Nerve Impingement and Sudden Cardiac Death?
What Happened?
In the early morning hours of 8 Aug, just a day before our National Day 2008, I was warded at the Singapore General Hospital. In fact, I checked myself into the hospital after waking up around 0230hrs and experiencing very bad numbing sensations on both my limbs; hand and legs. I took a taxi from Marsiling after weighing the pro and cons of calling for an ambulance which I felt would take much longer. Afterall, I had already popped an Alka-Selser, (an aspirin/sodium bicarbonate pill) and which had always been my trusted health panacea by my bedside to prevent sudden death. In my previous bout of heart burn (which I had attributed to over-eating and maybe nerve impingement), the Alka-Selser was provided relief within 20 minutes or so. The aspirin ingredient was to allow for better blood flow while the sodium bicarbonate was for heart burn (indigestion)
However, this time round, perhaps, the numbing sensation was pretty bad on both limbs and maybe, the aspirin was taking too long to kick in, plus my blood pressure reading taken by my good wife, measuring at a high 168 mmHg (systolic) made me panic even more. I decided to head for the hospital.
I decided to take a taxi since I had already taken an aspirin and as I stayed in Woodlands, far away from the nearest public hospitals, had assessed even before this episode, if this condition would to recur again, I would take a taxi. I had calculated if I was still conscious, could still walk 20metres to the roadside to hail a taxi, it would be faster than waiting for an ambulance which would take about half an an hour or more plus waiting time. My taxi ride took 17 twenty minutes via the via the Central Expressway to reach the Singapore General Hospital. I was relieved at least, I would be in good hands. At one point, I almost though I might pass out inside the taxi, since my blood pressure was pretty high.
At the ICU
The ICU staff were pretty efficient and took a couple of xrays including a CT scan on brain when I mentioned that my speech seemed pretty incoherent while I was in the taxi, mumbling and trying to fish out dollar notes from my wallet to pay the fare.
Was It Nerve Impingement?
Eventually when I was warded and while relating about my “heart attack” episode with the the duty doctor (maybe an Intern), it suddenly dawn on both of us that perhaps it could be the recurrent NERVE IMPINGMENT that I have been experiencing periodically following my motorcycle skidding accident in 2000. As the frequency of attacks had dwindled since 2006 after I moved to an office near to my home (lesser neck compression from my motorbike journey to work), and indeed it had slipped off my mind during this episode. Coupled with the fact that my mind was fixated on my elevated cholesterol level a week ago, before my ICU admission, when my family general physician (GP) established that I might have to be started on anti-cholesterol medications. This happened when I experienced limb numbness then.
Back at the hospital ward, The intern doctor explained that aspirin would reduce the nerve swelling, and during a nerve impingement it would provide relief. I paraphrased that aspirin had the analgesic effect, trying to let him know that I was in the know too.
In retrospect, after some thinking again, I now believe the reasons why my “heart attack” episode only occurred at night when I was sleeping.
Nerve Impingement stemmed my blood flow to the limbs
Well, you see, during daytime, my nerve impingement is still occurring without much awareness of mine other than some muscle stiffness which I probably would have shrugged off. However, due to the constant physical movement, like walking, working at my desk, or simply shuffling my feet, the voluntary muscular contractions contributed immensely to ensure circulation of blood throughout my body especially the remote corners like hands and feet that often sent out the “alarming” tingling or numbing sensation depending of the availability or stemmed blood supply. Hence during the night when I was sound asleep, the vastly reduced voluntary muscular activities could not not aid in propelling blood flow. Hence the “pinched” nerve effect would be exacerbated manifolds. It stemmed nerves signals to the involuntary muscles or gut interrupting or even stopping blood and intestinal movement that caused not only heart burnt (food indigestion) but worst still, reduced blood supply to my limbs. Hence effect not only mimic a “heart attack” but could attribute to high blood pressure since the heart would probably be pumping very heart to reach those areas stemmed by “pinched’ nerve for the supply of adequate oxygenated blood. I used the inverted commas “ “ to signify that the pinching effect could also be due to the “swelling” of the nerve rather than the continual compression of the cervical (neck) vertebrae. I noticed that whenever, I was having a sore throat or cold, my nerve would be pinched somehow. Maybe the swollen nerve (during viral infections like flu) could result in the “pinching” effect causing stemmed blood flow and indigestions. This is a casual observation of mine.
Can Nerve Impingements result in Sudden Cardiac Deaths
Well, unfortunately, I think the answer could be a YES! This is again my personal opinion basing of my experiences during such “heart attack” bouts. The MRI (Magnetic Resonance Imaging) scan result from my stay at the hospital also confirmed to pinched nerves at the fifth cervical vertebra. I should be going for some physio-therapy some to alleviate the problem soon.
Meanwhile, there should be some local researches done here to establish if any sudden deaths could have been attributed or even partly attributed to nerve impingement that cause severe heart arrhythmias or even the currently hyped “enlarged” left heart ventricles explanation being rattle-off as a plausible answer for the recent spates of sudden cardiac deaths. As I have pointed out, pinched nerves resulted in high blood pressure and palpitations, when the heart being the main pumping station, and not being assisted by the other involuntary blood transport elements like muscles, valves etc had great difficulty bring the needed oxygen to the capillaries of remote places like the hand and feet. So the tingling and numbing signals are sent out again. Hence the left heart ventricle could be enlarged from the stemmed effect. This could be validated against those with little arterial plaques to ascertain my hypothesis.
I am also very sure, it was nerve impingement I was experiencing rather than the high cholesterol effect. Three weeks ago, I started to lift heavy weights at the gymnasium when the swimming pool was closed. I was using the stationary weight stations (not free weights) and maybe some station exercises caused severe compressions against the nerves at my neck and shoulder region. I was also experiencing tight muscle contractions at my limb regions which on retrospect could be reduced blood flow to such region to bring the essential electrolytes that had been dissipated during my exercise regime in the gym. When I took my faithful potassium and magnesium combo tablet, it helped to lower my blood pressure and relax the muscles. I had been harping on the important of having adquate serum magnesium and potassium to everyone for heart maintenance for sometime. Maybe during my stay at the hospital, the blood test should also include a quantitative analysis of my magnesium serum. I noticed this “inadequacy” which my blood serum test result was out. I would also recommend it since there is indeed a correlation between heart problems and magnesium deficiency.
Maybe the intense muscle contractions during weight-lifting could have released some fragmented cholesterol plaques in my blood system, but I do not think it is major contributing factor.
Come to think of it, though it is important for to keep our muscle strong to lift our frail skeleton as we age, we should be mindful of lifting excessive weight and also the correct techniques (as Robert pointed out). I would probably focus more on those that “decompresses” the spinal column, rather than those the compresses the spine, especially my neck (cervical) vertebrae region.
Medication and Therapy
The hospital had prescribed a month dosage of anti-cholesterol pill for my elevated cholesterol-level. However, instead of taking the simvastatin pill, I am now taking my wife’s Red Yeast Rice pill (which is a natural statin pill) and of which my wife swear by it. Simultaneously, I have been doing some research in the internet, reading so many articles on both the synthetic statin drugs; Simvastatin, Lovastatin against the “natural” Red Yeast Rice which claims to be the original statin drug. In the meantime, the giant pharmaceutical companies that manufacture the synthetic or extracted statin drugs continues to mount effort against the Traditional Chinese Medicine or Herbal Therapeutic Medicine (that claimed to the original statin drugs) to gain shares in the lucrative cholesterol market.
Follow-up posting on the effect of Statin drugs
I would be writing another post on this topic later. In the meantime, I have to be wary of over-dosage of the anti-cholestorol statin pills, whether it is Simvastatin or Red Yeast Rice. The reason being that if your body detect that you have too little cholesterol, that it would start to metabolise the next available food source, that would be the muscle, and hence while some people who take very high dosage of statin drugs would have muscle weakness, and in extreme cases, blood in the urine leading to renal failure, vertigo (since cholesterol is needed for brain well being too) etc.
Right now, if I am taking my wife’s Red Yeast Rice tablets, I would definitely stay away from the Simvastatin to prevent for over-dosage of statin drug effect. I would not have done so, if I had not read out so much on it. Not many people does anyway. A word of caution to those who are trying to do a super quick cholesterol reduction like fasting, taking high dosage of synthetic statin drug plus also the herbal Red Yeast Rice (not realising that it is also a statin drug), then it is a double whammy, and highly possible that you could end up with severe muscle, renal and neural degenerations. During my stay in the hospital, I noticed a few patients next in my ward had dark coloured urine (needing assistance from nurses) plus muscle and breathing weakness. Maybe they could have over-dosing on statin drugs, intentional or unintentional without knowing it. This is just my sensing. Maybe the health authorities could make it mandatory for certain TCM product like Red Yeast Rice to be obliged to state the “contain natural statin and to consume wisely if also taking statin drugs” label since many people could be taking both product unknowingly. A questionaire survey for patients could be feasible to establish its prevalent usage here.
So please take care. I also have to take care. First I have to deal with my nerve impingement, find out other attributing factors and also to recover from my left knee’s suspected meniscus tear.
Mikey
