RE: Vagal Atrial Fibrillation & ResMed F20 Strap Neck
Thanks SarcasticDave94!
I will indeed look at alternative Masks, my main limitation is a miniscule budget, so I regret that I just do not have the option to invest in alternatives unless one is likely to be successful (even then I will need to save my pennnies)!
Long story, but I am also quite physically disabled from hips down (motorcycles and then HM Forces injuries) so, I only have a very limited ability to earn anything. Not yet retired, albeit close, although that won't help at all, no pension to look forward to! So, I get to work until I drop.
I did consider the older ResMed Quattro FX, as I heard that was very good for higher pressures, but they are now discontinued, and hard to obtain, especially at a good price.
But thanks for the suggestion, I will indeed investigate the Fisher & Paykel Vitera option, and see if I can get my hands on one.
Thanks also SevereApnea/Chris!
A quick one on CPAP pressure. This is linked to my physical disabilities, in that I struggle to get comfortable at night, so tend to move around a bit, and go in and out of the best position for CPAP. I start on my right side, which is great for CPAP, but not good for shot right hip and damaged knees. So, I involuntarily end up on my back, which is comfortable, but the CPAP then really struggles, and 20 Pressure is only just enough to stop Obstructive Apnoeas. Any leaks and I am into Apnoeas and then cardiac stress is shown via the Viatom.
I have tried variable pressure, but all scores just got worse, and I found 20 was the best of the lot. I was once a Diver, so am not at all bothered by air pressure and sleep like a baby even at 20. My gut feeling is I really need something like a ResMed AirCurve that can do 25, and then set that to variable pressure. Thus, even with possible Mask Leaks when extra Pressure is needed, the overhead should mean I will get at least 20 when I am on, say, my back.
I have tried to persuade the NHS to let me have an AirCurve, but to no avail.
Sorry if I was not clear, my first episode before Sleep Apnoea was suspected and diagnosed, was definitely Atrial Flutter, and was a 2:1 Block, so Atria were banging away at probably 300 bpm, and the AV Node was blocking that 50% (hence 2:1), down to around 147-150 bpm. The ECG was regular and with the classic saw tooth in between. That was a one off, and almost certainly caused by a trigger of bad fat that caused missed beats, then that night Sleep Apnoea probably suffocated me on top, and my heart thrashed itself half to death trying to pump poorly oxygenated blood, when it also needed that blood to function.
So, I think it went into Atrial Flutter as a result. As far as I know, that was the first time that happened. That was in late 2019.
That seems to have been a once-off. After that, we suspected Sleep Apnoea, and took steps to mitigate. Initially via the Viatom Alarm that woke me up via buzzer if Oxygen levels went below a set percentage, then later via CPAP, which once I found the right settings, effectively managed Sleep Apnoea and made it go away (albeit it's always there hiding behind the CPAP)!
After that, I only get missed beats after eating the wrong things (always bad fats, trans fats or now usually Palm Oil).
Before 2022, if I failed to spot what I was eating had Palm Oil in it, then every single time that has jumped from missed beats to Atrial Fibrillation. I think only 3 or 4 times, and all were of limited duration. But Palm Oil was the only obvious factor every time. It did not seem to be Sleep Apnoea, as nothing happened at night when this happened, and my sleep logs show no Atrial Fibrillation or elevated Heart Rate.
By that, I mean if I eat something with Palm Oil in it, and it's just one thing, then the usual is I get missed beats after that has been digested. If I spot it and stop eating what ever it was, problem solved.
The worst is when I don't work out what it is, and missed beats carry on over a few days, then that has almost always converted to a session of Atrial Fibrillation, unrelated to CPAP, and always diet/Vagal stimulated. That has happened maybe 3 or 4 times, and always with Palm Oil preceding it.
It was only after the very start of 2022, after accidentally consuming a large dose of Palm Oil from mid-December 2021 to early February 2022 (hidden in the Vitamins and Supplements), that the missed heart beats that that caused, went to Atrial Fibrillation, and then only after the neck pain when acute for 10 seconds on 3rd January.
The delay going to AFib was, I think, because the Palm Oil was very refined and clear, against the solid mass they tend to use in things like biscuits, cakes, bread and sauces etc. Then they use the lard like almost raw Palm Oil, that is a solid at room temperature.
After that, I have been in and out of Atrial Fibrillation ever since, now on 15 sessions, the longest 9 days, and I regret that I am in AFib still right now.
I do fully understand a watch ECG is not the ideal thing but, the point is, it is accurate enough to show actual QRS rate, so I can see if the rate is regular or irregular, and count the bpm from the QRS (or let the watch count, or count the ECG Report directly to cross-check or check rate change within the 30 second test, shown as a 3 line ECG Chart with 10 seconds per line).
It does also show limited other things, such as P and T Waves, but only clearly when in Sinus Rhythm.
I have attended the Doctors twice for ECG, but managed to go into Sinus on the way there, and both ECG were absolutely normal by the time they strapped me in, with no sign of problems! That was not at all helpful!
I did attended Hospital once in early February 2022, when I was in AFib, and the two ECGs there did show it was Atrial Fibrillation but, I do not have any more information, other than they did not seem to be worried about the ECG in any other area. So, it was basically an irregular fast heart beat, but not what they would call an emergency compared to other people, as my rate was between 110-140 bpm, when some I know can whizz up to 220 bpm.
Stroke Risk
Thanks, I am in fact very aware of the Stroke risk, more than most as my late father almost certainly had undiagnosed Sleep Apnoea, almost certainly had Atrial Fibrillation too, and he died of a Stroke at 65.
As I am getting close to that age, this is indeed a looming psychobiological threshold!
2019 Atrial Flutter (Bad Fat + Sleep Apnoea Combination)
In 2019, I did have an echocardiogram after the first Atrial Flutter episode, and that was normal, with no sign of any structural heart issues, heart valves all OK, nothing swollen, and it seemed very healthy, and no high blood pressure.
That was maybe 2 years or so ago. But I have never had high blood pressure, and still don't.
I am not diabetic, and seldom go to see the Doctor unless I manage to break something else!
Sleep Clinic Aware
I did speak to the Sleep Clinic yesterday, as I am under their direct care, because I wanted to mention the Vagus Nerve issue and the ResMed F20 Strap pain.
I get on well with the Respiratory Consultant, probably because of my keen interest in Sleep Apnoea, and because I tinker with a few pre-used ResMed units for my wife and I to use, so we usually have a good chat. Indeed, I think it was my use of the Viatom CheckMe O2 that persuaded them to buy the same unit for conducting initial Sleep Tests on new patients.
Anyway, whilst chatting, I mentioned that I was waiting for a Cardiac Referral, so he checked the system, and said that I have indeed been allocated a Cardiologist, and am now on the waiting list for an available appointment. I have yet to hear about that direct but, as he would be contacting Cardiology himself to pass on the Vagus Nerve issue suspicions, that may accelerate me getting seen.
He seemed a little shocked that I have been, more or less, in AFib since January, so I think he may push things along to persuade Cardiology to extract a digit.
My Doctor said I was below the threshold for needing anticoagulant medication, and the Hospital said the same thing when I attended with AFib in February.
I do take Serrapeptase every day. That's the Silk Worm enzyme that seems to help with my damage related osteoarthritis inflammation, and is said to help remove any dead material from veins and arteries. That may help to explain why my heart and blood pressure are so good? I have been taking that for decades. I do seem to bleed well if stuck with anything, and my Blood Platelets are just below the usual normal range, so that may help in avoiding clots from the AFib?
Past Medical History
In terms of past history, I had a lot of physical trauma when young, mainly from crashing motorcycles, but I did have something of a misspent youth, so broke various bits in various ways on top.
I had lots of orthopaedic surgery to fix that up, and when fixed, I still managed to get into HM Forces and became a pilot, where I continued my misspent youth, and broke a few more bits. Now I can hardly walk but, it was fun and I would probably do it all over again, if given the choice (OK, maybe with a few sensible changes)!
But I was very fit, once, and did have numerous detailed medicals to maintain Flying Category, which did not ever find any cardiac issues at all.
However, by the turn of the Century, I was self-employed and working myself like a dog. When it was really bad, I did have issues with missed heart beats when I was being particularly irresponsible, such as cutting down on sleep to get the work done. I was always OK on 4 hours of sleep, or less, but I pushed that hard and went down to maybe 1.5 to 2.0 hours a night for a couple of years.
That got seriously bad, and I ended up having to back off, and just concentrate on sleep. I have not been the same since, and cannot now push that as hard.
However, at the time, we noticed a link between missed heart beats and bad fats, especially if low on sleep. So, I also cut out Trans Fat and Hydrogenated Fat. The combination of extra sleep and no bad fats, fixed it. The irregular beats went away.
But, after that, every time I consume bad fats, the missed heart beats come back. That has happened so many times neither myself, nor my wife, are in any doubt that there is a link. We just did not understand the mechanism. But I think now there is some Vagal link between digestion and heart, that would now explain this.
Enter Palm Oil
That all went away for many years until it began to reappear maybe 5 years or so ago.
Not finding Hydrogenated Fat or Trans Fats, we instead realised Palm Oil was the new enemy. It seems to have the exact same effect as Trans Fats and Hydrogenated Fats used to do, and this problem only came back because it has only started being put into food after they were banned from using the other bad fats!
Now Palm Oil is creeping in to everything, even things that we once thought were safe. This means that we are constantly having to re-read Food Labels to check it has not been added. Once it appears, we stop buying that product.
In summary, I do not yet have any formal diagnosis for the current Atrial Fibrillation, so do not know what else may be going on.
My watch ECG is just a handy overview, and accurate to check rate when optical sensors cannot count when in AFib. It shows me enough to see the shape of the QRS Complex, which is helpful and, when in Sinus, I can see that everything looks normal from an ECG Lead I perspective, with no sign of the three classic Heart Blocks, and no sign of anything Ventricular. Not an absolute at all, I know, but it is all I have and does at least show when I am in AFib and when in Sinus.
There are a few other ECG Lead I type of ECGs, but they all do the same thing, so the watch is up there with other similar units.
If I had the money, I would buy a small 12 Lead ECG, which seem to be available in the UK for around GBP 400.00 if anyone is interested. Viatiom do one for that price, but I do not know if it is any good.
At the moment I am still in AFib, it feels close to coming out, blood pressure has stabilised, and the heart beat rate is trending now towards 115-118 bpm, which is around the rate when I suddenly converts to Sinus. This latest session is dragging on, and I had hoped to drop out sooner.
Hopefully I will hear something soon, and get to see a Cardiologist. Be nice if I get one who will actually listen, and who will at least investigate the Vagal side of things. Many I regret do not seem to listen, and it can be a lottery to get to see a good on.
I will update if anything develops.
MoreBeers
I will indeed look at alternative Masks, my main limitation is a miniscule budget, so I regret that I just do not have the option to invest in alternatives unless one is likely to be successful (even then I will need to save my pennnies)!
Long story, but I am also quite physically disabled from hips down (motorcycles and then HM Forces injuries) so, I only have a very limited ability to earn anything. Not yet retired, albeit close, although that won't help at all, no pension to look forward to! So, I get to work until I drop.
I did consider the older ResMed Quattro FX, as I heard that was very good for higher pressures, but they are now discontinued, and hard to obtain, especially at a good price.
But thanks for the suggestion, I will indeed investigate the Fisher & Paykel Vitera option, and see if I can get my hands on one.
Thanks also SevereApnea/Chris!
A quick one on CPAP pressure. This is linked to my physical disabilities, in that I struggle to get comfortable at night, so tend to move around a bit, and go in and out of the best position for CPAP. I start on my right side, which is great for CPAP, but not good for shot right hip and damaged knees. So, I involuntarily end up on my back, which is comfortable, but the CPAP then really struggles, and 20 Pressure is only just enough to stop Obstructive Apnoeas. Any leaks and I am into Apnoeas and then cardiac stress is shown via the Viatom.
I have tried variable pressure, but all scores just got worse, and I found 20 was the best of the lot. I was once a Diver, so am not at all bothered by air pressure and sleep like a baby even at 20. My gut feeling is I really need something like a ResMed AirCurve that can do 25, and then set that to variable pressure. Thus, even with possible Mask Leaks when extra Pressure is needed, the overhead should mean I will get at least 20 when I am on, say, my back.
I have tried to persuade the NHS to let me have an AirCurve, but to no avail.
Sorry if I was not clear, my first episode before Sleep Apnoea was suspected and diagnosed, was definitely Atrial Flutter, and was a 2:1 Block, so Atria were banging away at probably 300 bpm, and the AV Node was blocking that 50% (hence 2:1), down to around 147-150 bpm. The ECG was regular and with the classic saw tooth in between. That was a one off, and almost certainly caused by a trigger of bad fat that caused missed beats, then that night Sleep Apnoea probably suffocated me on top, and my heart thrashed itself half to death trying to pump poorly oxygenated blood, when it also needed that blood to function.
So, I think it went into Atrial Flutter as a result. As far as I know, that was the first time that happened. That was in late 2019.
That seems to have been a once-off. After that, we suspected Sleep Apnoea, and took steps to mitigate. Initially via the Viatom Alarm that woke me up via buzzer if Oxygen levels went below a set percentage, then later via CPAP, which once I found the right settings, effectively managed Sleep Apnoea and made it go away (albeit it's always there hiding behind the CPAP)!
After that, I only get missed beats after eating the wrong things (always bad fats, trans fats or now usually Palm Oil).
Before 2022, if I failed to spot what I was eating had Palm Oil in it, then every single time that has jumped from missed beats to Atrial Fibrillation. I think only 3 or 4 times, and all were of limited duration. But Palm Oil was the only obvious factor every time. It did not seem to be Sleep Apnoea, as nothing happened at night when this happened, and my sleep logs show no Atrial Fibrillation or elevated Heart Rate.
By that, I mean if I eat something with Palm Oil in it, and it's just one thing, then the usual is I get missed beats after that has been digested. If I spot it and stop eating what ever it was, problem solved.
The worst is when I don't work out what it is, and missed beats carry on over a few days, then that has almost always converted to a session of Atrial Fibrillation, unrelated to CPAP, and always diet/Vagal stimulated. That has happened maybe 3 or 4 times, and always with Palm Oil preceding it.
It was only after the very start of 2022, after accidentally consuming a large dose of Palm Oil from mid-December 2021 to early February 2022 (hidden in the Vitamins and Supplements), that the missed heart beats that that caused, went to Atrial Fibrillation, and then only after the neck pain when acute for 10 seconds on 3rd January.
The delay going to AFib was, I think, because the Palm Oil was very refined and clear, against the solid mass they tend to use in things like biscuits, cakes, bread and sauces etc. Then they use the lard like almost raw Palm Oil, that is a solid at room temperature.
After that, I have been in and out of Atrial Fibrillation ever since, now on 15 sessions, the longest 9 days, and I regret that I am in AFib still right now.
I do fully understand a watch ECG is not the ideal thing but, the point is, it is accurate enough to show actual QRS rate, so I can see if the rate is regular or irregular, and count the bpm from the QRS (or let the watch count, or count the ECG Report directly to cross-check or check rate change within the 30 second test, shown as a 3 line ECG Chart with 10 seconds per line).
It does also show limited other things, such as P and T Waves, but only clearly when in Sinus Rhythm.
I have attended the Doctors twice for ECG, but managed to go into Sinus on the way there, and both ECG were absolutely normal by the time they strapped me in, with no sign of problems! That was not at all helpful!
I did attended Hospital once in early February 2022, when I was in AFib, and the two ECGs there did show it was Atrial Fibrillation but, I do not have any more information, other than they did not seem to be worried about the ECG in any other area. So, it was basically an irregular fast heart beat, but not what they would call an emergency compared to other people, as my rate was between 110-140 bpm, when some I know can whizz up to 220 bpm.
Stroke Risk
Thanks, I am in fact very aware of the Stroke risk, more than most as my late father almost certainly had undiagnosed Sleep Apnoea, almost certainly had Atrial Fibrillation too, and he died of a Stroke at 65.
As I am getting close to that age, this is indeed a looming psychobiological threshold!
2019 Atrial Flutter (Bad Fat + Sleep Apnoea Combination)
In 2019, I did have an echocardiogram after the first Atrial Flutter episode, and that was normal, with no sign of any structural heart issues, heart valves all OK, nothing swollen, and it seemed very healthy, and no high blood pressure.
That was maybe 2 years or so ago. But I have never had high blood pressure, and still don't.
I am not diabetic, and seldom go to see the Doctor unless I manage to break something else!
Sleep Clinic Aware
I did speak to the Sleep Clinic yesterday, as I am under their direct care, because I wanted to mention the Vagus Nerve issue and the ResMed F20 Strap pain.
I get on well with the Respiratory Consultant, probably because of my keen interest in Sleep Apnoea, and because I tinker with a few pre-used ResMed units for my wife and I to use, so we usually have a good chat. Indeed, I think it was my use of the Viatom CheckMe O2 that persuaded them to buy the same unit for conducting initial Sleep Tests on new patients.
Anyway, whilst chatting, I mentioned that I was waiting for a Cardiac Referral, so he checked the system, and said that I have indeed been allocated a Cardiologist, and am now on the waiting list for an available appointment. I have yet to hear about that direct but, as he would be contacting Cardiology himself to pass on the Vagus Nerve issue suspicions, that may accelerate me getting seen.
He seemed a little shocked that I have been, more or less, in AFib since January, so I think he may push things along to persuade Cardiology to extract a digit.
My Doctor said I was below the threshold for needing anticoagulant medication, and the Hospital said the same thing when I attended with AFib in February.
I do take Serrapeptase every day. That's the Silk Worm enzyme that seems to help with my damage related osteoarthritis inflammation, and is said to help remove any dead material from veins and arteries. That may help to explain why my heart and blood pressure are so good? I have been taking that for decades. I do seem to bleed well if stuck with anything, and my Blood Platelets are just below the usual normal range, so that may help in avoiding clots from the AFib?
Past Medical History
In terms of past history, I had a lot of physical trauma when young, mainly from crashing motorcycles, but I did have something of a misspent youth, so broke various bits in various ways on top.
I had lots of orthopaedic surgery to fix that up, and when fixed, I still managed to get into HM Forces and became a pilot, where I continued my misspent youth, and broke a few more bits. Now I can hardly walk but, it was fun and I would probably do it all over again, if given the choice (OK, maybe with a few sensible changes)!
But I was very fit, once, and did have numerous detailed medicals to maintain Flying Category, which did not ever find any cardiac issues at all.
However, by the turn of the Century, I was self-employed and working myself like a dog. When it was really bad, I did have issues with missed heart beats when I was being particularly irresponsible, such as cutting down on sleep to get the work done. I was always OK on 4 hours of sleep, or less, but I pushed that hard and went down to maybe 1.5 to 2.0 hours a night for a couple of years.
That got seriously bad, and I ended up having to back off, and just concentrate on sleep. I have not been the same since, and cannot now push that as hard.
However, at the time, we noticed a link between missed heart beats and bad fats, especially if low on sleep. So, I also cut out Trans Fat and Hydrogenated Fat. The combination of extra sleep and no bad fats, fixed it. The irregular beats went away.
But, after that, every time I consume bad fats, the missed heart beats come back. That has happened so many times neither myself, nor my wife, are in any doubt that there is a link. We just did not understand the mechanism. But I think now there is some Vagal link between digestion and heart, that would now explain this.
Enter Palm Oil
That all went away for many years until it began to reappear maybe 5 years or so ago.
Not finding Hydrogenated Fat or Trans Fats, we instead realised Palm Oil was the new enemy. It seems to have the exact same effect as Trans Fats and Hydrogenated Fats used to do, and this problem only came back because it has only started being put into food after they were banned from using the other bad fats!
Now Palm Oil is creeping in to everything, even things that we once thought were safe. This means that we are constantly having to re-read Food Labels to check it has not been added. Once it appears, we stop buying that product.
In summary, I do not yet have any formal diagnosis for the current Atrial Fibrillation, so do not know what else may be going on.
My watch ECG is just a handy overview, and accurate to check rate when optical sensors cannot count when in AFib. It shows me enough to see the shape of the QRS Complex, which is helpful and, when in Sinus, I can see that everything looks normal from an ECG Lead I perspective, with no sign of the three classic Heart Blocks, and no sign of anything Ventricular. Not an absolute at all, I know, but it is all I have and does at least show when I am in AFib and when in Sinus.
There are a few other ECG Lead I type of ECGs, but they all do the same thing, so the watch is up there with other similar units.
If I had the money, I would buy a small 12 Lead ECG, which seem to be available in the UK for around GBP 400.00 if anyone is interested. Viatiom do one for that price, but I do not know if it is any good.
At the moment I am still in AFib, it feels close to coming out, blood pressure has stabilised, and the heart beat rate is trending now towards 115-118 bpm, which is around the rate when I suddenly converts to Sinus. This latest session is dragging on, and I had hoped to drop out sooner.
Hopefully I will hear something soon, and get to see a Cardiologist. Be nice if I get one who will actually listen, and who will at least investigate the Vagal side of things. Many I regret do not seem to listen, and it can be a lottery to get to see a good on.
I will update if anything develops.
MoreBeers
