In my last post I said I had an upcoming appointment for my first IV magnesium replacement treatment. Well I had the appointment and here’s what went down…
On the way to the clinic I was really nervous. I was nervous that I might have a bad reaction to the IV magnesium – like my blood pressure would drop dramatically or that I’d somehow go into afib. I have a tendency to get myself worked up over things if you haven’t noticed.
When I arrived at the doctor’s office I was pleasantly surprised to see it was clean and professional. The office (and staff) of the last integrative doctor I went to was creepy to say the least. I should write a blog post about it someday. Let’s just say I’ve been to veterinary clinics that were cleaner and more professional.
The nurse that checked me in was very nice and professional. She had me fill out a short form and then she took my weight and vitals (heart rate and blood pressure). I was all ready to go. I just had to wait a few minutes for the doctor.
When I met the doctor, he was very nice and professional as well. My nerves were settling down and I was feeling more comfortable about everything.
I had him take a look at my EXA test results from this year and last year as well as my RBC test results from this year and last year. I asked him two things:
- Could he explain why there was an inverse relationship between the EXA and the RBC tests?
- Based on what he saw, did he think I could benefit from IV magnesium supplementation?
His answers weren’t exactly encouraging. He point blank told me he had no idea why the test results were inconsistent. He agreed with me that if my EXA test showed an increase in my magnesium levels, the RBC test should have shown an increase too. He apologized but he didn’t have an explanation for the discrepancy.
As for the second question, I was hoping for a very confident, “Yes, you can definitely benefit from IV magnesium!” Instead I got a long pause as he looked over my test results and a nod of the head with the answer, “It’s possible but based on what I see here your magnesium levels look fine.” That is not what I wanted to hear!
Optimal Magnesium Levels
He followed up his answer with some additional information that I think is important to share. He said a reference range is just an average. Some individuals may be “healthier” at the low end of the range, while others might be “healthier” at the high end of the range. Each person is different so it’s possible what while my test results look normal, my optimal magnesium levels might actually be on the higher end of the reference range.
He said the only way I’ll really know what my optimal magnesium level is by experimenting and testing. He said we can do a 4-6 week course of IV supplementation and test my levels at that point and see how I’m doing. My palpitations will either be better or the same. We won’t know until we try.
I’ll Have a Myers Cocktail, Please
His more detailed answer made perfect sense and I was totally on board for “giving it a try.” I expressed my concerns with him that magnesium IV may cause my heart rate and/or blood pressure to drop too low since I already had a low resting heart rate (upper 50’s) and somewhat low blood pressure (110/70).
He understood my concerns but assured me he’s never had a patient experience those complications. Furthermore, to be extra cautious he would administer the magnesium very slowly. Instead of the usual 20-30 minute drip he’d slow it down to 45-50 minutes.
That was music to my ears so I told him I wanted the Myers cocktail with 2 grams of magnesium sulfate (not chloride) and I didn’t want any calcium. The reason I asked for magnesium sulfate is because there is more elemental magnesium per gram than chloride. I didn’t want the calcium because it’s a big no-no for most afibbers (i.e. can actually cause arrhythmias). He said my protocol sounded good and with that he left the room momentarily to mix the cocktail.
Myers Cocktail
The Myers cocktail was invented by the late John Myers, M.D., a Maryland physician who used intravenous injections of vitamins and minerals to treat many chronic conditions. The cocktail can contain any combination of vitamins and minerals such as vitamin C, magnesium, B vitamins, and calcium.
Houston We Have a Problem
He had me sit in a reclining chair – the type of chair you sit in when you go to the dentist. He poked my arm, which of course I didn’t watch because I hate the sight of shots or needles, and then he hooked up the IV. He told me he’d be stepping in every five minutes to take a heart rate and blood pressure reading to be sure I was doing o.k.
For the first fifteen minutes everything was going great. At each five minute interval all vitals were doing great. I was relaxing and reading a book and was excited about how much better I was going to feel when this was over. Then heading into the twenty minute mark things went downhill rapidly.
The doctor noticed that the IV drip was going very slow. He said at the rate it’s dripping I wouldn’t get out of there until evening. We both kind of chuckled. He started messing around with the IV bag and the IV line. Everything looked good there.
He thought maybe the needle in my arm was up against the vein or up against a valve. Apparently we have a bunch of valves in our veins and if the needle is up against one it can block the fluid from coming out of the needle.
He proceeded to slightly pull and push the needle in out of my vein and then started wiggling it around to see if he could reposition the needle to get a better flow. Fortunately, none of this hurt but I made the mistake of watching all of this. Keep in mind, I can’t stand the sight of needles in my skin so watching him pull and push and move the needle around my arm started making me feel queasy.
After his attempts at repositioning the needle, the IV drip was hardly dripping at all. He then proceeded to push down on the needle with his bare hands. This didn’t hurt either but it freaked me out because I didn’t think it was a good idea for him to be touching a needle that is inserted in my arm with this bare hands! Hello germs and blood infections!
He said we were going to have to pull the IV and try it on the other arm to see if we could get a better flow. I was relieved to hear that because I wasn’t about to tolerate any more maneuvering of the needle in my arm and I wasn’t planning on spending all day there either because of a super slow IV drip.
I’m not sure what happened but I had a panic attack of sorts. I think I was just overwhelmed at how rocky everything was suddenly going and my thoughts just spun out of control. At one point I was convinced that I was going to have septic shock thanks to the infection he gave me touching the needle with his bare hands. Yes, I know those were totally irrational thoughts but my mind just spun completely out of control and I went into a full-fledge vasovagal reaction.
Vasovagal Reaction
A vasovagal reaction, or vasovagal syncope, is when there is a sudden drop in your heart rate and blood pressure that often leads to fainting. It’s usually triggered by extreme emotional stress or some other trigger. I told the doctor we have to stop this immediately because I’m about to faint. Within a flash the room became dark and I felt I was drifting away. I was right on the verge of fainting but I didn’t. He was as shocked as me as to what was going on that his immediate response was, “Are you serious?”
I totally get why he asked that because just a second ago I was perfectly fine and all my vitals were fine. He took a blood pressure check and sure enough I was 70 over something. My blood pressure had dropped over 30 points in just a second. He immediately called his nurse in and when she looked at me she was in shock. Apparently I had virtually no color in my face and my eyeballs were rolling.
She put an IV in my other arm to pump me with fluids to get my blood pressure back up while the doctor pulled my Myers cocktail IV. The nurse also put a pillow under my head so I could rest. Just as quickly as this came on it disappeared. In just a few minutes I started feeling totally fine again. The whole ordeal couldn’t have lasted more than five minutes.
After things settled down and I returned to normal the doctor pulled my fluid IV and sat down to talk to me. Even though it wasn’t his fault he apologized profusely at how “bad” things had gone. I felt bad for him because this was the first time he had experienced an “emergency” during a routine IV magnesium treatment.
He said I experienced a vasovagal reaction. He said it was a common reaction to medical situations (i.e. getting a shot, getting an IV, etc.). He said we were obviously done for the day and that it was my call if I wanted to try this again in the future. He said he’d feel better if I didn’t but if I really wanted to he’d be willing to try it one more time.
I told him I’d think about it and get back to him. I got up and shook his hands and thanked him for his time. I asked him what I owed him and he said nothing. He said he didn’t feel right charging me given what happened.
Next Steps
As I was driving home I remembered I had a similar reaction about two years ago. I had an infection underneath one of my fingernails so they had to remove the fingernail to treat it. They had to give me three shots in my finger to numb it completely. Even though I couldn’t feel a thing I could hear the doctor cutting and pulling my fingernail off my finger. It was just too much for me to bear and I had the same exact vasovagal reaction.
It dawned on me that I’m officially a wimp when it comes to any kind of medical procedure being done to me! My mind just goes into overdrive. I may need to start smoking weed or something before any kind of medical procedure where I’ll be conscientious.
It’s funny. I can have a catheter ablation and not have single issue but give me an IV drip or three shots in my finger and I’m done for. Oh well, it is what it is.
For now I’m just going to stick with oral magnesium supplements. I’ll probably have my levels tested again in the fall and if they are lower than they are now, then I may buck up and give the IV magnesium replacement therapy one more try.
If I do, I’ll be better prepared. I won’t look at my arm or the IV at all. In fact I’ll just lie back and close my eyes and I’ll wear headphones with soothing music playing so I can’t hear anything either. If I can block out all outside stimuli I should be fine.
I am a little bummed because I was excited to experience how I would feel after an IV treatment. I was also hoping to share with you the wonders of IV magnesium replacement. I guess it just wasn’t meant to be right now. No biggie. I’ll press on!
Don’t feel badly, Travis. As a nurse, I can tell you that a vasovagal reaction is completely out of your control. I once saw a lab tech pass out during a biops on a patient, and it wasn’t even being done on her. Haha. My husband used to have the same problem, but he had a bone marrow transplant for cancer and while he was recovering, watched every episode of the series “E.R”, which had some gory scenes, and by the time he came home 6 weeks later, nothing made him sick anymore. Maybe you should try it too !
Travis I’m confused. Did you already have the ablation done before the IV?
Mike:
Yes, I did have the ablation before the attempted IV magnesium. The reason I was doing the IV magnesium was to see if it would help settle my PACs and PVCs – not to prevent a re-occurrence of afib.
Travis
Hi Travis,
When I get an attack, I started doing the following: I spray ten doses of Magnesium oil on my arms (especially on my left arm and wrist) and massage it in. Any excess, I rub on my neck around the Vegas Nerve. Then I drink a 5.5 can of low sodium V8 juice, then I get a clock that you can hear the ticking, and close my eyes, breath slowly and deeply, and tap my left wrist to the time of the clock. Ever since I started this, when I do have one, it only lasts 10-15 minutes, instead of an hour or more.
Two questions … have you or any of your readers heard if too much Vitamin D can start an afib? Also, (you may have answered this but will ask again) Can a person be having an Afib attack, and their heart rate is totally normal and steady?
Shannon:
By attack I’m assuming you mean an afib attack, right? This post is specifically about PVCs so I’m not sure what you’re referring to. Either way, you provide some good tips…thanks!
As to your question about vitamin D, I’ve never heard of too much vitamin D causing an episode. It would be impossible to have a normal and steady heart rate if you are in afib. When you are in afib your heart – the upper chambers (specifically the atria) are literally quivering so it would be impossible for your heart to be normal and steady.
It is entirely possible, however, to be in afib and not feel it. This is called silent afib or asymptomatic afib. Most people don’t fall into this category but a fair number of people do. This type of afib will only be detected by an EKG – be it in a clinical setting or if you have your own portable EKG device like the AliveCor monitor.
Travis
Hi Travis,
Two things:
When an IV line is installed, a needle with a snug plastic sheath is used. When this combo is in place in a vein, the needle is withdrawn leaving the soft plastic sheath/tube behind. There’s nothing sharp in there. Does that ease your mind at all?
And, there’s plenty of afib out there in the world that’s either directly or indirectly caused by a maladapted autonomic nervous system. Hyper sympathetic response means an exaggerated fight-or-flight reaction to modest threats. Constant challenges to heart rate, blood pressure, and consequent strain to the heart can lead to atrial dilation, fibrosis and afib in the long term. Sound like you? Sounds like me! I had to walk out of Alien, the first of that series of movies. Couldn’t take the stress.
Some research suggests that a beta- blocker might ease this situation. (Note all those qualifiers. Precious little is truly understood about this stuff!)
Hey Jeffrey! Thanks for the info on the IV. I had no idea how they worked. That would explain why the doctor had no problems moving the IV around in my arm – and why I didn’t feel anything! I assumed the needle was still stuck in my arm. You learn something new everyday!
I’m coming to learn I definitely have a hyper sympathetic response to some stressful things. I was never like this when I was younger:( But as I have gotten older it has gotten worse.
Thanks for the insightful comments!
Travis
I was alarmed myself, till it was explained. Here’s a video animation. It’s a realistc cartoon in color, so have your vodka first. :-) It’s typical of what’s used.
Jeffrey – thanks for the video! I had no idea that’s how an IV worked. The whole time he was pushing and moving the IV around I thought the needle was still in my arm…lol. Your explanation and this video helps put my mind at ease…thanks!
Travis
Hi Travis,
I love your blog. My AFIB was originally caused by an over-active thyroid. Last year I had a complete thyroidectomy, but after a few months the AFIB attacks started to reoccur. Instead of twice a year, they came every 2 weeks. I can predict them with 99% accuracy. It always happens at the end of the second week at night as soon as I doze off for a few minutes. I tried to stay up several times but without luck.
The attack lasts for 36 hrs and then it resolves on its own. I am taking bisoprolol 2.5 mg every night. I tried to eliminate every possible trigger known including alcohol, caffeine, stress, and no smoking. I went to another country to change the environment around me. I eat healthy. My TSH is perfect.
I tried magnesium and eating loads of salmon. Nothing works. The lack of randomness in AFIB recurrence puzzles me a lot. My EP tries to convince me to do the ablation but I am hesitant to make matters worse after.
I don’t have any structural heart damage. My CHADS2 score is 0. My next step is to explore if my AFIB is caused by an underlying autoimmune disease. I will ask my GP to refer me for ANA and C Reactive protein blood test to see if there is an internal inflammation in the body. That may be the cause of it.
Hey Alex. Glad you’re enjoying the blog! I admire your determination to find the cause of your atrial fibrillation and a natural cure. I hope everything works out for you.
If your journey leads you to a dead end, however, I wouldn’t hesitate if I were you to consider an ablation. As I’m sure you already know, it’s a progressive disease so the longer you wait to treat it the harder it can take to beat. Based on everything you’re telling me, including your young age and relatively short time with afib, you’d be an ideal ablation candidate in the hands of an EXPERIENCED EP (emphasis on experienced).
You are very much in the same boat I was in – same age, same “good health,” and about the same number of years with afib. Unfortunately for me, my afib quickly spiraled out of control in the 8th year. I went straight to the ablation and I don’t regret it for a minute. I’ve been afib-free now for 15 months and it’s been wonderful. Granted, I’m dealing with a new issue now (PVCs and PACs) but I’d take them over afib and the constant anxiety of another afib episode any day!
I’m not trying to push you to an ablation but if your natural attempts don’t work (and I hope they do), don’t totally disregard it. My personal opinion is that an ablation is the best shot we have at curing the beast right now.
I wish you well!
Travis
Thank you Travis. Sadly my GP refused to have the blood test done to rule out auto immune cause. He said that ANA and CRP tests are not specific and often lead to false positive results which in turn causes unnecessary anxiety. So I am back to where I was before: bisoprolol for rate , flecanaide for rythm and Zoloft for anxiety and depression.
Hi Travis,
Recently, I have stopped taking beta blocker meds. I have not experienced the afib attack for about a month now. I learned to know when it is about to come at night. As long as I stay up all night and not doze off I beat it for the next 2 weeks. I also changed my diet a little. I juice water melon and drink it before going to bed. I think it helps me lot due to its balance of magnesium and potassium. I also noticed that staying in the sun a lot and swimming helps me as well. I hope to keep afib at bay for now.
Alex:
That’s awesome to hear that you’re having success being off your beta blockers. Staying up all night doesn’t sound fun, however:)
That’s interesting to hear that sun and swimming help. Hey, whatever works!
I wish you well.
Travis
Hey Travis….
I hear you…a few years ago I was having blood drawn and the gal doing it must have been new. She stuck me 3 times and wanted to try a 4th when I said STOP!! I started to feel faint and told her I was going to pass out…another tech came over and escorted me to a back room with a cot. She drew my blood easily and I was on my way in a few minutes…I have had a few blood draws since that time and have not experienced any issues…of course I was only stuck 1 time!!
I’m almost fainting reading your story…lol. I’ve never had someone inexperienced try to draw blood so I’ve been very fortunate. I think after the second attempt I would be out – literally:)
Travis
Travis, I am glad you survived the procedure, did the magnesium that managed to get in your blood help with the PVSs and PACs.
Saad
No…lol. The drip was going so slow that even in that 15 minutes I barely got anything. Like I said, I think I’ll try it again in the fall if I can’t get my magnesium levels boosted with oral supplements.
Travis
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