What should I do?

[KHL]

I am a 53 year old woman diagnosed with tachycardia approximately 8 years ago and I am taking Toprol XL 100.  Three years ago I had renal failure and was hospitalized because my organs were shutting down, I was on a telemetry unit for 8 days, at that time there appeared to be some damage to my heart.  My father died at 55 of a massive cardiac aneurysm.  Recently I been experiencing major episodes of tongue numbness, loss of balance which has caused some serious accidents, dizziness to blacking out, I have developed a small cough that makes me balckout, a wheeze, nausea, severe shortness of breath, my blood pressure ranges about 90/50 with a pulse anywhere from 160 to 200.  I have also had 3 surgeries (out of over 30) where my heart stopped and I had to be resucitated.

I also have CRPS and I am taking large doses of neurotin and ultram to control the chronic pain.  The symptoms of above began years after I started this regimen.

I am in the process of moving from MS to NC where my cardiologist is, I have refused treatment here because I have terrible insurance and do not want these tests, if necessary, done twice.  Am I a time bomb in other words!

[Momto3]

Hi KHL,

Dr. McWilliams provides an awesome service to the members of this forum.  His answers are timely, thorough and supportive.  

My cousin is a ND graduate and practices medicine in Burlington, NC : )  Go Fighting Irish!!  I remember when we would all gather around my dad as he played the ND fight song on the piano!  Great times!!

I am originally from Cleveland (currently buried in snow) and now reside in the Raleigh area of NC.  Is Dr. Mangano in Raleigh?  I have a cardiologist in Cleveland and one here in Raleigh.  I answered your other post on the community board.  Hope you're doing OK.

Connie

[Michael J. McWilliams, M.D.]

Your history sounds very complicated.  I had not heard of CRPS.  It sounds like some older syndromes like RSD have been reclassified into this category.

Cardiac arrests in the setting of surgery does not necessarily mean the same thing as cardiac arrests in every day life.  I agree that you should have a cardiac evaluation and cardiac risk assessment.  The majority of the symptoms you describe are not cardiac in nature.  

In my opinion and the opinion I would give a family member, is to find an expert in CRPS and obtain a cardiac evaluation.  If the cardiac evaluation is ok, then that should help you feel better from a cardiac perspective.  It sounds like the majority of your symptoms are coming from CRPS and should be addressed.  This is not a problem that most physicians will know much about and or have much experience.  Experience is important.

Notre Dame is great place. You should be very proud of your father.  Good luck and I hope this helps.

[KHL]

Thank you so much for all your help.

[Michael J. McWilliams, M.D.]

I am afraid I can't answer that one.  EKGs are very visual.  You would be a very difficult person to tease out coronary symptoms because you have a multi system disease with complex symptoms.  I think further testing will be necessary to determine the clinic significance of non specific EKG changes.

[KHL]

You are correct regarding CRPS being RSD and I definitely have a very complicated history.CRPS is the new buzz word.

I am sorry, but I was concentrating on the symptoms, I forgot to provide you with this info, I was at the internist last week and had an abnormal EKG, and he wanted me to see a cardiologist then

Since these symptoms do not seem coronary in nature, I am a little confused because they don't seem CRPS in nature either.  Do you feel I can postpone my evaluation until I am back in the Raleigh area in approx. 2 months?

Thank you for your assistance, I don't have a great deal of confidence in the medical care I will receive here.

.

[KHL]

I just read your CV,etc.  My father played football at Notre Dame.  I lived in Raleigh, NC 20 years and Charlie Mangano is the doctor I am trying to get back to, and I had a house in Wrightsville.  Small world.