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Lisa, MSN, FNP-BC, CCRN, Nurse Practitioner
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I have been, due to a back injury, lying in bed for what will

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I have been, due to a back injury, lying in bed for what will now be 32 days straight. I get up to do some at home physical therapy and stretching, as well as take care of bodily functions and bathing. At this point, I can be on my feet about an hour at a time before having to go lie back down and relax the back. My question is this:

When I get up, my heart seems feel like it is going to burst out of my chest. The BPM almost doubles and I have been finding pulse rates of 140 + at times while on my feet. I do not feel light-headed, just extremely aware of the rapid beating. I was given Xanax (.25mg) to take because they think it is anxiety related.   I am on no other meds.

Since my heart has "gotten lazy" by only having to pump blood horizontally for so long being on the bed, is this just stress on the heart due to now pumping vertically, or should I be worried? I do not have insurance, so this is out of pocket and I cant have tons of diagnostic tests. Should I be worried?
<p>Hello;</p><p> </p><p>Thank you for writing in today.</p><p> </p><p>The spike in your heart rate is most likely a response from the increased physical activity. When a person is bedridden for a number of days, the body tends to atrophy.   Muscles begin to waist and stamina begins to diminish. Having been in bed for 32 days, your body is likely decompensated.     At this point, a rapid heart beat is to be expected. However, there could be some potential risks associated with an elevated heart rate. In particular, there may be a risk of abnormal rhythm. At this point, you should visit with a medical provider, you should have a complete history and full physical exam. This will help your provider determine if you may need some treatment until you resume more activity.   For example, some providers may want to consider using a beta blocker to reduce the heart rate and make the heart less irritable to stress hormones.   Also, you should develop a plan with your provider to increase your physical activity tolerance.   Slowly you will need to build your stamina. This may include spending time sitting in a chair each day and building up from there.   The exact plan will be dependent on your particular situation and tolerance with regard to your back injury. </p><p> </p><p>You did mention that your care is out of pocket. This can be very costly. I do want to offer some suggestions. You may want to consider consulting with local health and human services regarding available resources for assisting with medical care. You may also want to look into possible free and discount medical clinics in your area.   </p><p> </p><p>I hope this helps.</p><p> </p><p>Lisa</p>
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