To Vaccinate or Not---The Rat Flu Odyssey Continues

[Whiteroom_Guardian]

And just like that sitting here doing some work and left side chest pain, kinda took my breath away for about a minute. Ughhh.

[skiJ]

if we can't offer a fellow mag some solid advice on chest pain management, crypto investing, foreign policy, and what softshell to wear for a specific mountain's aspect on a specific day for a specific weather forecast then what are we doing here?

Good luck, WRG -

a 'normal' EKG is a good start ; it is a long way from 'a Clean slate' ;
I will be following your posts with interest and concern...

Be well...
( Please) Be Safe - skin

[bennymac]

And just like that sitting here doing some work and left side chest pain, kinda took my breath away for about a minute. Ughhh.

if you were in Canada or Europe you would just go to the ER and get checked out with blood tests and xrays and ECGs and get that heart monitor put on ASAP

I mean you can do that too but it sucks that the financial implications need to be considered

the only advice I have for someone having chest pain at rest is "go to the nearest ER now"

[Whiteroom_Guardian]

Yeah IDK what to even think. A little lightheaded/spacey feeling after these little weird episodes. It wears off though.

It's like a chicken or egg scenario. The last thing on my mind was my heart. Sitting here doing some work stuff and bam. Then stand up and pace around for a couple minutes waiting for the pain to go away....then of course the following anxiety.

It's not like I was sitting here thinking about it and then it manifested.......

Not fully sure why my doc wouldn't at least run a troponin blood test? IDK though. I'm not a doctor.

Was supposed to go lift with the other mountain bike guys in 30 mins. Doc said to keep doing what I've been doing......but thinking maybe not. Fuck.

[bennymac]

go to the ER is my advice

the free TGR advice is "you need to check what your pulse rate is during these episodes and is your pulse regular or irregular - using a HRM or even better one of these home ECG things - ask your athlete friends and get on this asap - today. Someone out there in your area has the ability to help you with this I'm guessing. Its likely also helpful to be monitoring your pulse rate and whether its regular or irregular even when you are not having pain "

but I say this with hesitation because I'd rather you be seen in the ER then doing chest pain diagnosis via the padded room

[Whiteroom_Guardian]

I check my pulse as soon as I feel anything weird and it stays nice and low. One of those home EKG things is probably a good idea.

Thing is that I feel the best when working out 99% of the time. I really want to go to the gym right now. Only time I didn't feel great when working out was yesterday while hiking the Ridge. First time ever.

Edit: Well just did like 20 jumping jacks to get my heart rate up and my chest was painful....left side...so not going to the gym now obviously. Trying to decide at what point I want to burn thousands of dollars going to the ER.

[XXX-er]

i went to emerg with chest pains a few years ago, they took blood, ran it thru the lab came back in < 45 min and told me it wasnt a heart attack

[Harry]

And just like that sitting here doing some work and left side chest pain, kinda took my breath away for about a minute. Ughhh.

You don’t have to name names, but you know who my Cardiologist is. Is that who you are seeing ?


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[Whiteroom_Guardian]

You don’t have to name names, but you know who my Cardiologist is. Is that who you are seeing ?


Sent from my iPhone using TGR Forums

No. Just been seeing my regular general medicine guy for now. As soon as I go to any specialist of any sort the ghetto-ness of my insurance will kick in.

[bennymac]

i went to emerg with chest pains a few years ago, they took blood, ran it thru the lab came back in < 45 min and told me it wasnt a heart attack

sounds like he saw his regular doctor - that test isn't typically gonna be done through an office visit - since if you need that test then by definition you should be in an ER / not going to some lab down the street and awaiting a result that could say "yep - that's a heart attack you're having"

[Tri-Ungulate]

WG, a few things.

'cuz it had to be said: whereas yes, supermodel159 is technically correct in that some individuals have experienced cardiac sequelae from SARS CoV2 vaccination, I should add that the number is vanishingly small, especially when one considers the billions of vaccinations administered worldwide thus far. I'm going to guess supermodel159 has little or zero medical or biology or epidemiology background, or real understanding for that matter, and is predictably flogging his tireless antivax opinions based on whatever Facebook pages he's parroting.

More importantly, actual SARS CoV2 infection is a well known and increasingly recognized cause of subsequent cardiac symptoms, as Bunion's article describes, with the incidence several orders of magnitude greater than what has been observed in vaccination side effect profiles.

My gut feeling (and there's plenty of others thinking along these lines) is that when the SARS CoV2 enters vascular endothelial cells via the ACE2 receptor, as is well established, the subsequent inflammatory conditions that are likely immune-mediated (and the proximal cause of thrombotic-related SARS CoV2 deaths, as well as "cytokine storm" pneumonias) can also continue long-term, in "long COVID" scenarios. They can be episodic (which is to say, they can come and go unpredictably, or can be triggered by as-yet-to-be-determined stimuli, often stress-related). This can lead to hard-to-describe or hard-to-objectively-measure symptoms that aren't really a heart attack or arrhythmia, and thus can't be measured by things like blood troponin tests (like the on that XXX-er prolly got) or by a spot EKG.

We're seeing a number of patients who got COVID19 with your symptoms, and as Bunion's article mentions, it looks a lot like POTS (postural orthostatic tachycardia syndrome) - the symptoms mirror yours to a T. This is a tricky one to diagnose sometimes, as it involves autonomic dysfunction, which can be more difficult to evaluate.

You might want to have your doc look into seeing if you can be referred to a cardiologist that has some experience with "long COVID" symptoms, usually in an academic setting (though not always). Not sure what the physician landscape is like in your neck of the woods, nor do I know what your insurance situation is like, but at the very least, if you get that referral, you'll be getting a specialist who has likely seen exactly what you're describing many times over the past year or so,and is actively up-to-date on how to evaluate and how to attempt to address the condition.

[skiJ]

This ^^^ x100. skiJ

[skaredshtles]

No. Just been seeing my regular general medicine guy for now. As soon as I go to any specialist of any sort the ghetto-ness of my insurance will kick in.

This shit pisses me off every time I hear it. It should not be a financial decision whether you see a specialist or not.

You need to see a cardiologist.

This country is so fucked up.

[old goat]

Let's not forget there are other organs in the chest besides the heart and they can be affected by covid.

[Whiteroom_Guardian]

WG, a few things.

'cuz it had to be said: whereas yes, supermodel159 is technically correct in that some individuals have experienced cardiac sequelae from SARS CoV2 vaccination, I should add that the number is vanishingly small, especially when one considers the billions of vaccinations administered worldwide thus far. I'm going to guess supermodel159 has little or zero medical or biology or epidemiology background, or real understanding for that matter, and is predictably flogging his tireless antivax opinions based on whatever Facebook pages he's parroting.

More importantly, actual SARS CoV2 infection is a well known and increasingly recognized cause of subsequent cardiac symptoms, as Bunion's article describes, with the incidence several orders of magnitude greater than what has been observed in vaccination side effect profiles.

My gut feeling (and there's plenty of others thinking along these lines) is that when the SARS CoV2 enters vascular endothelial cells via the ACE2 receptor, as is well established, the subsequent inflammatory conditions that are likely immune-mediated (and the proximal cause of thrombotic-related SARS CoV2 deaths, as well as "cytokine storm" pneumonias) can also continue long-term, in "long COVID" scenarios. They can be episodic (which is to say, they can come and go unpredictably, or can be triggered by as-yet-to-be-determined stimuli, often stress-related). This can lead to hard-to-describe or hard-to-objectively-measure symptoms that aren't really a heart attack or arrhythmia, and thus can't be measured by things like blood troponin tests (like the on that XXX-er prolly got) or by a spot EKG.

We're seeing a number of patients who got COVID19 with your symptoms, and as Bunion's article mentions, it looks a lot like POTS (postural orthostatic tachycardia syndrome) - the symptoms mirror yours to a T. This is a tricky one to diagnose sometimes, as it involves autonomic dysfunction, which can be more difficult to evaluate.

You might want to have your doc look into seeing if you can be referred to a cardiologist that has some experience with "long COVID" symptoms, usually in an academic setting (though not always). Not sure what the physician landscape is like in your neck of the woods, nor do I know what your insurance situation is like, but at the very least, if you get that referral, you'll be getting a specialist who has likely seen exactly what you're describing many times over the past year or so,and is actively up-to-date on how to evaluate and how to attempt to address the condition.

I appreciate the lengthy response. I'm not sure there are any long covid specialists around here. Most everyone I know with some coin just flies to SLC or Seattle when they have anything happening to them above very run of the mill stuff......or orthopedics. We have lots of people around here breaking legs and arms in weird ways that's for sure.

It's kind of the only thing I miss from living in NJ. Have had amazing experiences with docs at UPenn etc. Just a level of expertise we don't really have here.

Honestly I've been like 95% for the past year. On again off again where some days/weeks I just felt shitty with no explanation at all despite lots of exercise, vitamin D, etc etc.

I guess I have to wait and see for a bit and possibly think about looking into it and just spending the damn money.

[Tri-Ungulate]

From what little I can gather thus far, if you indeed do have SARS CoV2-related POTS, it's not life-threatening, as a real heart attack or arrhythmia might be. The caveat is that it's early days in terms of making this possible connection, so I can't say for certain, nor does anybody know the long-term effects.

But overall, my gut feeling (again, no guarantees) is that if this is the case, it won't kill you, but it may intermittently make your life miserable and stressful until it either goes away by itself or the medical community figures out how to deal with it.

It might not hurt to make a point of remaining well-hydrated, as being dehydrated can exacerbate autonomic hypotension. It's easy to do and might make episodes less frequent and/or severe. Don't overdo it, just make sure you've got light straw-colored pee.

EDIT TO ADD:
WG, get a blood pressure gauge, you can buy one at your local Pharmacy, for $10-20.
- When you have symptoms of your heart racing and feeling faint, headache, etc - take your blood pressure and measure your heartrate. Write them down.
- Lie down for 5 minutes or so, take your blood pressure and measure your heartrate while you're lying down. Write the numbers down.
- Stand up suddenly and take your blood pressure and measure your heartrate again within the next minute or so. Write that down.

If there's a big difference in the numbers, you may have POTS. Take these numbers to your doc.
If you're feeling super shitty, in terms of chest pain and shortness of breath and feelings of doom, don't wait and take the numbers to the ER.

If you get these episodes of lightheadedness etc often and they are significant, be careful driving and operating heavy machinery.

Don't take Viagra. If your erection lasts for more than 4 hours, seek professional help.

[Whiteroom_Guardian]

Thanks. Not to get totally derailed on this, but everything I am seeing with POTS is heart rate related.....unless I am missing something my heart rate seems to stay normal. The only long hauler place in the entire state is in Great Falls. Honestly, don't even know if I'm there. Most of the time I feel pretty good really. I'm gonna at least lay off the Z3 interval stuff for now. That seems to have triggered whatever these current symptoms are.

I really really want to keep training though. I had an awesome MTB race season last summer and am already registered for a bunch of races this summer.

[Tri-Ungulate]

Yeah, but you're describing heart symptoms that are episodic. POTS is kinda rare, and only recently associated with SARS CoV2 infection, and may only happen intermittently in that situation. Which is why gathering data (heartrate and blood pressure) can determine if your symptoms are possibly associated. Also get your baseline (normal) HR and BP.

I do need to add, for obvious reasons, that I'm NOT A CARDIOLOGIST, but I did stay at a Holiday Inn Express.

[riser4]

WG needs to steal Harry's ID and say he's coming back for seconds.

[rod9301]

And this right here is the issue for a lot of folks. Health care is just too expensive. Doc wasn't interested in doing a stress test? That way they can watch what happens. I'm not a doctor and it's been a long time since I've stayed in a HIE.

This is crazy, that a holter monitor skis cost anything other than a visit to the doctor.

My kid had it in France and the entire cost, including the doctor visit, before and after was 70 usd.

Sent from my moto g 5G using Tapatalk

[bennymac]

Could be post covid related - or could have nothing to do at all with covid (and as OG said these symptoms may have nothing to do with your heart) - doing a holter (or a home made holter using some consumer device) is a start. Blood pressure checks as well as TU said if you’re doing the “TGR home heart check up”

[bigdude2468]

Stay prepared for the worst (plenty of masks and sanitizer products stocked up) while hoping for the best.. What would really suck is for a variant to evolve that's also highly surface transmissible like norovirus is.. It's manageable for one or the other, semi airborne OR surface transmission.. But having to constantly mask up AND wash/sanitize fucking everything anyone else touched with in the past week would really suck.

Have not seen anything here about this New York Times article that the latest research through multiple studies is showing that three doses or even two of the mRNA vaccine provides long lasting protection for most people through T cells against serious illness and death for many months and perhaps years. They also believe that T cells will work against any future variants.

http://www.nytimes.com/2022/02/21/he...s-t-cells.html

[skiJ]

Vaccine protection from T cells and memory B cells may last long time, even though serum antibody levels wane fairly quickly.
This cellular immunity adapts well to variants, compared to serum antibodies.
https://www.nytimes.com/2022/02/21/h...s-t-cells.html
https://www.nature.com/articles/s41586-022-04527-1
https://www.biorxiv.org/content/10.1...02.14.480394v1

covered.
4:18PM, 2-21

Thank you, ' goat.

[Trackhead]

And just like that sitting here doing some work and left side chest pain, kinda took my breath away for about a minute. Ughhh.

Go to a cardiologist, consider:
1. Holter (you are already doing that)
2. CRP/D-dimer (how long ago was your covid?)
3. Echo
4. Cardiac MRI

I recently had an otherwise young, healthy, unvax patient 5 weeks post covid with MIS-A. Crazy case. Did fine with corticosteroids, echo/cardiac MRI normal, but this patient had soft blood pressures at presentation, persistent tachycardia refractory to fluids, a crazy high D-dimer/CRP/ferritin. I see a lot of post covid patients in ER/primary care. Mostly adolescents, handful with appendicitis mimicking presentations that end up having mesenteric lymphadenitis on CT, older folks with post covid pulmonary fibrosis, etc, etc......

[Trackhead]

Yeah IDK what to even think. A little lightheaded/spacey feeling after these little weird episodes. It wears off though.

It's like a chicken or egg scenario. The last thing on my mind was my heart. Sitting here doing some work stuff and bam. Then stand up and pace around for a couple minutes waiting for the pain to go away....then of course the following anxiety.

It's not like I was sitting here thinking about it and then it manifested.......

Not fully sure why my doc wouldn't at least run a troponin blood test? IDK though. I'm not a doctor.

Was supposed to go lift with the other mountain bike guys in 30 mins. Doc said to keep doing what I've been doing......but thinking maybe not. Fuck.

25 years of ER experience here: Take it for what it is worth as getting a valid patient history on TGR is utterly impossible. Using your words, my observations. I've seen literally thousands and thousands of people presenting to ED for similar symptoms before covid existed, and after. Human nature follows patterns, most of the time. Your symptoms sound like anxiety/stress, which is something that will probably piss you off, which is normal. That said, a workup is justified and indicated. Intermittent, short duration chest pain without exercise intolerance is rarely cardiac in nature. Post covid is in the differential diagnosis, but so is non-cardiac. Rule out the former, consider the latter.

1. "Light headed/spacey after episode" (common with anxiety)
2. "Following anxiety" (you specifically mention anxiety). I bet you also wonder when the next episode will occur. Perhaps a feeling of impending doom, difficulty concentrating. You mentioned tingling in your fingers in another post (super common with anxiety). Any tingling in lips/face?

If blowing your brains out exercising is not reproducing the pain, a troponin is unlikely to be abnormal. Critically ill covid patients often have elevated troponin DURING ACUTE ILLNESS. I've seen one case of MIS-A where young patient had grossly elevated troponin 5 or so weeks out after recovery, but she was also obviously ill.

Low hanging fruit labs:
1. CRP (crude inflammatory marker) - likely normal
2. Troponin (cardiac enzyme) - likely normal
3. D-dimer (crude marker of pulmonary embolism in setting of pleuritic chest pain) - likely normal, but I'd include it given your post covid pleuritic chest pain.

If you ever want to discuss on phone, be happy to give you insight. Or you can just tell me to fuck off, which is fine too.