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Old 02-03-2013, 08:04 AM   #1
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Help! Pain×30yrs, narcotics & heart problems

Hi all, I need help pronto from all anyone that knows about intractable pain symptoms versus opioid side effects! I have severe back pain treated with fentanyl & morphine for 12 years called chronic, intractable, multiple failed back surgeries, arachnoiditis, tethered cord by PM & have been having a constant hard, pounding, hear it loud in my ears & head heartbeat for over 4 months & it was suggested that intractable pain was causing it but may be side effect of narcotics. I need to know everything & anything that you know about pain or the opioids causing this! I have held the narcotics & it still pounds away & is it from pain or the meds i dont not know nor can i figure this out! Please help, have cardiology appt but that doesnt mean that he will know squat about this & if he says that its all caused by the narcotics then what do i do about the pain, i cant live with it, too severe! My pain dr thinks that this is caused by intractable pain & if i say that i think its from the meds then he wouldnt give them to me unless the
cardiologist says im ok. Im confused but mostly miserable from the
constant pounding! Do you know what this is or might be? Do you know about what morphine can do to your heart or any ideas ? Thank you in advance!

Last edited by gmak; 02-03-2013 at 10:47 AM. Reason: info

 
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Old 02-03-2013, 10:54 AM   #2
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Re: Help! Pain×30yrs, narcotics & heart problems

Hi,
Sorry to hear about your difficulties. I am not a doctor but, having experienced heart pounding for several hours recently, I looked it up. Heart pounding is normally, but not always, something that happens along with rapid heart beat so people often think of both of them as the same thing. Rapid heart beat is caused by norepinephrine but pounding heart is caused by another hormone produced downstream of norepinophrine most of the time. It is called vasopressin. The reason a heart pounds is that your brain thinks you need to squeeze your heart ventricles harder so blood can reach all your muscles in preparation for fight or flight. This is a good thing in an actual fight or flight situation and obviously a bad thing when you are not threatened in any way. To stop a heart from pounding, you need a vasopressin antagonist type drug. Any benzodiazepine will do it but they are highly addictive. Benzos suppress the entire Central Nervous System so norepinophrine (the cause of rapid heart beat and a host of other anxiety and panic symptoms) is kept at manageable levels too. The main thing to remember is that if you can block vasopressin or at least limit its production somewhat, you won't get the super heart squeeze that causes pounding heart. By the way, the actual pounding sound is caused by your heart valves slamming shut when the ventricles (the left one - the big one- in particular) compress. Normally you don't feel or hear the valves but when vasopressin starts the big squeeze, it is, as you know, quite uncomfortable and prevents sleep. Just google vasopressin antagonist to see what drugs prevent heart pounding. Also, google vasopressin and norepinephrine AGONIST to find what food or drink facilitates these hormones. That way you can help your condition somewhat by avoiding them.
I hope this helps. God Bless you. Don't hesitate to post your progress or lack of it here.

Last edited by agelbert; 02-03-2013 at 10:58 AM. Reason: Spelling error

 
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Old 02-03-2013, 12:31 PM   #3
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Re: Help! Pain×30yrs, narcotics & heart problems

Dear agelbert, Thank you so much for taking the time to give me the explanation & information that i was hoping to receive. It was a God send , i dont think i would have gotten this good of explanation from my drs!.Very informative & i understand autonomic response but i didnt know it was vasopressin, thought cortisol but it happens if severe pain or controlled pain. First i want to stop it & have benzos then studying, i will let you know what happens & know i will have questions so thanks for your help

 
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Old 02-05-2013, 10:06 AM   #4
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Re: Help! Pain×30yrs, narcotics & heart problems

Hi all, Just wondering if anyone else with chronic pain on narcotics ever had pounding heartbeat? If so, what happened? Did it go away by itself, was it transient, or a one time thing? Also, Did anyone have their pulse or blood pressure rise due to extreme pain?

 
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Old 02-05-2013, 08:38 PM   #5
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Re: Help! Pain×30yrs, narcotics & heart problems

I definitely think it could be from the pain (assuming you have had high levels over a long period of time), but better safe then sorry. From my reading I'm not aware of any interaction of opiates and the heart (besides methadone). However, yes many folks do get a pulse drop or rise and blood pressure drop or rise with increased pain. Both go up for me. Definitely seek out an urgent care or your primary doctor in the meantime to ensure this isn't something to worry about.

Did you have a med/dose change right before this started? What would your doctor think about tapering down some and see if it subsides any? That may be a reasonable test without completely going off of them. Assuming you are on long acting meds and just held off on the dose, I'd guess that you'd probably have to be into a good withdrawal before you'd see a side effect start to subside (not just late a few hours). Best wishes.
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Old 02-05-2013, 09:52 PM   #6
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Re: Help! Pain×30yrs, narcotics & heart problems

Quote:
Originally Posted by tortoisegirl View Post
I definitely think it could be from the pain (assuming you have had high levels over a long period of time), but better safe then sorry. From my reading I'm not aware of any interaction of opiates and the heart (besides methadone). However, yes many folks do get a pulse drop or rise and blood pressure drop or rise with increased pain. Both go up for me. Definitely seek out an urgent care or your primary doctor in the meantime to ensure this isn't something to worry about.
Did you have a med/dose change right before this started? What would your doctor think about tapering down some and see if it subsides any? That may be a reasonable test without completely going off of them. Assuming you are on long acting meds and just held off on the dose, I'd guess that you'd probably have to be into a good withdrawal before you'd see a side effect start to subside (not just late a few hours). Best wishes.
Hi Tgirl, The fentanyl patch has stayed the same but the morphine has been dropped from 120/day to 60/day starting in september & all this started in October but the pain seems controlled. At first my pulse was going over 100 & bp up slightly but now those are fine just the pounding so hard, loud! Great to hear that nothing to read about opioids causing heart failure that i could find either & hopefully it is not that b/c pain does drive up pulse & bp. Thank you for answering me, it means so much!

 
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Old 02-06-2013, 04:30 PM   #7
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Re: Help! Pain×30yrs, narcotics & side effects

Hi!

It could certainly be from the pain. Are you on any other medications? Anti-depressants, including the ones commonly given for nerve pain, can cause rapid heart beat and very high blood pressure. There is a rare adverse interaction between most anti-depressants and some blood pressure medications, clonidine in particular. Have you checked your BP? High BP can cause that sound/feeling.

Hope you feel better soon.

Tigg.

 
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Old 02-24-2013, 10:48 AM   #8
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Re: Help! Pain×30yrs, narcotics & heart problems

Quote:
Originally Posted by gmak View Post
Dear agelbert, Thank you so much for taking the time to give me the explanation & information that i was hoping to receive. It was a God send , i dont think i would have gotten this good of explanation from my drs!.Very informative & i understand autonomic response but i didnt know it was vasopressin, thought cortisol but it happens if severe pain or controlled pain. First i want to stop it & have benzos then studying, i will let you know what happens & know i will have questions so thanks for your help
Hi agelbert, I told you I would update & heres what is happening. I made cardiologist appt, the "worked in quickly" appt is for 2/26/13. I started xanax that i had from over a year ago given to me by my PM, & yes i called & asked if it was okay first. Immediately, it stopped the ventricles pumping like so hard i could hear the valves to normal, normal bp, pulse, everything. This a.m. it was there again, still taking 0.5 mg og alprazalopam q 8 hrs. Earlier when you posted to me immediately til now, i tried looking up all you gave me & more & all i could find is it can be caused by hyponatremia which is low sodium,( im on no diurectics,) small cell carcinoma, hormone problems like low cortisol, but pain makes high cortisol levels! To cardio tuesday but still afraid of why this is happening especially if the dr says its the narcotic bc i have pain incompatible with being alive & then what? If you dont mind i have a question, you mentioned that my brain thinks that i am in fight or flight, why would it think that or what causes it to think that & send ephinephrine & vasopressin? I usually have really low bp like 86/ 50 probably bc i live in a constant state of " not drinking enough". In dehydration, vasopressin is released to constrict blood vessels, make heart pump the low blood volume harder so it gets to brain but im not at all convinced that i had dehydration. Ive lost 30 lbs over 5 months, not on purpose but i retain alot of fluid in summer but its winter & its very conceivable that i could carry 10-20 lbs of fluid bc lyrica does this to me & im on highest dose. But 30, thats a stretch. So, any comments, suggestions? You will Never know how much the info helped me, it was getting pretty critical to me & everyone that helped me thank you soooo! Sorry tigger & tgirl if i left you hanging im so sorry but, if you still think that by answering
your questions now would help me i would be glad to & am so
grateful to you all! Thank you again from the botton of my heart, literally my heart!Lol

Last edited by gmak; 02-24-2013 at 11:03 AM. Reason: typos

 
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Old 07-01-2013, 09:47 AM   #9
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Re: Help! Pain×30yrs, narcotics & heart problems

I am still taking tenormin or atenolol but the pounding is still there. I dont know if atenolol is a vasopressin antagonist, i dont think that it is. Its a beta blocker but cardiologist hasnt changed it. Im about to have bloodwork repeated & a halter monitor but doubt any abnormality will be found. Apparently pounding is something that cant be measured on any test, echo has leaky valves but shows no cause for pounding. I think it definitely has to do with pain causing fight or flight, does anyone know what i should do next, if anything? I want some dr to tell me if pounding constantly can wear out heart muscle or if its ok to ignore it then i will but if not whats next? I still dont know if pain is causing my heart to pound or if narcotics are causing my heart to pound or if it is even that!

Last edited by gmak; 07-01-2013 at 10:01 AM.

 
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Old 07-01-2013, 01:41 PM   #10
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Re: Help! Pain×30yrs, narcotics & heart problems

When i weaned off narcotics, I went through a period of heart pounding. That was awful, but it was the only withdrawal effect I had. Can't be what you are experiencing but definitely related to narcotics.

 
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Old 07-01-2013, 04:50 PM   #11
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Re: Help! Pain×30yrs, narcotics & heart problems

hi gmak,I just saw your post,I was thinking some 35yrs ago I was getting either migraines or feelling that pounding without bad headache.The dr. put me on inderall not for blood presure but they found a side effect of inderall stops that migraine heart pound feeling.Now I'm still on it never had that again.Could you be at the beginings of migraine type pounding? just a thought. I feel so bad for you.Im on pain management now for MS pain and other problems.
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Old 07-01-2013, 06:19 PM   #12
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Re: Help! Pain×30yrs, narcotics & heart problems

Hi 5 alive, Ive had migraine headaches very occasionally since age 15 but i dont know what you mean by migraine type pounding? Thank you for answering though. I feel bad for you with MS! Im ok, have arachnoiditis but im ok except for massive pain thats semi controlled most of the time, the dying spinal nerve symptoms i cant feel at all most days but this pounding, arrgh!


Hi galalena, It is very strange that this pounding started with a 120mg decrease in morphine but surely im not still withdrawing from that 8 months later!! Especially since im still on long acting & bt opioid. Maybe? Stranger things have been known to happen & the timing of the reduction & start of pounding are synonymous! Thank you for answering!

 
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Old 07-01-2013, 07:55 PM   #13
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Re: Help! Pain×30yrs, narcotics & heart problems

Hi galalena, It is very strange that this pounding started with a 120mg decrease in morphine but surely im not still withdrawing from that 8 months later!! Especially since im still on long acting & bt opioid. Maybe? Stranger things have been known to happen & the timing of the reduction & start of pounding are synonymous! Thank you for answering![/QUOTE]

Gmak,
I'm sorry to hear about your continued heart pounding. I learned that my heart pounding episode was caused by an interaction between a diuretic (hydrochlorthiazide) and Prozac. Another poster here mentioned that interaction between anti-depressives and diuretics (diet pills that are sometimes prescribed to lower blood pressure by eliminating some body fluid) can trigger heart pounding. I mention it because you have lost a LOT of body fluid and there may be a connection having to do with sodium levels. I don't know.

As to fight or flight being triggered by your brain, they don't really know why. They think it's in a brain region that triggers WRONGLY the flight or flight when it's not supposed to. That, in turn causes heart pounding and several other effects.

Google this phrase: "We’ve Nothing to Fear but an Overactive Amygdala". There's a nice article on how it works.

God bless you.

 
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Old 07-02-2013, 08:02 AM   #14
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Re: Help! Pain×30yrs, narcotics & heart problems

Agelbert, Thank you! You have helped me so much before & thanks again! I take maxzide very, very occasionally, like less than once a month, have had my gastro mostly tell me i have an overactive sympathetic nervous system response for > 20 years, i could go see him because i know that he will keep testing until he gets to the bottom of the problem. Only thing he always wants to admit me to hospital!! No, no no! i will definitely check it out, thank you for helping me!

Last edited by gmak; 07-02-2013 at 08:03 AM.

 
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Old 07-02-2013, 02:40 PM   #15
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Thumbs up Re: Help! Pain×30yrs, narcotics & side effects

Gmak,
You are very welcome. May the Lord Jesus Christ continue to guide your footsteps, my friend.

 
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