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1 day ago · What to do when in SVT? in Heart & Blood Health

When we have someone like Kanaaz (@kanaazpereira) to reassure us on a medical problem that gives us worry, we don't need much else until it's time to submit to medical professionals for treatment. Her posting on SVT is the best I have seen on this vexing problem and the outlook needed by SVT victims to keep on keeping on despite a rushing heartbeat, sometimes with chest-rattling palpitations, but often not so fearful.

In my case, the SVT is a condition that recurs in my wife's heart (while I deal with atrial fibrillation). Her SVT started with her diagnosis of diabetes-2 about 25 years ago, then stayed in the background until last year when it returned for two worrisome episodes. Last Spring, a new cardiologist tried medicinal cardioversion with XCartia (a version of Diltiazem) that warded off palpitations for several months, but side-effects (mainly edema in her extremities) ended that therapy. He switched her to Flecainide which lasted a few months until dizziness, instability, and fatigue forced a return to the Tenormin (Atenolol) she had taken for several years to combat the arrhythmia that manifested as PSVT — paroxysmal (unpredictable) supraventricular tachycardia.

Crucial to my wife has been her moderately heavy exercise regimen. She was forced off of that with her PSVT episode last Spring and remained largely unexercised through last November. But now, back on Atenolol, she is pretty comfortable with the prospect that an episode is unlikely, but if it recurs, she knows how to handle it. Her Flecainide is now on standby for use only as-necessary if a new episode occurs.

Ablation of the errant tissues in the heart is on her list of options, but in reserve if any serious recurrence sends her to the Emergency Room a mile from home.

I hope her experience with PSVT and its treatment is reassuring for Connect members with the problem. She has learned how to handle the threat and the episodes themselves and looks forward to her 83rd birthday in the coming Summer. Martin

Sat, Jan 11 10:15am · trouble getting words out in Ear, Nose & Throat (ENT)

Hello, @debmc1958. Welcome to Mayo Connect and thanks for coming in to help a friend in need. I'm not an expert in this field, so consider my immediate reactions as questions to consider.

First, functions of the brain are governed by different parts of the brain — movement using muscles is directed from a different place than sensing, emotions, memory, creativity, etc. In my case, a "small stroke" deep in my brain — barely visible on computerized tomography (CT) scan — impeded my speech, hand writing, walking, and balancing. After six months of physical therapy, other brain cells are learning how to replace those that were damaged, and I have recovered enough to sing again in public and write thank-you notes to my neighbors.

Second, every disturbance affecting motion and balance below the skull involves nerve signals that pass through the spinal cord. Deviations from normal often originate there rather than in the brain, which comes into focus when stroke is suspected. A problem that might seem to be in the spinal cord could be in a peripheral nerve that is outside the cord and disturbed immediately by bone of a vertebra or by a disc between vertebrae.

Third, it seems to me that a physician specializing in Neurology is crucial to finding a convincing diagnosis of the cause of her disabilities. A neurologist is well-equipped in such cases to call together a team of physicians if needed. If the cause involves facial nerves or blood circulation, a combination of specialties might be appropriate.

Dec 16, 2019 · AFib - Question about blood thinners in Heart Rhythm Conditions

Hello, @cece55. I'm sorry to hear of your latest complication — pain and inflammation — to go with your Afib and Apnea. Like you, I was diagnosed with Afib four years ago, and I have been on a beta blocker (Carvedilol) and an anticoagulant (Coumadin). The main difference for me is that I do not feel irregular heart beats; they only show up on my electrocardiograms. But my Afib is definitely real — I had a small stroke last summer, apparently from a blood clot that formed in my heart from Afib slowing the blood flow through my Atrium. I too am restricted from taking Advil or other NSAIDs, because of their adverse interaction with my main medications. Can you share what kinds of pains you're dealing with and where inflammation is causing you severe discomfort. When I have similar problems, my personal care physician either gives me treatment for them or refers me to a specialist. Has your medical team offered you advice on what to do to alleviate the pain and to redress your inflammation?

Dec 16, 2019 · Prostate and Bladder Issues in Kidney & Bladder

Cancer? Nope! That from my urologist after my last cystoscope exam last summer. While examining the inside of my bladder (which has given up some space to my bulging prostate), he obtained a sample of urine and sent that to the laboratory for microscopic examination. No cancer cells were detected with that exam. That's a major difference from 10 years ago, when I had a dozen papillary tumors of various malignancy sprouting on the internal bladder lining. In that case and at that time, the lab examined the tumors themselves after they were removed. After BCG treatment in the bladder to kill any cancer seeds remaining there, cystoscope exams were planned on a schedule of increasing duration, and that duration is now once a year. This year's was, once again, clear of any visible tumors, and — in addition — the newly applied test of urine reassured me that neither bladder nor kidney cancer were detected. Martin

Dec 16, 2019 · Prostate and Bladder Issues in Kidney & Bladder

Hi @amgracing1. Glad to see you're on the move — so much better than "hanging tough," going nowhere, and relying on hope. My main response now: Delay making any down-the-road decisions until after a good talk with your new urologist. Put a half-dozen strategic questions to him and see what develops from his answers. After that, you could think about things for a few days and — if you are concerned about a firm plan for next steps — ask him about helping you get a second opinion from a urologist that isn't on staff in his joint practice. Isn't that likely, given that Ohio State University's medical expertise is also located in Columbus? You could ask him about satisfied customers, but medical privacy laws and rules get in the way on that — he may not have permission from former patients to reveal their medical information to you. It seems to me that you're more likely to get patient input from Mayo Connect where members control whether they "undress" their private information. One way to do that is to post a new, challenging appeal for input from Connect members on the issues that concern you most. As to doing it "again every few years," I understand your concern, but I am dealing with that as follows: My TURP and TURB ten years ago were readily tolerated, and I'm not very concerned about undergoing it again. That may be necessary in the days ahead. Like you, I'll be investigating whether HoLEP is a good alternative to a TURP. Incidentally, I dropped off of Tamsulosin (Flomax) several years ago because of its minimal impact and its potential for harm after several years of uninterrupted use.

Nov 28, 2019 · Happy Thanksgiving to all! in Cancer

. . . being an octogenarian (plus four)! Happy Thanksgiving, All!

Nov 26, 2019 · Prostate and Bladder Issues in Kidney & Bladder

Any time, Steve (@amgracing1). I'm here almost every day, enjoying my control and wrestling with my other medical challenges. I'll look forward to your postings and/or your private messages under the envelope on the upper right of your screen! The best part of the future for you (and me) is the cystoscope examinations of the bladder lining that are common after a TURP. In that respect, be sure to check on the antibiotic that nurses like to supply before the cystoscope procedure. I don't allow fluorquinolones (like Ciprofloxacin or any of its relatives) because of issues raised by the FDA. Martin

Nov 26, 2019 · Prostate and Bladder Issues in Kidney & Bladder

Hi @amgracing1. Welcome to Mayo Connect. Your story is very similar to mine, although about 10 years later. I had a bulging prostate that reached the point of forcing me behind a bush or rushing to a rest room. The prostate had filled a large share of the capacity of my bladder. For several years, I had taken medication — first Propecia (Finasteride) and later Flomax (Tamsulosin), but alas they proved inconsequential. So my Urologist said, "It's time," and we scheduled surgery at the hospital for Transurethral Resection of the Prostate (TURP).

That was a good decision from two perspectives: First, pieces of my prostate were snipped off, removed through my urethra, and piled up to a little more than a golf ball. Second, removal of that tissue revealed a small papillary tumor on the lining of my bladder; it was also removed before a temporary tube was installed to collect my urine during a few days of healing.

When the tube was removed, the urologist examined the interior lining of the bladder thoroughly and found a dozen more of those little tumors, so we scheduled another Transurethral Resection procedure to be held at a walk-in surgery the following week. That also was a success. What followed was a series of five "BCG" bacterial treatments, which involved injecting a solution into the bladder; the solution was intended to kill any remaining tumor "seeds" in the bladder lining — and it did. For the past 10 years, I have undergone regular cystoscope examinations of the bladder lining. No tumors — not one — has ever appeared since my second surgery.

From my experience, you may come up with questions. I'll be glad to respond to any that you have, and I know your urologist will also. One question I'd suggest for the doctor: What are chances that another TURP will be needed in the future? I hope that, if you choose a TURP, you will find it to be as vital and satisfying as I did. Martin