
Felt Suffocated After Waking Up And Loss Of Breath. Strange Sleep Paralysis. Reaction To Flecainide?

Highest Regards,
XXXXX
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- Normal stress test excludes physiological phenomena (reduced blood supply from Coronary Artery Disease) as the cause of the problem...
- Normal ECHOcardiogram excludes major structural abnormality
They are indeed reassuring...
The difficulty in waking up is not likely to be related to this; only a part of sleep apnoea...
Pause is a well known feature and is an effect of Flecainide. It may be ignored, if the duration is less as is here. Since your arrhythmia is controlled well, you may attempt reducing the dose of Flecainide...
Flecainide not a simple drug and is not usually the first choice in most cases...Your doctor might have a reason?? There are a few other drugs and you can go for a different one...but every drug has its limitations; this one a bit more...
Electro-physiologist may offer thermal or radio-frequency ablation in some cases, which may reduce or obviate the need for drugs.../ at times, they might have tested the effectiveness of a few drugs during the procedure and chosen this? / discuss with him...
A decade of the problem generally means it is probably benign?
And an alternative is always possible, if the patient is concerned...
Take care
Wishing speedy recovery
God bless
Good luck


Highest Regards,
XXXXX
We can simply reduce the evening dose by 50 mg (to 50 mg here).
Continue the morning dose (100 mg here) as usual
Check in two weeks
ANY ADJUSTMENT OR ALTERATION (any drug for that matter) SHOULD BE UNDER THE SUPERVISION OF YOUR PHYSICIAN
All the best
Regards


Highest Regards,
XXXXX
Yes
Another Holter after this interval is preferable (even otherwise too).
Also after any change in medication...
Regards
All the best


Highest Regards,
XXXXX
There is no problem in waiting - until you see him...
The dose is not high; the control is good and the pause is not big...
The dose needs individual titration... it may be possible to reduce the dose in your case, after next Holter, which is necessary, but not urgent...
Regards


Highest Regards,
XXXXX
- Swelling of glands is often secondary to infection in their area of drainage...
- Only rarely, it is a primary disease of the immune system – if so, it could not have remained silent!
- Repeated inflammation of the tonsil is not often infection and that too there – it simply arrests them there from its area of coverage...
- Everybody gets them, when young!
- Adrenal insufficiency won’t cause this – if anything, excess of it, can!
There are several adrenal hormones and adrenaline (epinephrine) excess is the culprit for rate and pressure.
- Steroids are immuno-suppressive / anti-inflammatory – they don’t do this.
Relief by a drug is no proof of the cause – ‘Post hoc ergo propter hoc’ (meaning "after this, therefore because of this")
- It seems very unlikely to be related to immune or endocrine systems.
That will not be restricted for long to one system like the heart and that too one aspect like the ectopic...
- A second opinion is always welcome – There is no harm in seeing an endocrinologist or immunologist; they can exclude problem in their field, which will be greatly reassuring...
- I strongly believe it is from the heart and the Electro-physiologist is the apt one...
And your specialist is doing a great job...
Regards
Have a great day (– today, tomorrow, everyday...)


Highest Regards.
XXXXX
In such a situation, one cannot be certain whether it is an aggravation of the original problem or a side effect of the drug – and the solution will also be exactly opposite!
The best and safe option is to give the benefit of doubt and consider the drug as the contributing cause. We should reduce the dose (50 mg) and watch – not stop it.
A single episode need not alarm – even if the drug is not controlling completely, it could prevent more complicated arrhythmia...
Regards

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