bigemeni pvcs on ekg during flight physical

[tulsa]

An anonomyous friend recently went to get an FAA class1 flight physical.  He had consumed 3 x 16oz bottles of diet mountain dew before hand.  (This is a normal daily intake for him.  On many days he drinks lots more).  The last one was in the waiting room immediately before the physical.  He had also been using a pre-workout sports supplement called NO-Explode which also has a lot of caffine in it among other things, although he had not taken any that morning.  When the doctor looked at the strip from the EKG he looked at my friend like he was a ticking time bomb.  It had multiple PVCs mostly w/ a bigemeni pattern.  He abstained from all caffine for 48hrs and went back for another EKG.  This one started w/ a longer rythem test which showed a single bigemeni PVC at the beginning and then was normal.  The shorter strip displayed no PVCs at all.  The doctor cited the first test w/ the PVCs and a T-wave abnormality as well as an ST abnormality as a big concern.  He wants a full cardiac work up including a hoster strapon thingie, stress test and possible imaging.  Frankly, my friend is not pleased w/ the doctor's extra concern for his health above and beyond the minimum required by the FAA.  BTW, he works out routinely both running and lifting and his cholesterol number is 150 total w/ the "good" cholesterol comprising 100 of the 150.  Further, this guy has been flying fighers in the military for over twenty years without ever having any negative health issues.  The civilian doctor was very eager to share his information w/ the military.  Frankly, my friend is very distrustful of doctors at this point and wants to provide the minimum information that could mortgage his employment present and future to a doctor so eager to do everything possible to find any possible problem.  FAA only appears to require a stress test if more than one PVC is found on a single strip.  

So, his questions:  1.  Anyone familiar w/ NO-Explode?  Can it cause abnormal EKGs?  If so, how long after discontinuing use would it take to no longer have an impact on the EKG?  2.  If all that FAA requires is a stress test should my friend resist being coerced into extra tests holter monitor, etc.  3.  Other than eliminating caffine, reducing alcohol intake and getting sufficient rest do you have any other recommendations on do's and don'ts prior to next visit whether it be resting EKG, stress test or other (ie. running or lifting, etc)?

[Darlingorla]

Great answer Cindy - this guy should take better of himself ...  I can only think he is taking these beverages to stay extra alert which the body is not designed to do for extended periods ...

If he carries on this way, he will end up with some of the problems/issues which many of us here have to contend with on a day to day basis - through no fault of our own, except that these are the cards we have been dealt.

[cindy707]

Okay i can comment about a couple of these things.  First off Mountain Dew is super super high in caffeine and that should be a definate no no because yes it can cause you to overload on PVC's .....i would definately cut out all caffeine for at least 72 hours period...whether it be for himself or the doc.  This means......no colored sodas at all, no coffee, no iced tea, definately no red wine, limited amounts of sugar, no chocolate and definately and especially no energy drinks or anything with electrolytes in it such as gatorade.  He has to make sure that he stays super hydrated with water because dehydration can toss out PVC's as well.  I think probably what the doc is trying to do with a holter monitor is rule out anything that may be lurking in the background here and that is normal.  I have never heard of No Explode but looked it up on google and saw that it is absolutely loaded with caffeine and in reading further said that there are studies going on right now with it because users are reporting heart problems so i guess the FDA is now looking into it and doing clinical trials on it.  Would i put it in my body???  Not a chance i am not going to tach out my heart no matter how tired i am.  After what you have posted i am not surprised that he came up with an abnormal test at all.....the big question is why is he loading his system with all of this garbage?  Sounds like he takes great care of himself but loading up on the Mountain Dew, energy drinks and No Explode could literally cause permanent damage to his heart.  I personally think what he should do is give that same doc a call and be honest with him...tell him that he drinks 3 plus mountain dews a day plus drinks energy drinks....i think it will give the doc a whole nother perspective and enlightenment and may not want to do all of these tests after he has all of the facts.  Good luck......and lighten up.......hoorah......