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Dr. Hive - I shouldn't call the doctor, right?


Jenny in Florida
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I'm over-reacting, right?

 

About a year and a half ago, I went to the doctor several times with a lingering cough and what I referred to as a "fluttering" sensation in my chest. The two seemed to me to be connected, but it took a few months to nail down what was happening. On day, I was in the office having yet another EKG, and they decided I was in atrial fibrillation and sent me to the hospital. Eventually, they determined that the underlying cause of the problem was hyperthyroidism. I was put on anti-thyroid meds, and both the cough and the irregular heartbeat subsided within hours.

 

Just in the last few weeks, I've started having very occasional, very mild episodes of coughing and/or "fluttering" again. To be honest, I'm not super great at taking the meds regularly. So, I assumed that was the problem and have been very careful to take every dose every day. However, this morning I am fairly uncomfortable. The fluttering has been going on for over 30 minutes, and I'm coughing on and off. I also feel a bit trembly, and my internal thermostat is wonky. (I'll feel so cold I'm shivering for a few minutes, then overheat and have sweat dripping down my face, when the temperature of the room hasn't changed and is entirely comfortable for other people.)

 

Just to make this more fun, neither the cardiologist I saw while I was in the hospital nor the endocrinologist I've seen a couple of times since is in my insurance network now. I have been planning to research replacements and make getting-to-know-you appointments, but I haven't done so yet.

 

So, since I know what this is and I am already on meds for the underlying issues, I should probably just wait it out and plan on calling my primary care office if it gets significantly worse or happens again, right?  Or is there some reason I should go ahead and call now?

 

I have a slight tendency toward hypochondria, and I often work so hard to resist that I end up being less proactive than I probably should be about my health. So, it's difficult for me to assess when I should actually be concerned enough to act.

 

Thoughts?

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If it were just a cough, I'd wait.

 

But it's the fluttering heart.  You only have one.  You have kids who need you.  Go to the doctor.

 

I'm a bit of a hypochondriac myself.  I have a rash on my leg, but I'm self-treating at home.  I usually self-treat at home.  However, when I had blood in my urine last month, I went to the doctor that day.  Yes, it as expected, it was just a bladder infection. But there are some things that you should not wait to see what happens.

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I would call the primary and try to get in today.  (Most have some space where they can squeeze you in for more important issues.)  Then I would ask for a referral that takes your insurance.  Your symptoms could be the same as what you had before but it could be something different.  The fact that it is going on for more than a few minutes is concerning to me.  

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Just in the last few weeks, I've started having very occasional, very mild episodes of coughing and/or "fluttering" again. To be honest, I'm not super great at taking the meds regularly. So, I assumed that was the problem and have been very careful to take every dose every day. However, this morning I am fairly uncomfortable. The fluttering has been going on for over 30 minutes, and I'm coughing on and off. I also feel a bit trembly, and my internal thermostat is wonky. (I'll feel so cold I'm shivering for a few minutes, then overheat and have sweat dripping down my face, when the temperature of the room hasn't changed and is entirely comfortable for other people.)

Well, by way of perspective, I have an irregular heartbeat - meaning my heart often feels like it skips beats. I also have occasional bouts where my heart will start racing which makes me feel out of breath and a little dizzy. Mine typically last no more than a few minutes, but my Mom had some that lasted as long as you mention. She ended up wearing a monitor and had an ablation to nix the part of her heart that was triggering it. I haven't sought any treatment for mine, though my doctor is aware of it and is not concerned. Sometimes these things really aren't a huge issue. Annoying, but not life threatening.

 

That being said, if my symptoms were to change, if the racing lasted longer than usual, or if I felt off, then I'd be either calling my doctor's office or heading in to the ER. So, yes, in your case I'd go in.

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Actually, given your history, I'd worry about a thyroid storm which is NOT benign. I'd either call my primary for an appt today (!) or go to an ER. The phrase you want to use is "thyroid storm" or (to be more accurate) possible thyroid storm.

 

This needs to be checked out sooner rather than later.

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You'll get a huge range of opinions from everyone here... But I probably would go for the primary care appointment rather than the emergency room if you're just feeling a bit off. I've come close to a thyroid storm and it's unmissable. Out of breath all the time, super fast pulse, high blood pressure, temperature, tremors, crazy high thyroid levels, etc... And I don't think that was even a real full-on thyroid storm.

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I would definitely go to wherever you decide is best. It sounds like it is hard for you to get it under control, so go, go. Then you have to report back because now we are all concerned. I hope it is not more serious. I used to go to the dr frequently for sinus stuff but have quit. Now I have heart issues myself (emergency open heart) so I am a little more prompt at seeking medical advice or attention when it seems like things aren't right. :grouphug:

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Okay, I should thank you all for encouraging me to make the call. I spoke to the nurse at my doctor's office, who said I definitely needed to be seen and instructed me to go to the ER, because they would be able to do blood work on site.

 

It turned out I was in atrial fib again. After a calcium beta blocker IV drip, my heart rate returned to normal. They are insisting on keeping me overnight for observation, but I feel significantly better now.

 

Thanks again, all, for kicking me in the pants so I would make the call.

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Okay, I should thank you all for encouraging me to make the call. I spoke to the nurse at my doctor's office, who said I definitely needed to be seen and instructed me to go to the ER, because they would be able to do blood work on site.

 

It turned out I was in atrial fib again. After a calcium beta blocker IV drip, my heart rate returned to normal. They are insisting on keeping me overnight for observation, but I feel significantly better now.

 

Thanks again, all, for kicking me in the pants so I would make the call.

 

:grouphug: Jenny. Take care.

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Thanks to everyone for the concern and the hugs!

 

I'm home again, feeling much better. The endocrinologist I was seeing after the last episode was trying to cut back on my medications as much as possible, and it seems we may have gone too far with that. So, my thyroid went out of control again, which caused the atrial fibrillation. Despite lots of testing, they couldn't find anything else wrong with me. So, I am home again, with a prescription for an increased dose of methimazole and appointment to follow up with my primary care doctors.

 

 

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Thanks to everyone for the concern and the hugs!

 

I'm home again, feeling much better. The endocrinologist I was seeing after the last episode was trying to cut back on my medications as much as possible, and it seems we may have gone too far with that. So, my thyroid went out of control again, which caused the atrial fibrillation. Despite lots of testing, they couldn't find anything else wrong with me. So, I am home again, with a prescription for an increased dose of methimazole and appointment to follow up with my primary care doctors.

 

Thank you for the update. I'm glad all is well.

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