Crazy Heart

Several months a go, my husband and I sat down to watch "Crazy Heart," the 2009 musical-drama film starring Jeff Bridges (who went on to win the Academy Award that year for Best Actor) who plays a down-and-out country music singer-songwriter named Bad Blake. Blake tries to turn his life around after beginning a relationship with a young journalist portrayed by Maggie Gyllenhaal. I heart the movie but I especially loved the music. The original music was composed by T-Bone Burnett, Stephen Burton, and Ryan Bingham. Bingham and Burnett received the Academy Award for Best Original Song for co-writing "The Weary Kind," which Bingham also performed.

I have since downloaded "The Weary Kind" on my ipod and the soulful and haunting lyrics move me to tears every time. And although I'm sure the lyrics are all about booze, hard living, and lost dreams, something in it resonates with me. The chorus states:

And this ain't no place for the weary kind
this ain't no place to lose your mind
this ain't no place to fall behind
pick up your crazy heart and give it one more try

So although I've had a particularly rough end to the year with lots of heart palpitations, anxiety, fatigue, and stress, my soul tells me to "pick up my crazy heart and give it one more try."

"When My Heart Finds Christmas"

Harry Connick, Jr. croons this song, "When My Heart Finds Christmas" in his first Christmas album titled by the same name.

I don't know about you but when my heart finds Christmas it does a little palpitation dance. The hustle and the bustle of the season (God forgive me) makes me sort of dread the Christmas season. December and the even more bleak month of January are often hard months for me. And I know I'm not alone. Numerous studies as well as anecdotal evidence from distress centers and crisis workers confirm that there is an increase in both the numbers and severity of calls by depressed and anxious individuals during the holiday season.

The holiday season is often a period of frenetic activity, a time when people are trying to juggle work, an increase in social obligations, shopping, decorating, wrapping, entertaining and staying on budget. All this leads to a rise in both physical and emotional stress. It is also often a time for reflection. A time when others look back and see the losses they incurred--loss of a loved one through death, divorce or separation, loss of a job, or even loss of familiar social environment.

How can we manage the stresses of the season? I found an online article on wikiHow, and although its a bit long-winded, I think it has some good tips on how to beat the holiday blues. And whatever you do this Christmas season, don't start a major kitchen renovation in the middle of Dec. like we're doing this year. When you have to contemplate whether or not to get a tree because you're worried about the remodeling dust, you know you picked the wrong time of year to do it.

How to Sidestep Depression/Anxiety During the Holidays

1) Start early. As the adage “The early bird catches the worm" counsels, getting a head start on your holiday preparations can save you a lot of headaches later on. Gather your family members and quiz them on their favorite foods. Compile a list of your favorite meals, then select the ones that combine the best. Who ever said you can’t have spaghetti for a holiday meal? Do what works for yourself and your family. Reaching a compromise and an agreement early on takes the stress out of last-minute meal planning.

2) Shop ahead. If you have a mile-long list of people to gift this year, consider buying in bulk. Forget buying an individual gift for all your child’s preschool pals. Go to a warehouse which sells things in large quantities and earmark those items for larger groups.

3)** Remember the reason for the season. If you come from a Christian background, remind your children that Christmas is not about Santa Claus alone, but about celebrating Jesus’s birthday. We give and receive gifts as a reminder of his importance in our lives.

4) Manage your children's expectations. It will help prevent an embarrassing outburst on Christmas morning in front of Aunt Sarah when your child fails to get his favorite toy.

5) Make a mailing list. Use your Excel computer application, if you have one, to manage your addresses. Have your children help dig through old Christmas cards to find addresses of long lost friends and relatives. Allow your children to cut up the old Christmas cards to make new ones of their own.

6) Use an Advent calendar. Advent begins on the fourth Sunday before Christmas. In order to help children deal with the anxiety of waiting, wrap little treats for the child to open each day after the beginning of Advent, or use a regluar calendar and put a special sticker on each day as it begins.

7) Get exercise. For those in the Northern Hemisphere, light is a precious commodity. Be sure to get out during your lunch break for a bit of sun exposure. Even on cloudy days, it can revive your spirit and give you the oxygen you require. Shovel snow if it applies to you. (HAAAAAAAA if you live in Texas like I do)

8) Get enough sleep. Have you noticed that when the days are shorter your need for sleep increases? It is a natural response. In a way, our bodies shut down. Honoring your need for rest is as important as ever.

9) Eat vitamin-enriched food. If the sun is weaker in your area, your daily dose of vitamins needs to come from your food intake. Take vitamins and drink fruit tea and lemon to stave off the common cold.

10) Communicate with your partner. Oftentimes, admitting you feel blue is all you need to reach acceptance that things aren’t always perfect.

11) Take time to celebrate with friends, or catch up with people you may not see often. A phone call to distant relatives or friends will brighten both your days.

12) Volunteer in your neighborhood. Helping others often gives a boost to your own spirit, and is a good way to meet new people and build new friendships. Is there a canned food drive? What about gift wrapping for a charity? Maybe a soup kitchen?

13) Celebrate the winter solstice. Mark off the days on your calendar to encourage yourself that a new beginning is right around the corner. Gather with friends to honor this age-old rite of passage into the season of renewal.

14)The winter solstice also marks the fewest number of daylight hours, and that can make getting out of bed difficult in the mornings. To create your own artificial "sunrise" in an otherwise dark bedroom, use a multi-light lamp hooked up to timer. There are other ways to Brighten-up-a-Dark-Room too.

**Something I would like to add to step 3. There is a wonderful movement going on called the Advent Conspiracy. The concept behind this movement is to recreate Christmas whereby we Worship Fully, Spend Less, Give More, and Love All. Check it out if you ever have an empty feeling of missed purpose during Christmas.

Broken Record

Although I was born in 1980, I do have many memories of listening to music on LP records. And with the ballads of Patsy Cline or the rock of Sgt. Pepper's Lonely Hearts Club Band, came the inevitable popping sound as the needle met a scratch mark. If the needle jumped outward to the groove it just finished playing, it would repeat in an infinite loop, serving as the simile for things that continuously repeat ("like a broken record"). Sometimes I feel like my heart palpitations are like this "broken record." It's like for whatever reason, the pacemaker hits a groove and gets stuck. So my heart will be dancing in a perfect beat, and then the stressors of life scratch my vinyl heart. The pacemaker tries to make up for the missed beats and jumps ahead. And if I don't relax, my heart will start skipping in an infinite loop. Then I get up and take action (just like I did when I had to pick up the record player's needle and manually move it forward) such as deep breathing or a brisk walk, and then my heart goes back to its steady beat.

Cold & Flu Season

I know every time I'm coming down with something because along with congestion and fatigue, I start to get heart palpitations. When my body is run down, I get the dance in my heart. And I'm not going to lie. It sucks. Not only do I feel crummy but on top of it, I have to deal with accepting my heart palpitations. And not surprisingly, they always feel worse when I'm sick. When you just want to sleep and your heart goes into the dance, it's extremely frustrating. Of course, the key is to prevent colds and flu from even happening in the first place. I try to wash my hands often but with a small child it's hard to avoid everything she brings home. And I always get my flu shot but I know that's not fool proof either. If I do start to feel ill, I know I should start taking care of myself immediately. That means plenty of rest, drinking liquids, and using some alternative healing techniques such as massage, saline solution, hot baths, etc. I definitely do not recommend taking cold/flu medications that contain pseudoephedrine to anyone that experiences heart arrhythmia. Decongestants are known to cause heart palpitations and high blood pressure. Sudafed and Benadryl make me feel like I'm on Speed (not that I've ever tried an Amphetamine but I'd imagine it to feel that way). Some cold medications, such as Coricidin HBP, don't contain decongestants. However, these medications may contain other powerful drugs, like dextromethorphan (DXM), that can be dangerous if you take too much. Follow the dosing instructions carefully. I'm a staunch believer in the Neti pot and Vick's VapoRub.

I got sick last week. And to be honest I didn't do such a great job taking care of myself. The first day I started feeling bad, I continued to push it and ran a million errands. By the time I got in bed later in the day, I could tell I had pushed my body too far. I paid the price with some pretty nasty heart palpitations. But I learned, and the next day I canceled all my activities and did as little as I possibly could get away with while still taking care of my child. I felt a lot better.

I hope you stay healthy this Cold and Flu Season. But if you do come down with something, please take care of yourself.

Fear. Keeps us safe or keeps us boring?

This is a great passage I found and wanted to share with you. It's from Donald Miller's book, A Million Miles in a Thousand Years:

The most often repeated commandment in the Bible is "Do not fear." It's in there over two hundred times. That means a couple of things, if you think about it. It means we are going to be afraid, and it means we shouldn't let fear boss us around. Before I realized we were supposed to fight fear, I thought of fear as a subtle suggestion in our subconscious designed to keep us safe, or more important, keep us from getting humiliated. And I guess it serves that purpose. But fear isn't only a guide to keep us safe; it's also a manipulative emotion that can trick us into living a boring life.

So what did Donald Miller do to prevent a boring life from fear? He hiked the Inca Trail to Machu Picchu (an "excruciatingly" difficult trail even for seasoned veterans) despite being overweight and a novice at hiking. But he did it, and he lived to tell the tale.

I know fear has stopped me from doing a lot of things. But sometimes, I say "heck" to fear and do it anyway. My biggest fear hurdle was becoming a mom. And although it's still many years before I reach the summit and let my little girl go, it has been a wonderful journey thus far.

Oldie But Goldie by Dr. Gott

The Nevada Daily (Feb. 18, 1991)

Click on the article to read the full article

'Hungry Heart Syndrome'

Never heard it called this before. But according to a 1974 article appearing in The Ledger, a doctor believed his premature beats (PVCs) were due to his heart being "hungry." Supposedly he noticed his premature heart beats approximately one hour before meals and stopping within 10 to 15 minutes after eating. Thus, he coined the phrase "hungry heart syndrome." Interesting. Never really noticed a strong correlation between PVCs and hunger but I'm sure I've experienced this phenomenon on occasion. I like how he found that eating 6 small meals a day lessened their irregularity (something that is in vogue right now with diets), but that unfortunately he gained 10 pounds. Ha, sort of funny. But good to hear that a doctor actually felt them and didn't say it was all in his head.

Have you ever noticed a correlation between PVCs and hunger?

Hungry Heart Syndrome Article (The Ledger, Feb. 1, 1974)

What I Have in Common with Her Majesty the Queen

What do I have in common with Queen Rania of Jordan? Well, besides the fact that we're both stunning brunettes (insert smiley face), it looks like she suffers from premature ventricular contractions just like me. Imagine, a royal queen suffers from these annoying irregular heart beats. It's not just a commoners disease. On a serious note, Queen Rania had a non-surgical heart procedure at the end of Sept. in an attempt to normalize her heart's rhythm. Although the article doesn't specifically go into detail about the procedure, it sounds like it was an ablation based on the description.

Jordan's Queen Rania undergoes treatment for irregular heart rhythm

It sounds like she is recovering and doing well. May she live happily ever after.

Yoga is Not a Religion

Just thought I would address this issue and nip it in the bud since I talk a lot about meditation/yoga helping ease the symptoms of anxiety and heart palpitations.

A friend recently sent me a link to an ABC news article about a Southern Baptist leader who is calling for Christians to avoid yoga saying that "the meditative discipline is not a Christian pathway to God." And then I got on facebook today and my teenage sister-in-law had written this on her status update: "Some ppl think yoga will send you to hell but I think it brings you to a heavenly bod!"

Oh Lord, give me strength. Here's the article:

Southern Baptist Leader on Yoga: Not Christianity

Besides the utter ignorance of this Baptist leader, I believe this particular individual is spreading fear to many people who might benefit from yoga both physically and spiritually. We all know the benefits of yoga physically (flexibility, strength, posture, heart health), but it can also have great spiritual benefits. But let's be clear spirituality is different than religion. Spirituality has to do with one's inner life, the ever-evolving understanding of one's self and one's place in the cosmos—what Viktor Frankl called humankind's "search for meaning." Religion, on the other hand, can be seen as spirituality's external counterpart, the organizational structure we give to our individual and collective spiritual processes: the rituals, doctrines, prayers, chants, and ceremonies, and the congregations that come together to share them. Yoga was rejected by Hinduism because yoga would not insist that God exists. It didn't say there was no God but just wouldn't insist there was. Yoga is not a religion, but the science of religions. Yoga demands discrimination rather than faith. Where most religions teach us 'what to do', Yoga teaches us 'how to be'.

And what do some of the great yogis think?

Swami Sivananda Saraswati: "Yoga is not a religion, but an aid to the practice of the basic spiritual truths in all religions. Yoga is for all, and is universal."

Georg Feuerstein: [To practice yoga] "You need not believe in anything other than the possibility that you can transform yourself." "...some Yoga practitioners are more religious than others. But Yoga itself is simply a tool for exploring the depth of our human nature, of plumbing the mysteries of the body and the mind.

Shri Ram Sharanam Ashram: “Yoga is not a religion. it is not necessary for you to believe in a certain god or to chant certain hymns. it is spiritual and ancient science, which leads to health in the body, peace in the mind, happiness in the heart and liberation of the soul.”

Pandit Usharbudh Arya: “Yoga is not a religion or a church. It requires no belief in a doctrine, no credo. All yoga philosophy is concerned with the experience of meditation and nothing else. It does not require anyone to adhere to a belief system.”

Osho: “First, yoga is not a religion—remember that. Yoga is not Hindu, it is not Mohammedan. Yoga is a pure science just like mathematics, physics or chemistry. Physics is not Christian, physics is not Buddhist. If Christians have discovered the laws of physics, then too physics is not Christian. It is just accidental that Christians have come to discover the laws of physics. But physics remains just a science. Yoga is a science—it is just an accident that Hindus discovered it. It is not Hindu. It is a pure mathematics of the inner being. So a Mohammedan can be a yogi, a Christian can be a yogi, a Jaina, a Buddhist can be a yogi.”

When I practice yoga, I contemplate the mysteriousness of the Holy Spirit and my eye is towards Jesus in heaven. My meditations are no different than King David's prayers. Yoga renews my spirituality, but it certainly is not my religion.

My Own Happiness Project

Now that I finished reading The Happiness Project (see my previous blog), I've decided to come up with some resolutions of my own. These are things that either brought or currently bring happiness to my life. And since Rubin worked on one resolution per month, I thought I would come up with at least 12. The list is in no particular order.

1) Blog regularly
2) Jog at least 3 times a week
3) Make time for yoga/meditation
4) Be musical (start playing the piano again and singing in the choir)
5) Dance
6) Laugh more
7) Keep 9 to 10 p.m. for my husband Jake
8) Mission/Volunteer
9) Pray
10) Contemplate the Heavens (remember my loved ones)
11) Read novels written in Italian
12) Renovate my kitchen

Do you have resolutions of your own? I would love to hear what some of you do to make yourselves happy! :)

Ruby Slippers

Dorothy: Oh, will you help me? Can you help me?
Glinda: You don't need to be helped any longer. You've always had the power to go back to Kansas.
Dorothy: I have?
Scarecrow: Then why didn't you tell her before?
Glinda: She wouldn't have believed me. She had to learn it for herself.
Scarecrow: What have you learned, Dorothy?
Dorothy: Well, I—I think that it, that it wasn't enough just to want to see Uncle Henry and Auntie Em — and it's that — if I ever go looking for my heart's desire again, I won't look any further than my own backyard. Because if it isn't there, I never really lost it to begin with! Is that right?
Glinda: That's all it is!
Scarecrow: But that's so easy! I should've thought of it for you -
Tin Man: I should have felt it in my heart -
Glinda: No, she had to find it out for herself. Now those magic slippers will take you home in two seconds!
Dorothy: Oh! Toto too?
Glinda: Toto too.
Dorothy: Now?
Glinda: Whenever you wish.
...
Glinda: Then close your eyes and tap your heels together three times. And think to yourself, 'There's no place like home'.


I woke up again in the middle of the night last night. This time I was in an intense dream and woke up to a few heart palpitations. This in turn set about a physiological response and my anxiety levels rose once again. As I started into panic mode, I remembered the lesson of the ruby slippers. Perhaps, I was still on a kick about childhood memories as The Wizard of Oz had been my favorite movie to watch while growing up. I remember we didn't own a VCR back in those days so my dad would sometimes bring the VCR from his work home as a treat. It would take him a good hour to hook it up to the TV and track down a copy of the Wizard of Oz from our local Blockbuster. When it was finally time to watch and we all gathered onto the couch, I felt giddy with excitement as the opening credits rolled onto the screen. I haven't thought a lot about the movie in recent years but last night I couldn't get the dazzling ruby slippers out of my mind. I remembered Glinda telling Dorothy that she "always had the power." And when it comes to dealing with heart palpitations and anxiety, nothing could be truer. I have the power to decide whether or not I'm going to let it bother me. I have the power to accept what ever comes my way. I can choose whether or not I'm going to have a good day or a bad day. I've always had it in me. I don't need anyone else. I hold the power of the magic ruby slippers. And nobody can help me except for me. I have to believe if for myself.

And as a reminder, I'm thinking I might purchase a little reminder such as this cute one from Etsy: Wizard of Oz tile jewelry pendant

Pat the Cat

I've recently been reading The Happiness Project by Gretchen Rubin and although most of the book is pretty general about how to be happy (i.e. get more sleep, exercise, start laughing more, find your interests, etc.), I was struck by the reminder that "regularly having fun is a key factor in having a happy life; people who have fun are twenty times as likely to feel happy." And I wonder when I start experiencing heart palpitations (which are obviously no fun), how much fun had I been having prior to their onset? Most likely, not so much. In fact, if stress is the number one reason for my heart palpitations, how can I de-stress? Be serious about play. As Rubin explored how to have more fun, her friend posed the question to her: "What did you like to do when you were a child? What you enjoyed as a ten-year-old is probably something you'd enjoy now." As I muddled this over in my head, I tried to think of some of the things I liked to do as a ten-year-old. I loved to read books, play with friends, cuddle my cat, dance to music, draw/color, play house, and ride my bike. Some of these things I still do such as reading and obviously "playing" house. But some of these things I haven't done in a long time. When is the last time I put on the Ventures and danced to "Walk, Don't Run"? Last night, I woke up around 1 a.m. I was nervous before I fell asleep because I was afraid I might have another panic attack, and sure enough the anticipatory anxiety woke me up in the middle of the night. As I could feel my anxiety level rise, I thought about what I had enjoyed as a child. I turned myself over in bed so that my head was now at the end of the bed and my feet were on my pillow. My cat Quinn was curled up in a small ball. I started petting him and the sweet sound of his purring soothed my soul. I remembered fondly the days of petting my childhood cat, Midnight. I felt at peace, and it was so wonderful to do something childlike again. Something so simple, but something I had long neglected. I simply got to pet my cat. I fell peacefully asleep to the hum of his tiny motor.

Know Thy Limits or Suffer Thy Consequences

My little girl turned 2 last Sunday, and she is every bit of a toddler. Preparing for her party and then having something to do EVERY evening this past week, wreaked havoc for me last night. I had a panic attack that lasted for hours last night. Yep, you heard me, hours! Usually when I get a panic attack, they last a few minutes but this one was the mother of all panic attacks. For 2 hours, I contemplated going to the hospital. I would breathe well and then forget to breathe and then the panic cycle would start all over again. The reason for all of this panic? Balance. Or lack there of. When I'm feeling well and generally not experiencing heart palpitations, I tend to start taking more things on. I start feeling "normal" again and feel like I can do it all. So I stack up my calendar with one thing after the other, take on more responsibilities, and forget all my important preventative measures (like regular exercise, healthy eating, meditation, etc.). So when I woke up this morning after the horrendous night, I knew what I needed to do to prevent this acute anxiety from returning. Go back to square one. I need to re-examine my life and start finding that much needed balance. I'm off for a walk on this beautiful Fall day in Central Texas. :) And that brings peace to my soul.

A cautionary tale of PVCs in the workplace

Okay, I've been dreading this post. I've wanted to do it for awhile but every time I start to think about it, I hesitate because in some ways I think I'm still traumatized. It's going to be a long post, so if you don't read it all, that's okay. It's more for me. As children start heading off to school this year, a flood of emotions always catch up to me as I relive my first (and only) year of teaching in a public school.

Palpitations have certainly wreaked havoc in my life from time to time, but none more so than 6 years a go when I ventured into a public school classroom and began teaching 2nd grade. Previous to that year, I survived what could only be called a "hellish" student teaching experience. It was not that it was so bad for me, but my good friend who was at the same school as me, was partnered with a horrible mentor. She made her life hell and in turn, I was left shaken by the experience of watching my friend suffer. Trust me, it was bad. But despite warning signs about that school district, I went ahead and signed on as a new teacher in a brand new school. It was in a wealthy neighborhood, and I soon came to find out that most of the mothers' main job was harassing the teachers. Despite constant bombardment from these helicopter moms and a principal who was about the most type A person I've ever met, I muddled through the first semester. 6 months into teaching, I wasn't eating or sleeping well. I remember coming home from school every day and passing out on the couch. I cried every Sunday night. I don't remember seeing my husband that entire first half of the year. But everyone kept telling me that the first year was the hardest and I was doing such a great job. I kept at it. But high levels of stress eventually always catch up and I was about to learn the hard way.

It started when I was driving. I started getting nervous on highways and at red lights. I started having panic attacks on my lunch breaks at school. I weighed in at less than 100 pounds. I remember dreading recess duty because I started having feelings that I might pass out in front of all the children. I attended a teaching conference held in a huge auditorium. I remember having the feeling that I had to get out of the building. I sat there the whole 2 hours in constant fear that I was going to faint if I didn't get out. All of this acute anxiety was new to me. I had some general anxiety before my teaching experience, but never panic attacks. I could feel the world closing in on me. But still I muddled. I began seeing a therapist but looking back I should have been seeing a doctor. I still wonder if I had taken medication if it would have helped.

The real nightmare began in the middle of March. I was teaching math that day and I could feel my heart go whump...whump...whump. Where do you go to take a breather when you are teaching? And as more and more kids needed help with their math assignment, I could feel my anxiety level start to rise. My heart was doing the dance. It was in constant bigeminy. I went next door and got a teacher to look after my class, while I headed down to the nurse's station. At this point, my principal (remember, she's type A) came barging in and wanted to know what the matter was with me. I proceeded to tell her that I've suffered from heart palpitations over the years and it was particularly flared up today. At that point, she FREAKED out! She started telling me about her dad who had heart palpitations and how serious it was. How he almost died. Clearly, not the thing to tell someone when they are experiencing them. Then she starts telling me that she certainly won't let me go back to the classroom and that she was going to call an ambulance. She mumbled something to the effect of "teaching isn't for the faint of heart." Again, I tried to reassure her that I could deal with them and that I was in no danger. But she wouldn't have it. We finally compromised and my husband came and picked me up and took me home. I took a personal leave the following weak.

But when I came back, things hadn't changed. I was just as stressed and anxious and to make matters worse, my principal acted like I had some terrible disease. I remember dropping off some books in the library, and the librarian stopped me and asked me about my panic attacks. How the hell did the librarian know about what had happened to me a couple weeks a go? It seemed like the whole school thought I was some sort of mental freak. I plummeted into a depression. As the heart palpitations became more frequent, I finally had to pull out of school for the rest of the year with just a couple weeks left. My heart broke for my precious 2nd graders who couldn't understand what had happened to their teacher.

I was given a couple weeks to move my stuff out of my classroom. But my principal thought I wasn't acting fast enough and yelled at me on the phone that she was taking charge and moving my stuff out of my classroom herself. I told her she better not touch any of my private stuff. I came up to school with my mom and sister and we started boxing everything up. At one point the vice principal started yelling at my mom that it was a privilege that we were even able to move my stuff out. My mom who has been a teacher for 20+ years, said that she had never been spoken like that in her entire life. He even yelled at her that if she didn't stop arguing with him, he would call the cops. What? Call the cops on a teacher and her mom because we were arguing with them? I was on medical leave and I had every right to get my stuff out of my classroom before the deadline.

What the f*ck? Is that how you treat any human being, especially one diagnosed with MVP, PVCS, panic disorder? If I had had cancer, do you think they would have done the same things to that person? What crime had I committed that they thought they could treat me like that? Up until the time I met my principal in the nurse's office, I had only gotten positive raves. My principal had even watched me do a lesson and said it was one of the best she had ever seen. So where did they get off and treat me like they did? Despite the statistics that one out of five people in a typical office can be expected to suffer from a mental condition, mental illness and the workplace is still considered taboo. Many people fear opening up to their co-workers and supervisors for fear of being stigmatized when they seek help. And in my case and in many others, the fear may be well founded.

How can a workplace combat the myths, lift the stigma and make sure people with mental illness get the treatment they need?

A clear message needs to come from the head of a company and be communicated to every employee. The main point to be made is that the organization has a nondiscriminatory attitude—it sees mental illness as no different from physical illness in terms of how people are treated in the workplace. “A company needs to tell people that, if they ever seek help for mental illness, it won’t be held against them,” says Robert Dinerstein, a law professor at American University in Washington D.C., who focuses on disability issues.

If only I had had that message. :(

Me Day

Everybody needs a day to themselves every once in awhile, especially people that suffer from chronic anxiety and stress related palpitations. After another busy week playing host to my dear sweet sister-in-law, I was ready for a break this weekend. My husband took my young daughter and headed out of town to his parent's house today. That meant I got a Me Day. I started my day by going to get a pedicure with a friend. Then, it was off to the grocery store. Now, that might not sound like too much fun to you, but you have to believe me, it is when you are WITHOUT child. I came home and after fixing me a yummy lunch, I fell asleep for a couple hours. I woke up and decided I wanted to go swimming. Again, swimming is a completely different experience when you aren't worrying about swim diapers and flotation devices. I lounged by the pool and read a good book. I then came home and took a shower. I actually had time to put in a hot oil treatment and scrub my face. I even started singing in the shower--since no one was around to hear it. Now, I'm trying to decide what steamy romance to watch tonight. I could feel my stress level drop every hour today. I'm thankful to my husband for giving me such a wonderful treat.

No palpitations for me today. :)

They're back, and I'm back

My respite from palpitations a couple months a go has given way to a vengeance of them the last couple of weeks. Last Saturday evening, I had the worst case of them I've had in years. I had just laid down to go to sleep when they started to rear their ugly heads. The end of a day seems to be a common trigger for many of my palpitations. I'm not sure if I'm just not feeling them during the day and then when I go lay down, I start to notice them or if they are just they byproduct of a long stressful day. Usually, I believe it's the latter. A couple whumps later, I can tell my anxiety level starts to rise. I start to practice my deep breathing, but then my mind starts to play little tricks on me like "Uh oh, what if they don't stop? What if I start getting more of them? What if I have to go the hospital?" And as soon as that negative anticipatory anxiety starts, I get more and more of them. Pretty soon, I was in bigeminy or trigeminy where I started getting them every other or every third beat. I would exacerbate the condition when I started putting pressure on myself to "beat these pvcs" after all I'm an expert on them now, right??? I continued to deep breathe and then decided I would try talking to my husband for distraction. I started telling him all the things I had on my plate right now and all the stresses and worries I'm dealing with. That helped a lot and before I knew it, a gentle peace enveloped me and I fell asleep. I remember waking up around 3 a.m. in the morning excited that I had gotten some sleep and that the pvc's were no longer bothering me. Every time I'm successful at accepting and dealing with them, I'm encouraged that I do have the power to make them stop. I don't need a magic pill or a doctor to help me through them. I have me. My mind and attitude is my greatest ally.

But even after that successful night of stopping them, palpitations continued to bother me off and on throughout the week. It was the week before my period was to begin, and I firmly believe (although some male doctors won't admit it) that the fluctuating hormones played a role in the abundance of pvc's that I experienced this week. I also went out of town for a week and although vacation can be relaxing, just the change of routine, most likely contributed to them. I got back late yesterday and instead of relaxing and taking it easy I went over to a friend's party. As I was sitting outside in the hot and humid late afternoon sun she handed me a Mexican martini. I knew I was dehydrated and should have been drinking water, but I started to sip on the alcohol anyway. A couple minutes later, whump...whump...whump. My heart was skipping in a dance. We excused ourselves early. I went home and took a shower. They were still bothering me but when I sat up in a meditative pose and started to breathe in and out fully to counts of 3, 4, 5 and they started to diminish. My husband came in and gave me a back massage and once again, I started talking through all my worries. And guess what? The palpitations disappeared after an hour or so. I was able to go to sleep without any trouble and woke up late the next morning feeling refreshed and energized.

Readers Wednesday

This is a call to anyone who reads this blog and would like to share about their own experience with heart palpitations.

How long have you had them?
Do you have any tips for long time sufferers?
What do you do when you get a bad case?

I would looove to hear back from any of you!

Remission

Many people that have chronically suffered with heart palpitations know that for whatever reason sometimes we get a break and don't suffer from them as much. Some people say they had them for several years straight after a stressful event in their lives. Then they go away, only to return many years later. I've never been fortunate not to have been bothered by them for years at a time, but I definitely have weeks and months where I won't have any sensation of them. Right now I'm in my brief remission. It could be because I'm currently taking pretty good care of myself with exercise and healthy eating. Or I could attribute it to finding my groove with motherhood and still finding time to do things I enjoy. Whatever it is, I'm reveling it. I'm accepting this time of remission with joy but not expecting it to continue indefinitely. One day (hopefully not too soon), life is going to throw me a curve ball. And most likely my body will respond with palpitations. But "the dance in my heart" is always a good indicator that I need to slow down and relax. And the cycles of arrhythmia and remission will repeat itself. I have learned to take solace in the knowledge that whatever discomfort I may be feeling, one day soon the palpitations will pass.

Pregnancy and PVCs

Many women have their first episodes of heart palpitations during pregnancy. This is understandable in that the state of pregnancy causes significant shifts in blood volume (which peaks at 28-32 weeks) and also puts a new stress on the heart that may bring out a tendency for rapid heart action that was not manifest prior to pregnancy. The stroke volume of the heart increases and under the influence of progesterone, the heart can beat irregularly occasionally. After the pregnancy, the patient may not experience palpitations or may begin to see palpitations occur under other stressful circumstances. There certainly doesn't need to be anything wrong with the heart in order for palpitations to occur during pregnancy. But of course, if the palpitations are accompanied with dizziness or shortness of breath, or if the mother has had some history of cardiac problems, she should be seen right away.

My experience? I was sooo nervous about getting pregnant because I feared what it might do to my heart. I got myself so worked up with anxiety that the first trimester was a real nightmare. In fact, I experienced quite a few scary episodes at night while I was asleep. I went and saw my electrophysiologist and I wore a holter monitor for the rest of my first trimester. So if you do experience palpitations during your pregnancy, be sure to mention it to your doctor because they might also want you to wear a holter monitor. I think wearing it gave me reassurance and peace of mind because I don't think I ever experienced nighttime arrhythmia the rest of my pregnancy. As my pregnancy progressed I do remember experiencing the occasional flip-flop but no more or less than my non-pregnant state. And through contractions, drugs, epidural, and pushing (for 3 hours!), my ticker was fine. I was a little nervous about postpartum because I was physically and emotionally exhausted, but at that time, my heart was just doing a happy dance. I was so proud of myself for giving birth to the most beautiful little girl. And the things that I feared (not getting enough sleep, dealing with a newborn, etc.) weren't even an issue when given the privilege of taking care of one of God's children.

Female's Heartbeat with PVCs after energy drinks and coffee

And to keep with yesterday's topic about drinking too much caffeine, check out this crazy YouTube video. Make sure you turn up the volume pretty loud so you can hear her heartbeat. I hope she lays off the energy drinks in the future.

Signore Antonio Maria Valsalva

I love that I have the emotional and fiery temperament of an Italian. Of course, my husband loves to point out that I'm really only one quarter Italian, but in my eyes, I'm 100%. Perhaps my personality makes it so I have more run ins with palpitations than the chillaxed kind of person.

But Dr. Gary Francis, director of the coronary intensive care unit at the Cleveland Clinic Foundation, thinks that the solution to relieving palpitations may be in doing a maneuver that was developed by none other than an Italian.

Forcible exhalation against a closed airway was originally described as a method for inflating the Eustachian tube, and its diagnostic use has been attributed to Antonio Maria Valsalva (b. 1666- d.1723). Francis says that a similar move may help in derailing palpitations. Dr. Francis says that the next time you start experiencing heart palpitations you may want to try the Valsalva's maneuver. Pinch your nose and close your mouth. Then blow out while keeping your nose and mouth shut. The built-up pressure in your nose and mouth can force your heart back into its normal rhythm.

Hey, it's worth a try. Grazie Antonio!


[Precautions: The Valsalva maneuver should not be performed by patients who have severe coronary artery disease , have experienced recent heart attack, or have a moderate to severe reduction in blood volume.]

Cough It Up

If your drum isn't giving you a steady beat, start coughing. Cough during your next heart palpitation episode. The force of the cough will sometimes get a heart back on its regular track, says Robert March, M.D., associate professor of cardiovascular surgery at St. Luke's Medical Center in Chicago. A good cough can break the pattern of the palpitation.

[I know that I instinctively start to cough when I start to experience them. My husband always knows when I'm getting them because I'll start coughing abruptly. And forget about having time to cover my mouth with my sleeve. Ha!]

Please don't confuse this with "cough CPR" or the attempt of a conscious person to forcefully start coughing to maintain blood flow to the brain during a heart attack. Coughing to alleviate heart palpitations is only recommended during brief arrhythmia.

From the American Heart Association website (http://www.americanheart.org/presenter.jhtml?identifier=4535):

The American Heart Association does not endorse "cough CPR," a coughing procedure widely publicized on the Internet. As noted in the 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, the American Heart Association DOES NOT TEACH THIS AS PART OF THE CORE CURRICULUM IN ANY COURSE.

During a sudden arrhythmia (abnormal heart rhythm), it may be possible for a conscious, responsive person to cough forcefully and maintain enough blood flow to the brain to remain conscious for a few seconds until the arrhythmia disappears or is treated. Blood flow is maintained by increased pressure in the chest that occurs during forceful coughs. This has been mislabeled "cough CPR," although it's not a form of traditional resuscitation.

Why isn't "cough CPR" appropriate in CPR training courses?

"Cough CPR" should not be routinely taught in lay-rescuer CPR courses, because it would complicate teaching traditional CPR. It would add information that's not generally useful in the prehospital setting. In virtually all lay-rescuer CPR courses, the finding that signals an emergency is the victim's unresponsiveness. This signals the rescuer to begin the "A, B, C's" of CPR. Unresponsive victims will not be able to perform "cough CPR."

Are there situations when "cough CPR" is appropriate?

This coughing technique to maintain blood flow during brief arrhythmias has been useful in the hospital, particularly during cardiac catheterization. In such cases the patient's ECG is monitored continuously, and a physician is present.

During cardiac catheterization, patients may develop sudden arrhythmias. If a life-threatening arrhythmia is detected within the first 10 to 15 seconds and before the patient loses consciousness, a physician or nurse may tell the patient to cough. Repeated, forceful coughing can help the person stay conscious until the arrhythmia disappears or is treated.

Therefore, the usefulness of "cough CPR" is generally limited to monitored patients with a witnessed arrest in the hospital setting.

AHA Recommendation

The best strategy is to be aware of the early warning signs for heart attack and cardiac arrest and respond to them by calling 9-1-1. If you're driving alone and you start having severe chest pain or discomfort that starts to spread into your arm and up into your jaw (the scenario presented in the Internet article), pull over and flag down another motorist for help or phone 9-1-1 on a cellular telephone.

Drinking for Life

One of the first things you'll hear when your doctor diagnoses you with heart palpitations is to cut out all caffeine. Some people even claim once they cut out coffee, they never had any heart problems again. I had never been a huge coffee or Coke drinker so I knew I couldn't blame caffeine on all my heart palpitations, but I knew it contributed to some. I remember when I was in college, I loved getting a cafe au lait from a local coffee shop. Well, it took one night of experiencing the dance in my heart and I swore I would never drink coffee again. And I haven't. I also try to stay away from soft drinks but I do sip an occasional one for special occasions. But my rules are never drink a Coke when I'm experiencing high levels of stress or late at night. We were in the midst of packing up our apartment and moving into our first home and we knew it was going to be a long night before we had everything ready for the movers. I remember it was a little after midnight, I was worn out from teaching that day, and I thought it would be a good idea to get a little energy boost by drinking a Coke. I guzzled it down and no sooner had I just put the empty can down when my heart paused and let out a hard THUMP. I was tired, I was stressed, and I had just consumed caffeine. Not a good combination.

Another thing that is usually recommended is to eliminate alcohol. I try to limit my alcohol consumption to a small glass of red wine (since it's suppose to be good for your heart) once a week or so. I also like to reward myself for working out and staying healthy with an occasional mixed drink. But that's all. Of course, if you notice heart palpitations after drinking alcohol, put the drinks away.

Previously I mentioned that one of the things I do when I start getting palpitations is to immediately drink a glass of water. A lot of times we are dehydrated and don't even know it. And you've heard it time after time, but I'll repeat it. Make sure you are getting the recommended amounts of water every day, especially in the summer. "Eight 8-ounce glasses of water a day" is a good rule of thumb.

Alternatives to water? While sugar IS something you want to minimize, I would choose small amounts of natural sugar any day, over foods sweetened with high fructose corny syrup or artificial sweeteners like aspartame, saccharin and sucralose (Equal, Nutrasweet, Sweetn'Low, Splenda, etc). The following are some healthy alternatives to water. If you have other suggestions, let me know, as I love trying new healthy drinks.

-Water with lime or lemon or cucumber.
-Decaffeinated hot or iced tea with honey, agave nectar, or lemon
-Green teas (even if you choose decaf you'll still experience some of the healthy antioxidant benefits)
-Smoothies: My favorite recipe is very simple. 1/4 cup apple juice, 1/4 cup water, 1/4 cup blueberries (or other favorite fruit), 1 scoop (10 mg) whey protein powder (vanilla flavored). Blend together and enjoy. This is a perfect snack because it contains 1 block of protein and 1 block of carbohydrates.
-Vegetable juices (Hey Mom, my taste buds are finally tolerating these!)
-Fruit juices (but I always dilute them with at least 50% water)
-Fizzy water (or in Italy it's known as "con fizz") such as Pellegrino

Science of Breath (Part II)

So it should now be clear that abdominal breathing is preferable to that of chest breathing. The following are breathing exercises designed to improve breathing and to reverse Sensory Motor Amnesia (aka residual tension).

Major Rules of Breathing:

1) Never fill your lungs more than 90% of their capacity. Your lungs are very delicate and are easily damaged.
2) Focus on exhaling completely!
3) Breathe in and out through the nose. But if you find it difficult to breathe through your nose, you should open your mouth and breathe normally.
4) Breathing should be comfortable, not forced. If you find that the breathing exercise you are practicing causes anxiety, panic, frustration, or other negative emotions, discontinue and let your body breathe in its own style until you feel calm and centered once again.

Diaphragmatic (Abdominal Breath) Exercise:Lay down flat on your back. Place your left hand (or small bag of rice or bean bag) on your abdomen the navel, and your right hand on your chest. As you breathe, notice whether there is more movement in the abdomen or the chest. Try to take your breath down deeper and deeper into the lungs so that you feel the abdomen lifting as you breathe in and falling as you breathe out. Gradually, you should begin to notice the abdomen moving more firmly and the chest moving less. Try to let your breathing become slower, deeper, smoother, and circular.

Complete Breath:
Exhale ALL of the air from your lungs in a gentle manner, then use the diaphragm to draw air into the bottom of the lungs first, then allow the lower ribs to expand filling the middle lungs, then allow the upper ribs and chest to expand, and finally, lift the shoulders to fill the topmost lobe under the collar bone with air (during this last phase the stomach and abdomen will be drawn up and in slightly). Breathe out in reverse order, starting by lowering the shoulders, contracting the upper chest, lower ribs, and lastly the diaphragm so that all air is again gently squeezed from the lungs. The whole process should be done smoothly, and effortlessly as a perfect yawn.

Take a couple complete breaths at least 3-4 times a day. I like to do this exercise when I first start experiencing heart palpitations.



Remember to keep you face and jaw relaxed while practicing your deep breathing!

My favorite restorative yoga poses:

Cat pose

Extended puppy pose

Locust pose

Happy baby pose

Child's pose

Bridge pose

Science of Breath (Part 1)

Several years a go, I attended an informal class at the University of Texas taught by my yoga instructor Charles MacInerney on the topic of A Matter of Life and Breath. The following is my attempt to summarize what I learned and practiced in that class. It has done wonders for me when I start experiencing high levels of stress and heart palpitations.

The relationship between tension and breathing:

Ideally muscles are designed to briefly tighten and relax until needed again. However, our modern culture is such that we undergo constant and repeated "red light" reflexes in which our muscles think we are threatened. Every time some one honks a car, slams a door, etc. our muscles tighten. And when we lose awareness of a tense muscle, it begins to hold onto the tension longer each time it contracts, until it holds a residual tension. It is this residual tension (Sensory Motor Amnesia) that transforms the rib cage into a straight jacket that prevents people from breathing freely. So the key to learning how to breathe (yes, we need to learn--it doesn't come naturally in a culture like ours anymore) is to reverse Sensory Motor Amnesia. How do we do that? I'll get to that in the next session but let's first look at the differences between Diaphragmatic (Abdominal) and Thoracic (Chest) breathing.

Diaphragmatic (Abdominal) Breathing:

Slow, and rhythmic breathing
Large, tidal volume
Decreased heart rate
Decreased blood sugar levels
Decreased muscle tension
Decreased fatigue
Increased blood and oxygen
Increase lymphatic flow
Increased relaxation response
Decreased cardiovascular risk
Decreased likelihood of major EEG abnormalities
Associated with normal blood pressure
Associated with absence of type A behavior

Thoracic (Chest) Breathing:

Rapid, irregular breathing
Associated with hyperventilation (O2 levels rise, CO2 levels fall)
Low tidal volume
Increased heart rate
Increased blood sugar levels
Increased muscle tension
Increased fatigue
Decreased blood and oxygen
Decreased lymphatic flow
Decreased relaxation response
Increased cardiovascular risk
Increased likelihood of major EEG abnormalities
Associated with high blood pressure
Associated with type A behavior

Okay, so which type of breathing do you think you do on a daily basis? Which type of breathing is best for you?

MVP & PVCs

All these abbreviations are starting to make me loopy. Ha!

I recently returned to a support group that I was a member of many years a go when I was still learning how to cope with my palpitations. Over 10 years a go, after finally getting up the courage to see a cardiologist, I was diagnosed with Mitral Valve Prolapse (MVP) after a routine cardiac ECHO (aka cardiac ultrasound). MVP is an abnormality of the mitral valve leaflets, or supporting chords. It is a well-recognized, clinical entity with a reported prevalence of 4% to 18%. MVP is frequently associated with a myriad of symptoms. The term MVP syndrome refers to the occurrence of symptoms unexplainable on the basis of the valvular abnormality. (That always seemed strange to me.) Common symptoms include: chest pain, fatigue, palpitations, lightheadedness, shortness of breath, anxiety/panic attacks, headaches, low exercise tolerance, and mood swings. Hello, all of the above, ME! I was glad to get a name for what I was experiencing and even more glad to find out that it wasn't suppose to kill me. I knew early on that my valve was floppy but my doctor didn't think I would ever have to have valve replacement surgery. The doctor just mumbled something about taking antibiotics before going to the dentist. I joined mvpsupport.com soon afterward and participated with others like me who had been diagnosed with MVP and its strange symptoms. The woman who started the support group, Lorelei, was a long time sufferer and had even written a book on the syndrome. For awhile, the support group had been a life line for me but eventually I felt like I no longer needed as much help and I gradually stopped coming to the site. A few years a go, I switched cardiologists and after doing another cardiac ultrasound, he determined that it looked like I didn't even have MVP! I didn't understand how at one time I had it and now I didn't. Also, if I didn't have MVP why did I have all its classic symptoms? Fast forward to today. I stumbled upon my old support group website today--only it looked very different. The moderator and creator, Lorelei, had left an important message.

Here is an excerpt of what she had written:

Times are changing; technologies are changing -- it's not surprising to find our health affected by these changes.

My journey with Mitral Valve Prolapse began 18 years ago, and in that time I've had multiple visits with cardiologists and had multiple echocardiograms confirming my diagnosis. Fast-forward all these years later and now cardiologists have more advanced machines and improved knowledge about the heart. I was just told that I actually do not have Mitral Valve Prolapse afterall.

Did I ever have it? Who knows. Or maybe it's just so mild that it's not labeled as Mitral Valve Prolapse, since only those patients who have severe prolapse are now considered to have the condition. Any case that's less severe is "not something to worry about," I'm told. I asked my cardiologist, "When you say my echocardiogram was 'normal', do you mean that the MVP is just so mild that it's nothing to worry about? Or do you mean there's nothing there at all?" Her response was that everyone's valve leaks to some degree, and it's perfectly normal. Not really an answer to my question, but the end result is the same: I don't have Mitral Valve Prolapse.
Here is So where does this leave me?

I've written a book about my experience with MVP; I've been running this web site for 13 years; I've provided this online support group for years as well. What service am I providing to all of you -- how can I be of any use -- if I don't even have the condition myself? My motivation is now gone. For this reason, I'm stepping down from my MVP soap-box.

What does this mean for you, you may be asking? Well, for starters, I will be taking down my web site. However, the message boards will remain. Too many of you have found a "home" here and I don't want to take that away.

--Lorelei

Too many people had found a home! Did you catch that? There are so many people out there like me that have had this strange diagnosis and felt the effects of its mysterious syndrome. There are a lot of confused souls out there who have heart palpitations and fatigue and anxiety and no proper diagnosis. You would think that if it is true and technology is more advanced and doctors know more about the heart then we would know more about why we suffer with real physiological (read--not psychological, as some would like us to believe) symptoms. I hope one day science and medicine will get to the bottom of this strange and complex disease.

Which Came First, the Fear or the Flutter?

I believe a stressful first year of college along with genetics and the death of my beloved cousin was the catalyst in the beginning of my heart palpitations. I feared them and had a couple panic attacks after experiencing many in a row. So I believe my panic attacks started when I first got the dance in my heart. In fact, most of my panic attacks today still revolve around when anticipating or experiencing a bad round of PVCs. About 5 years a go, I was in the midst of the hardest year of my life--my first year teaching. Up until Christmas of that first year I was just trying to stay afloat. I got up early, taught seven year old children, pacified crazy parents, worked late, and came home only to crash on the couch. I dropped below 100 pounds that year. In the Spring of that year, I was driving to Target on the highway and thought I felt a couple flip flops. My heart started to race and I panicked. I started to hyperventilate and the only thing I could think of was to get off that highway as quickly as possible. As soon as I exited, my heart started to calm down, and I was able to complete my shopping trip taking side streets on the way home. Little did I know that that event would trigger one of my biggest anxieties that I deal with to date. Driving on the highway. I can get around okay for the most part and even a couple years a go, I thought I had it beat because I drove all the way to Austin from San Antonio by myself. But I got pregnant and for whatever reason toting a child and being responsible for her safety made me fear the highway again. I had a big panic attack last Summer while getting on the highway and I haven't been on it since.

So that leads me to the important question: Which came first, the panic or the heart flutters? It seems like if you look at my history, the heart flutters began while I was driving on the highway. Then the panic set in. But I can see it the other way around, too. The stress of driving that day 5 years a go caused the palpitations. And now I associate the highway with palpitations--the two linked with fear and loss of control.

I've come so far at accepting my heart palpitations. And overall I think I'm a highly functioning person. I don't let my fear of highway driving stop me from going out. In fact sometimes I think I even overcompensate by making sure I don't close myself off from the world like Paula Deen did. I'm pretty social and I definitely want my daughter to see me driving around and going places. Currently I'm on a new found quest to start driving on highways again. I'm looking into a trying out a highly recommended source--"The Original Driving Fear Program" at http://www.drivingfear.com/index.php. I'm also working on trying not to feel embarassed or ashamed that I'm not comfortable driving on highways. There are certain people in my life that I would still like to tell and have them offer me support.

Maybe one day I'll be that annoying girl cruising on the highway--windows opened, music blaring, singing loudly, and hair flying.

Do You Need an AED?

I mentioned in a previous post, that my beautiful older cousin died of a rare heart arrhythmia. It is still uncertain why she died of sudden cardiac arrest at such a young age of 30. Very few young people die of cardiac arrest but when they do the causes vary. Some specific causes of sudden cardiac death in young people include:

Hypertrophic cardiomyopathy (HCM): This is a disease in which the heart muscle (myocardium) becomes abnormally thick, making it harder for the heart to pump blood. Hypertrophic cardiomyopathy, while usually not fatal in most people, is the most common cause of heart-related sudden death in people under 30. It's the most common cause of sudden death in athletes. HCM often goes undetected.

Coronary artery abnormalities: Sometimes people are born with heart arteries (coronary arteries) that are connected abnormally to the heart. The arteries can become compressed during exercise and not provide proper blood flow to the heart.

Long QT syndrome (LQTS): Long QT syndrome (LQTS) is an inherited heart rhythm disorder that can cause fast, chaotic heartbeats. The rapid heartbeats, caused by changes in the part of your heart that causes it to beat, may lead to fainting, which can be life-threatening. In some cases, your heart's rhythm may be so erratic that it can cause sudden death. Young people with long QT syndrome have an increased risk of sudden death.

Beth was plagued by PVCs but I am certain that they alone are not what killed her. Many doctors believe that premature ventricular contractions do not necessarily cause ventricular tachycardias or ventricular fibrillations, but they could be an indicator of serious heart disease or electrical abnormality.

So now that Home Automated External Defibrillators (AEDS) are available over-the-counter without a prescription, I've often wondered if it would be wise for me to purchase one? The Mayo Clinic has written an excellent article on this topic. An AED certainly would have helped save my cousin's life. But since I'm fairly confident that my PVCs are benign after undergoing extensive testing and I have no other known heart condition, I don't think I need a home AED. Would it give me peace of mind? Maybe. Just as it might give anyone.

What Causes Heart Palpitations?

Here is a list of possible causes:

* Ischemia (restriction of blood supply)
* Certain medicines such as digoxin, which increases heart contraction
* Myocarditis (inflammation of heart muscle)
* Cardiomyopathy (heart muscles disease)
* Myocardial contusion (v-fib)
* Hypoxia (deprivation of oxygen)
* Hypercapnia (CO2 poisoning)
* Mitral valve prolapse
* Smoking
* Alcohol
* Drugs such as cocaine
* Caffeine
* Tricyclic antidepressants
* Magnesium and potassium deficiency
* Calcium excess
* Thyroid problems
* Chemical (electrolyte) problems in the blood
* Heart attack
* Adrenaline excess
* Lack of sleep/exhaustion (aka having a newborn-ha!)
* Stress

Remember, if you have occasional extra beats, but you are an otherwise healthy person, there's generally no reason for concern, and no treatment is needed. If you have frequent symptoms or you have underlying heart disease, you may need treatment to help you feel better and treat underlying heart problems.

A Little Clarification

When people say they are experiencing heart palpitations it can mean many different things. Some people (my mom for example) think of palpitations as feeling as if your heart is pounding or racing (tachycardia). You may simply have an unpleasant awareness of your own heartbeat. When I refer to heart palpitations in my blog, I'm usually referring to a sensation of a skipped or stopped beats. Sometimes they feel like a flip-flop or a flutter. Of course, your heart does not stop. A premature ventricular contraction (PVC) or a premature atrial contraction (PAC) is simply the heart's ventricle or atrium prematurely contracting before the normal electrical discharges arrive from the SA node (or pacemaker of the heart). Immediately after a premature contraction, the electrical system of the heart resets. This resetting causes a brief pause in heartbeat (as the heart refills with blood). It's usually the normal after beat (and sometimes it can feel very strong) that one feels and not the actual pause. Also, it may be useful to note that it is very hard to distinguish a PVC or PAC unless a trained technician is watching your heart palpitations on an EKG. Some people claim they can tell a difference between the sensations of a PVC or PAC, but I generally cannot.

The intensity and frequency of my PVCs differ greatly. Sometimes I feel single mild misbeats. These I have learned to live with. Other times, I will have one really strong one that I can feel in my chest, throat, or neck. These sometimes make me feel a bit queasy or short of breath. A lot of times, these intense single palpitations cause me to panic causing my adrenaline to surge and my heart to race (but I attribute this to the anxiety and not the actual palpitation). Sometimes, I go into bigeminy where one PVC occurs after every normal beat, in an alternating pattern, or trigeminy where one PVC occurs after every two normal beats. These have usually only occurred when I was dealing with a major life stressor (like a loss of a job or continual lack of sleep). Going into bigeminy or trigeminy is no fun for me. But supposedly there are thousands of people (especially older people) that experience bigeminy and trigeminy on a daily basis and can't even feel them! There is no prognostic difference between the PVCs that are felt by the patient and those that are not. Obviously the symptomatic PVCs are of more concern to the patient because they can be annoying and distracting. Beyond that, the PVCs are all the same, prognostically. In most patients who are otherwise healthy, PVCs on a Holter are of little prognostic value regardless of whether they're experienced or not.

And the million dollar question? How many is too many heart palpitations? According to a Cleveland Clinic doctor, generally in a normal heart there is no "maximum limit" to PVCs; although in someone with underlying heart disease, doctors are somewhat more concerned if they are occurring more that 6 times a minute.

Lady Gaga: "I have heart palpitations"

Lady Gaga has revealed she suffers from heart palpitations.

The singer, real name Stefani Germanotta, says she needed medical attention after a recent gig.

'I have heart palpitations and... things,' says Lady Gaga, 24.

'But it's OK. It's just from fatigue and other things...

'The other day...in Tokyo, I was having trouble breathing. I had a little oxygen, then I went on stage. I was OK. But like I say, I don't want anyone to worry.'

Lady Gaga admits she's also been tested for lupus, because her aunt died from the disease in 1976.

'I'm very connected to my aunt, Joanne, who died of lupus,' she tells The Times Magazine.

'It's a very personal thing. I don't want my fans to be worried about me.'

When you are experiencing heart palpitations

In a previous post, I discussed all the things I do to be healthy and prevent heart palpitations. But sometimes no matter how well I try to take care of myself, I'll still get those pesky misbeats. This has been an important realization as I used to get very depressed when I thought I was doing everything right and still got them. Now I just know that no matter how well I think I'm doing taking care of myself, life will inevitably get in the way and shake things up. Unexpected events, changes, chasing a toddler, fluctuating hormones, getting cut off on the road, etc. These are things that we have no control over and normal if we are to live full lives. Some stress is good. If we didn't have any, we'd be dead. But what do you do when you are stressed out and feeling the effects of heart palpitations? Here's what has worked for me:

--a glass of water
--splashing my face with cool water
--getting on the floor on my yoga mat and doing some gentle stretches (cat stretch, sun salutation, rock the baby pose)
--deep breathing (you can add meditative music, but sometimes I find it distracting)
--reaching deep inside myself and trusting my heart/body/soul
--reciting the mantra "This too shall pass."

But sometimes just trying to calm down, actually makes me panic more. Sometimes if the above doesn't work, the alternative is to get up and move. Go on a walk. Even if you're experiencing heart palpitations at 2 a.m., get up and start walking circles around your dining room table. Keep breathing slowly. In through your nose, out through your mouth. Or change up the scenery and go outside. You can enlist the help of a friend or spouse, but I've noticed that I really am the only person to help me through a bad episode. And when you have a history of being the one helping you through your panic, you don't have to rely on anyone else in the future.

[Disclaimer: If you have never experienced heart palpitations or have an underlying heart condition, please inform your doctor if you start experiencing them. I've had mine diagnosed as benign PVCs via EKG; thus there is no need for me to go to the hospital when they start bothering me. Of course, if my symptoms ever change or I start to feel lightheaded, I would immediately consult my cardiologist. But I've done the hospital thing in the middle of the night, and all they've ever done is hook me up, say yep you're experiencing palpitations, and send me on my way with a prescription for beta blockers (which I have never filled but that's another topic). So now I know when I start feeling them again, that it's best for me to stay home and work through them on my own.]

My New Hero is...

a butter-loving, finger-licking, joke-cracking queen of melt-in-your mouth Southern cuisine...Paula Deen!



I picked up her book It Ain't All About the Cookin' because I heard that at one point in her life she suffered from a debilitating agoraphobia whereby she didn't leave her house for years. Fortunately I've never suffered from full blown agoraphobia but there have been times in my life when I haven't wanted to be in public because I was either experiencing uncomfortable PVCs or afraid I would start to get them outside my comfort zone. Paula Deen suffered from intense anxiety for over 20 years before she finally came to the end of her rope and realized that she had to start living. One morning she got out of bed and like a thunderclap heard the words to the Serenity Prayer--the ones that alcoholics use at Alcoholics Anonymous: God grant me the serenity to accept the things I cannot change; courage to change the things I can; and wisdom to know the difference. At last she had got it. Deen writes, "Sure, I'm gonna die, I said to myself. My children are gonna die. Everyone I love is gonna die. But today has given me today and I'm gonna go out and live today. I won't die today." She started slowly and got better and better. She went on to start her own catering business, open two hugely successful restaurants, publish numerous cookbooks, have her own cooking show, star in a movie, and appear on Oprah! But through it all, she would still carry a brown paper bag in case she started to hyperventilate. Of course, she seldom needed it. And when life challenges presented themselves and she too began to suffer heart palpitations, she was smart enough to go to the doctor right away and tell him that her nerves were shot. She got on Zoloft and started feeling better. She is a shining example of a strong woman who has experienced intense anxiety and its effects, but has gone on to be successful and happily fulfilled.

Jogging with heart rate monitors

I've been doing P90X for the past couple months, but it has become increasingly difficult to get in the 1-1.5 hours daily to accomplish the DVD program with a little one. So the easiest way to get exercise with a toddler, is to put him/her in a jogging stroller and start jogging. I've been jogging early in the morning (before it gets too hot) three times a week for about half an hour. (Of course, I would encourage anyone with heart problems to consult their doctor first.) I also thought it was important that I bought a heart rate monitor watch to monitor my heart rate while I jog. While these watches are useful for a lot of reasons (distance, calorie count, staying in the zone, etc.), I think it has been most beneficial because it gives me reassurance that I'm not overdoing it and putting too much stress on my heart. Before I got the watch, I think I pushed it too far because after the jog, I would start to get a lot of very quick palpitations. This caused me some concern. But once I got the heart rate monitor watch, and simulated the same run I had been doing, I noticed that my heart rate was going way over 80-90% of my HR max. That's a pretty hard intensity and one that is recommended occasionally for fit people. And since I was just starting out, I knew I was pushing it too hard. Ideally, I should jog in a moderate intensity zone or about 70-80% of my HR max. Definitely not over 90% or 171 beats per minute. And now that I own the watch, I can easily do that. I simply notice when my heart goes over 162 bpm, and then I back off (usually I stop jogging and start walking or I take good deep breaths) to about 148 bpm. And once I reach that number, I'll start to jog again until I again reach my max and then I back off again. I keep this up for 30 minutes and then I do a cool down. The good news. This type of interval jogging is the best for losing weight. And I'm still trying to lose my post baby tummy. The results? I am no longer experiencing palpitations after jogging. Plus, I have recently discovered something I had never experienced before but heard so much about. Runner's high. The endorphins being released at the end of my jog makes me feel wonderful. I can already feel it working on my nervous system.

I'm pretty proud of myself thus far. When I first started experiencing palpitations over 10 years a go, I was so scared, I was even afraid to go on a walk. Anything that would raise my heart rate, scared me. I've come a long way. My advice is to go slowly at first and trust that what you're doing is very good for your heart. And not to sound morbid, but since I've started jogging, I've even thought to myself on occasion if I were to die while running (although I now know that's highly unlikely), at least I know I tried. I got out there and took control of my health and my heart.

I still have tummy to lose, but a girlfriend of mine, just commented that my legs look so good and toned. That was awfully nice of her to notice but I'm just glad that my heart is getting stronger every day.

Target heart rates
Polar heart rate monitor
My new jogging stroller

Middlesex

I've recently been reading Middlesex by Jeffery Eugenides. The story is about Calliope Stephanides and three generations of his/her Greek-American family, who travel from a tiny village in Greece to Prohibition-era Detroit. I got to page 20 and nearly fell out of my chair. Here it was. A perfect description of a woman living in fear of her heart. It had me written all over it.

In the late summer of 1922, my grandmother Desdemona Stephanides wasn't predicting births but deaths, specifically, her own. She was in her silkworm cocoonery, high on the slope of Mount Olympus in Asia Minor, when her heart, without warning, missed a beat. It was a distinct sensation: she felt her heart stop and squeeze into a ball. Then, as she stiffened, it began to race, thumping against her ribs. She let out a small astonished cry. Her twenty thousand silkworms, sensitive to human emotion, stopped spinning cocoons. Squinting in the dim light, my grandmother looked down to see the front of her tunic visibly fluttering; and in that instant, as she recognized the insurrection inside her, Desdemona became what she'd remain for the rest of her life: a sick person imprisoned in a healthy body. Nevertheless, unable to believe in her own endurance, despite her already quieting heart, she stepped out of the cocoonery to take a last look at the world she wouldn't be leaving for another fifty-eight years.

Every time I read this, it makes me want to cry. How many times have I not fully lived because I thought I was about to die. And if I am fortunate to live another fifty-eight years, when I do die will I laugh to myself and think "Gosh, I was healthy all along. Why did I give all those heart palpitations so much power?" Interestingly, after a recent conversation with my mother, she said that her grandmother always complained about her heart and feared it was going to kill her. She lived well into her 80's. So were we all crazy? I think not. It's just that when your life organ is awry it's only natural to fear. And when norepinephrine is being released, it's doing what it's suppose to be doing. Fight or flight kicks in. Fighting and stressing over your heart makes it worse, and it's awfully hard to flee from your own body. So the only thing you can do is counter intuitive. You have to relax and accept. So no wander it's so darn hard not to care about those pesky misbeats. You literally have to turn off the protective mechanism your body was designed to do. But you have to if you want to live a full and happy life. I'm working on it.

Heart Healthy

What do I do to prevent PVCs?

This is my current preventative regime. But basically it's striving for a healthy lifestyle.

Walking/Jogging (30 min.) at least 3 times a week
Eliminate all caffeine (no cokes, no coffee)
Yoga
Deep breathing
Reduce white sugars and carbs
Progressive muscle relaxation
Paraliminals: Self-Improvement Audio programs
P90X: a fitness regime consisting of weights, lunges, core work
6 small meals a day and always pairing a carb with a protein unit
Plenty of water
8-10 hours of sleep
Naps
Down time
Play time
Neck adjustments/massage by a chiropractor
Plenty of fruit and vegetables
Occasional mental health therapy sessions
Limit alcohol consumption (but occasional Mexican martini)
Medication: 15mg. of Lexapro