mon.)

Does posting on PR from the hospital with an IV in your right hand causing pain (but doing it anyway) count as an addiction? :D
 

Kati

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@Sushi thank you and so far I am tolerating the Midodrine today. I cannot leave the bed b/c I am attached to an IV but I have the bed propped up to sit instead of lie down. Unless something changes I am supposed to go home tomorrow (Mon.)

Does posting on PR from the hospital with an IV in your right hand causing pain (but doing it anyway) count as an addiction? :D

@Gingergrrl you can leave the bed with an IV! Is your IV pole on wheels? If you have an electric pump on it just disconnect from the wall.
 

Sushi

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@Sushi thank you and so far I am tolerating the Midodrine today. I cannot leave the bed b/c I am attached to an IV but I have the bed propped up to sit instead of lie down. Unless something changes I am supposed to go home tomorrow (Mon.)

Does posting on PR from the hospital with an IV in your right hand causing pain (but doing it anyway) count as an addiction? :D

Yes, you should be able to get up. It is the ultimate test for midodrine, so you might like to try it.

And....
upload_2014-9-21_15-21-40.jpeg


That is a joke! I can relate to it myself.
 
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