‘When someone dies in front of you it can be a little unsettling. Thankfully, sometimes, all they need is a little extra magnesium.’
If you could have the perfect drug what would it be? The answer is that it would probably look a lot like marijuana – cheap; safe; effective; cures cancer; stops fits; and, arguably, the best recreational drug too – but magnesium would be up there.
Magnesium is that fantastic metal that any student of chemistry can tell you burns with a pyrotechnic flare. Magnesium is also the chemical element at the centre of chlorophyll that gives green leaves their hue, and creates energy from sunlight. This is important when we understand the Chinese medicinal properties of magnesium.
I first got interested in magnesium when I needed to give a talk as a junior doctor. I found a review article on it and was astounded by what I learnt. Firstly, industrialisation of our diets had led to increasing loss of micronutrients in our food and magnesium was one of the worst affected. This loss was then being reflected in a chronic deficiency in our bodies.
The next fact was the most astounding though. When scientists looked at magnesium in the cells in our bodies (serum, or blood, levels are not an accurate reflection of body magnesium) they found a simple correlation between the severity of illness and magnesium status. In the general population just a few percent have magnesium deficiency, but within hospital inpatients it rises to 11%. As severity of illness increases so does the rate of deficiency and by the time a patient is in intensive care there is an over 60% chance they are magnesium deficient! Magnesium deficiency appears to be an independent marker of ill-health.
Magnesium treatment appears to be one of the simplest and most wonderful treatments we have available as doctors. It has showed benefit in asthma, arrhythmias, stroke, myocardial infarction and eclampsia: all severe and potentially fatal conditions. I love magnesium and will find practically any excuse to give it to patients, one of those being tachyarrhthymias.
Tachyarrhythmias (a quite wonderful word which means a fast abnormal heart rhythm) all universally respond beneficially to magnesium. It might be atrial fibrilliation; ventricular tachycardia; torsade de pointes; or even a Wolf-Parkinson-White; but they all have a a chance of being cardioverted with iv magnesium. So when the ward doctor suggested iv magnesium for the following rhythm I said… why not?
Now, you don’t have to be a doctor to find the last part of this rhythm, the bit where it goes flat, to be rather alarming. The nonagenarian owner of this rhythm strip had woken in the morning to find that his head was ‘full of bees’ as he went to the toilet. There he had passed out and when the paramedics had arrived they were rather alarmed to find that his heart was fluctuating between going at 200bpm and then stopping… for quite a long time.
The paramedics were excellent and had phoned the cardiology lab to say that they were bringing someone in for a pacemaker but were told to go to the Emergency Room instead.
And so there I was with this charming and engaging man, who was telling me about the ‘bees’ in his head, feeling his pulse bounding against my finger like a metamphetamine addict at a rave when…
His body slumped back against the bed, and the wind of life moving his body simply disappeared. His heart had stopped and, instantaneously, so had every other function of his body. I talk about this effect in my book – The Spark In The Machine – and how it is proof that the Chinese concept that the Heart, and not the brain, is the centre of our being is correct. When the heart stops death is instantaneous, like turning a light off or extinguishing a flame.
I looked up to see the rhythm strip as a flat line and for a moment I felt a sense of rising panic in my own body…
I calmed my own breath and waited for just a few seconds more and then, like a generator restarting the electricity in a house, his body reanimated back to life. He looked around apparently oblivious to his near death experience and said:
‘It’s a very strange sensation, these bees.’ and smiled at me.
“Nurse, I think we need to put out a peri-arrest call!’ I said, my relief only matched by my urgency. Shortly afterwards one of the arriving team suggested the magnesium.
The remarkable thing about the magnesium is that it completely controlled his rhythm. You give 2 grams through a vein and you give it over 20 minutes because otherwise it can cause hypotension. Magnesium works because essentially it is a calcium antagonist: calcium makes our bodies hard, not just our bones but also our arteries and our muscles. Magnesium forces calcium to flow out of the cells and softens everything. This is why it relaxes the muscles in our airways and helps asthma; in the heart it relaxes and calms the conduction system that uses calcium as it’s fuel; in the arteries it relaxes the muscle and drops the blood pressure.
Simple Yin/Yang philosophy explained what was happening to his heart. The heart was beating far too fast (excess yang) and exhausting itself and so stopping (excess yang turning into yin). In the iconic TaoJiTu this process of excess Yang turning into yin is represented by the small circle of white within the black, and vica versa. This process would have inevitably led to what the Chinese call ‘yin and yang separating’ or death.
Every doctor there was in agreement that a pacemaker was needed, but this is where the miracle of magnesium appeared. The magnesium stabilised and slowed down the heart and when it did this the heart no longer collapsed from exhaustion. The last I saw of him his heart was poodling along at a pleasant 80bpm and the bees had all gone.
(If you want a little extra magnesium in your life I can recommend this. I’m not on commission but the owner’s a good friend)