Dr. Roach: Lesser-known symptoms of AFib
Dear Dr. Roach: About 15 years ago (I am now 62), I had night sweats, and woke up frequently to urinate, sometimes five to six times a night, but not consistently. Days or weeks could go by without these symptoms, other than some urination one or two times a night due to very mild BPH.
I was in excellent health, or so I thought, and saw my internist regularly. I exercised regularly, ate well and could do long cardio workouts without trouble. I brought these (sweats and urination) problems to my doctor’s attention, and he did further workups on me, including a treadmill cardiac stress test and tests for diabetes.
Over the years, I was tested again by my internist and by kidney specialists, with no findings of abnormalities. Then one day, during the day I raced up three flights of stairs and felt faint at the top. I went in to see my internal medicine physician immediately, who noted I was in AFib in his office.
It was the first I ever heard of it.
This led to ultrasounds, an angiogram, stress tests, different meds to try to control it, multiple visits to multiple cardiologists, two ablations and continued meds, which help but do not eliminate my AFib. It is always intermittent, and usually happens at night when I’m sleeping.
Unfortunately, the years of uncontrolled AFib have led to poor heart function, so that instead of doing mini-triathlons, I can pretty much only walk.
The electrophysiologist had a big, glossy chart on the wall that said, “Do you have ...” and listed six to eight symptoms that could result from AFib, and prominent among them were night sweats and frequent urination (other symptoms were weakness, dizziness, heart palpitations, racing heart, etc.).
I wanted you to consider and mention the possibility of paroxysmal AFib when patients have some of these symptoms. Stress tests, EKGs, echocardiograms, etc., might not show any AFib. A monitor might pick it up, but even the 48-hour type might not if nothing occurs during that period.
I just don’t want others to go undiagnosed for as long as I did. Earlier intervention might stop the cardiomyopathy I have developed because of the years of untreated, random, AFib.
Dear A.C.: Thank you for sharing your story. My own personal (internal) short list of common causes of night sweats and urination did not include AFib, and I appreciate your writing to increase the public’s awareness of this presentation of a common condition.
Dear Dr. Roach: In regard to the 72-year-old man who had difficulty passing stool: Years ago, I would become very dehydrated overnight. I found that drinking a large glass of water (16 ounces or more) as soon as I awoke would soften the stool and make for easy bowel movements a few hours later. I ate normally, but did include a lot of fruit, especially bananas.
I notice when doctors advise drinking water, they rarely mention how much and when.
Dear E.K.: Today is a day for listening to wise people. Dehydration is a common cause of constipation, and as the weather gets warmer, it’s worthwhile to remind ourselves that an extra glass of water can prevent some problems. Prunes, dates, apricots and other fruits also can help with constipation.
Email questions to ToYourGoodHealth@med.cornell.edu.