I am a 72 year old male in good health and exercise regularly. I recently started wearing a watch that tracks my heart rate and noticed that it regularly drops below 40 beats per minute for up to ten minutes.
It seems to happen at night and early in the morning.
I have a history of low blood pressure and am not overweight. Should I be worried?
DR. ELLIE CANNON: Low blood pressure tends to bother people with natural high blood pressure who take pills to lower it. (archive photo)
Some people have naturally lower blood pressure than others, and this is usually not a cause for concern.
Low blood pressure tends to bother people with natural high blood pressure who take pills to lower it.
These patients may find themselves suffering from fainting, dizziness, and falls if their blood pressure falls too low.
Heart rate should not be confused with blood pressure.
Heart rate or pulse is the rate at which the heart beats every minute. The normal rate is 60 to 100 beats per minute (bpm) when you are resting.
It rises when we exercise and falls when we sleep.
If it is below this value, in medicine it is called bradycardia.
This is not uncommon in very athletic people.
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Dr. Ally can only answer in a general context and cannot respond to individual cases or give personal answers. If you have health problems, always consult your doctor.
Often, these patients have a resting heart rate of around 50, and doctors are not bothered by this.
There are many heart rhythm disturbances that can cause episodes of abnormally low heart rate.
Doctors may decide to check this with a heart test called an EKG using a small device worn for two to three days.
Many GPs, like myself, are wary of using fitness technology like tracking watches to diagnose health problems.
They are unlikely to be accurate enough to detect a dangerously low heart rate or rhythm problems.
However, it is worth checking all potential concerns with a general practitioner, even if informed of the health tracker results.
They may decide to continue research using a medical heart rate monitor to see if there are any serious problems.
About eight months ago, I had a third-degree prolapse of the uterus and vagina, which was treated with a vaginal hysterectomy, pelvic floorplasty, and vault fixation.
The operation was successful, but since then I have had copious discharge, sometimes bloody. This is fine? I use estrogen pessaries twice a week.
The general rule of thumb is that any ongoing bleeding is not normal and should be checked by a doctor.
Prolapse of the third degree is a very serious problem, and the operation to eliminate it, which includes the removal of the uterus, is a big operation.
It is important that doctors discuss the possible risks before patients go for surgery. This includes infection, bleeding, and constant pain.
But eight months after surgery, we expect any side effects to disappear if the patient is otherwise doing well.
The doctor should examine a patient who has discharge and bleeding, and also take swabs.
It is possible that this symptom is the result of an ongoing vaginal infection or scar tissue.
Sexual activity or regular use of pessaries can irritate the vaginal walls. It is worth stopping them for two to four weeks to check if this is the case.
Although unlikely, bleeding can also be a sign of cancer. Gynecological cancer can develop even after a hysterectomy.
This is why consultation with a general practitioner or gynecologist is crucial.
I suffer from terrible anxiety, I feel sick and sweat all the time, and the medicines don’t seem to work. More recently, a GP put me on citalopram, but that aggravated the panic attacks, and then diazepam.
I even went into seclusion and the doctor said that I should not take citalopram, but amitriptyline or mirtazapine, although I have tried them in the past and they did not help.
Maybe I don’t really suffer from anxiety, but something else?
Anxiety is becoming an increasingly common mental health problem.
Extreme anxiety is known medically as generalized anxiety disorder, and it is important to get a proper diagnosis from a psychologist or general practitioner.
The healthcare professional should ask a series of questions to identify symptoms that indicate a problem.
Medications will only help if patients are genuinely anxious, and making many changes to the medication may not be helpful, causing withdrawal-related side effects that increase anxiety.
Anyone who has taken drugs for mental health problems will tell you that it can take time to get used to them and become effective. This may take two to three months.
Pills and therapy are just as effective as each other.
More from Dr. Ellie Cannon on Sunday…
Cognitive Behavioral Therapy is a specific psychological tool that is considered useful for anxiety. It should be offered along with medications or as an alternative to them.
If symptoms persist despite treatment, it is important to check if the diagnosis of anxiety is correct, as sweating, feeling of heart palpitations, and feelings of panic may be related to other health problems.
This includes a heart condition, menopause, or a malfunctioning thyroid.
It would be wise to have blood tests or further examination by a physician to rule out these problems.
Cancer surgery without cancer
Last weekend I answered a reader’s question about a hysterectomy, she was told she needed cancer removed but was shocked to learn after the operation that she didn’t have cancer but cysts and fibroids.
And that seems to have resonated with some readers.
Some wrote to me and told me that the operation had brought them early menopause, but they were told that they never had cancer.
As I explained in my column, it’s a tricky balance and all risks and benefits of the procedure should be fully explained to patients prior to the procedure.
But from what some of you are saying, it doesn’t seem to happen in some cases.
How many more women have been hurt? If you are one of them, write and tell me.
You don’t need a test if you just have a runny nose
Are you worried that you won’t be able to get tested for Covid? Do not be. Testing is not a “stop”.
If you have the main symptoms of Covid – cough, fever and anosmia (loss of smell) – you can still get a PCR test in the usual ways.
Hospitals will still test patients, and some employers may make their own rules.
DR. ALLY CANNON: For the vast majority of us who are immune, Omicron is mild, causing perhaps a few cold-like symptoms. (archive photo)
But the “test twice a week even if you don’t have Covid symptoms” rule has ended for the rest.
In my opinion, this is a good move, because mass screening for Covid no longer makes sense.
For the vast majority of us who are immune, Omicron is mild, causing perhaps a few cold-like symptoms.
If you feel like this, stay home for a few days until you feel better.
You don’t need a phenomenally expensive testing program to tell you this. It’s just common sense.