Palpitations After Falling Asleep, Only Face-down?

Hi Folks,

I am nine years post-RNY and have stayed thin and fit. However, the last couple of months, I have been waking up with a stronger or faster heart beat and usually with a feeling of fullness around the pouch. I never have this or any other problems even during the most strenuous of exercise (interval training or cross-country Nordic skiing on a pro-level course), unless I'm totally cold and try to go up a very steep hill.

The other odd thing is, I NEVER have it when I fall asleep on my back on the couch, even if that happens to be 3-4 hours. It is only after getting into the actual bed and then changing to face-down sleep.

This is usually 3-4 hours after dinner and I usually don't avoid carbs at dinner, so wondering if it could be low blood sugar or dumping? In the worst cases I may have the feeling that my feet are getting ready to cramp. My family does have a history of both clogged arteries and arrhythmia, with several of the men developing severe cases of either of even dying in their 50's, so I have made an appointment to be checked. 

Has anyone else experienced these palpitations? 

Best Wishes,

Dave

Hi Dave,

I am about 4 1/2 years Post Op. I have never had any type of situation like you describe above. However, in the fact that it pertains to your heart and secondarily your pouch, I would arrange to see my PCP or Surgeon in regards to it ASAP!!! I hope you are able to get to be seen to have it checked out sooner than later. Keep us updated, hoping all is well.

Best,

Bill

Cardiologist - STAT!

You mention feeling issues in your abdomen and that sends me a red flag of an abdominal aortic aneurysm.  No bueno.  That's what my Dad died of 21 years ago.

Don,

Thanks and yes I am going to the cardiologist. I do heavy deadlifting, sprints and stuff like that and have for about 8 years. Not sure if that could cause an aneurism. I'll look up the symptoms to see if they match. It seems more like dumping, but the heart effects are more intense sometimes. Let's hope they'll do the test. My impression of aneurisms is that you have to be pretty lucky to catch them in advance. I'll see what I can do. 

Best Wishes,

Dave

Don,

It doesn't quite fit this description and I have never smoked. 

http://www.mayoclinic.org/diseases-conditions/abdominal-aortic-aneurysm/basics/symptoms/con-20023784  

To tell the truth, I hope the cardiologist will check me out based on age and family history risk factors, because all of my bloodwork, BP and all are miraculously, the opposite of what would cause a heart attack or stroke or anything metabolic. My only risk factors that they found when I was about to have surgery, was the BMI of 41-2 and low Oxygen levels (mystery, but serious and especially at age 44). Everything else was great and of course, now it's even better. An angiogram would be ideal, but I think that's a radiation risk, especially since I've had about three surgery-related CT's and a kidney stone scan at 24.  I have had cardio ultrasound as recent as 5 years ago and they were unable to find anything.

Lifting or strenuous activity they SAY doesn't cause it:

http://www.mayoclinic.org/diseases-conditions/abdominal-aort ic-aneurysm/basics/causes/con-20023784

Thanks Again,

Dave

Hope you have found your answer by now.  I have had some heart rhythm problems but don't have them now.  I was found to have A-fib just before surgery.  I had some BP problems around surgery.  I tried medication but my doc decided to cardiovert me.  So I was shocked back into a regular rhythm and have been fine since.  Mine was also possibly related to medication. I had had a heart catherazation a year ago and all was clear.  There are so many reasons for rhythm changes.  Your doc will most likely do a portable monitor for 2-4 weeks so they can see what your heart is doing while you sleep.  I would want an electrical pathway study if everything else checks out.  Be sure to tell your cardiologist of your family history and the positional aspect because it is significant.  Not knowing is the worst part of it.      

My 2 cents...Feels like I'm watching a "House" episode...Trying to diagnose. Have as many tests done as you can.  Could it be a stricture, twisted bowel or could your pouch collapsing during sleep?  Below is a copy and paste by DX concerning late stage dumping...Don't know if it fits.  Brian

"Late Stage Dumping”
Happens 1 to 3 hours After eating.
Symptoms of late dumping include weakness,
Sweating, and dizziness.
Late dumping has to do with the blood sugar level.
The small bowel is very effective in absorbing sugar,
So that the rapid absorption of a relatively small
Amount of sugar can cause the glucose level in the blood
To "spike" upward.
The pancreas responds to this glucose challenge
By "cranking up" its output of insulin.
Unfortunately, the sugar that started the whole cycle
Was such a small amount that it does not sustain
The increase in blood glucose,
Which tends to fall back down at about the time
The insulin surge really gets going.
Yes?
So you feel like
Someone has given you an unnecessary
Shot of insulin.

It’s basically a bout of hypoglycemia (low blood sugar),
Which causes you to feel weak,
Super Sleepy, and completely fatigued.
Late Dumping has another Evil in its arsenal.
It is a way for gastric bypass patients
To Fall into a vicious cycle of eating.

If the patient takes in sugar
Or a food that is closely related to sugar
(simple carbohydrates like rice, pasta, potatoes)
They will experience a small degree of Hypoglycemia
In the hour or two after eating.
The hypoglycemia stimulates appetite,
You eat more, cycle repeats,…..
And it's easy to see where that is going....
Yes?
Some, who claim “bingeing” with Carbs
Have actually been riding like a surfer
On a wave of hypoglycemia.
That requires some bravery and stupidity
In just the right balance, but does happen.
That “Emotional Eating,” Thing is a doozey!

The reason that sugar does not cause dumping
In non-operated people is that the stomach,
Pancreas, and liver work together to prepare nutrients
(Or sugar) before they reach the small intestine for absorption.
The stomach serves as a reservoir that releases food
Downstream only at a controlled rate, through the Pyloric Valve.
This avoids the sudden large influxes of sugar
That can occur after a Roux En Y.
The released food is also mixed with stomach acid,
Bile, and pancreatic juice to control the chemical makeup
Of the stuff that goes downstream
And avoid all of these effects above.

For Late Dumping –
Lying down immediately after eating reduces the symptoms
Because gravity isn’t draining the stuff straight into
Your intestines. Yes?
It may give you just a serious nap.

Thanks, Guys. I'll be sure to get tested. It sounds more like late stage dumping. And today I got the 10-15 seconds of palpitation climbing my first Nordic hill. I have been taking some Ginseng before exercise, which could be causing that. I'm guessing the night ones are dumping, but it seems closer to four hours after eating. The Holter monitor sounds like a good idea. I'll check on that.

Best Wishes,

Dave

Also having weird tingly sensations accompanied by low heart rate (57) and not-so-low BP (110/70). Seems to point to hypoglycemia, but the potential causes are endless: http://symptomchecker.webmd.com/multiple-symptoms?symptoms=d izziness%7Cfeeling-faint%7Clow-blood-pressure%7Cnumbness-or- tingling&symptomids=81%7C99%7C405%7C164&locations=66%7C66%7C 66%7C40

Also having weird tingly sensations accompanied by low heart rate (57) and not-so-low BP (110/70). Seems to point to hypoglycemia, but the potential causes are endless: http://symptomchecker.webmd.com/multiple-symptoms?symptoms=d izziness%7Cfeeling-faint%7Clow-blood-pressure%7Cnumbness-or- tingling&symptomids=81%7C99%7C405%7C164&locations=66%7C66%7C 66%7C40

Peripheral neuropathy is also one they used to warn us about as a side-effect of surgery. I wonder if dumping or alcohol/ carbs could cause B vitamins to get cut off, even if I'm supplementing during the day. I'm guessing that just plain reactive hypoglycemia is the cause. 

Dave