Example of problems when increasing/decreasing Blood Pressure/Heart meds.
I'm going through a reduction of my Beta Blocker, Coreg, from 25mg per day, to 12.5mg per day.
Here's a detailed description of what I went through, and why:
I wanted to increase my Beta Blocker, Coreg, while at the same time, reduce my Digoxin.
So........ On March 28, I reduced my Digoxin from .25mg to .18mg (25% reduction). At that time I had been slowly increasing my Coreg, and had been on 18mg Coreg for 24 days.
By April 18th, I had increased my Coreg to 25mg per day, after being on 21mg Coreg per day for 16 days.
On May 3rd, I made a major change to my diet. I had been on 25mg Coreg for 15 days, and .18mg Digoxin for 36 days, and was doing pretty good. No significant side effects, no increase in heart-beat dysfunction, blood pressure still at healthy levels, after some fluctuation after each change in medication.
On May 4th, after 37 days of .18mg Digoxin, I reduced Digoxin down to .125mg.
On May 6th, started having problems breathing, after doing weight lifts and pushups. Started having difficulty breathing at night, along with chest pains and a weak heartbeat.
On May 10th, after 4 days of .125mg Digoxin, increased Digoxin back to .18mg because of frequent breathing problems.
On May 12, experienced very low blood pressure readings during the night, a weak heart beat, and increased breathing problems, especially at night, or when attempting to do pushups or weight lifts.
By May 15th, I determined that the change in diet and/or the reduction in Digoxin, caused an over-reaction to the Coreg, and that I had to reduce the Beta Blocker Coreg.
So...... starting on May 15th, I reduced Coreg down from 25mg to 21mg.
On May 18th, I reduced Coreg down from 21mg to 18mg. On 18mg, I was able to do more exercise without breathing problems, but I still wasn't up to full strength.
On May 20th, due to blood pressure readings still too low and a weak heart-beat, I reduced Coreg down from 18mg to 15mg.
May 21st, slight chest pains, difficulty breathing at night, weakness, still can't do full sets of exercises without breathing problems.
May 22nd, Exercise tolerance getting better, breathing getting better.
May 23rd, Breathing problems and chest pains. Can't exercise at all. Sluggish, weak heartbeat. Breathing problems most of the day.
May 24th, I still figured (guessed?), that the difficulties that I was having were caused by the change in my diet and/or the reduction in Digoxin, which caused Coreg to work too well. So...... After 4 days on 15mg Coreg, I reduced down to 12.5mg Coreg.
May 25th-May 26th, still can't do full sets of exercises due to breathing problems.
May 27, exercise tolerance getting much better. On 12.5mg Coreg for the 4th day.
May 30th, exercise tolerance back to normal. Can do all weight lifts, pushups, power walks and stepper. Blood Pressure still at healthy levels. It jumps up, somewhat, after each reduction, but then comes back to previous healthy levels after about 3 days.
May 30th. Cut Digoxin down to .125mg from .18mg. I intend to get completely off Digoxin. From what I have read, Coreg can prevent ventricular tachycardias caused by Atrial Fibrillation, without the need for Digoxin. So, why take Digoxin?
Today, June 4th. Have been on .125mg Digoxin for 6 days and 12mg Coreg for 13 days. I intend to stay on 12mg Coreg, but get totally off Digoxin. I will stay on .125mg Digoxin for another week or two, before deciding when to reduce again.
Doing very well. Heart beat nice and "regular" and firm. Infrequent breathing problems. Can do all exercises. Average Blood pressure, so far, for the month of June is 123/74.
So..... I went from 25mg Coreg to 12.5mg Coreg in 9 days. This is a lot faster than I usually reduce medication, but I felt that I had no choice because of the increased breathing problems, chest pains, weak heartbeat, too low blood pressure and physical weakness.
I am not going to get totally off of it Coreg. For me, Coreg is an extremely important and necessary medication for my particular heart and health problems. It works great. The problem that I had was that, at 25mg, it worked too great!
I cut the Coreg much faster than I usually would, because of the problems I was having. My plans are to stay on 12.5mg Coreg for a month or two, get totally off Digoxin, and then see if I can't increase the Coreg again. We'll see.......
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
Machaon,
You are a walking Brittanica...for those who are too young, this was an Encyclopedia.....something you consulted....oh just forget it.
Anyway, I was curious about one thing. You mentioned "weak" heart beat as opposed to "firm". How can you tell? Is it just how it feels, or can you tell via some instrument? Just curious. Keep up the good work!
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
Interesting post. Thanks for giving us a very detailed insight into the problems that may arise from increasing and decreasing one's blood pressure and heart medications (with or without your doctors' knowledge )
The fact that things are slowly returning to "normal" on your current doses of each of the drugs is a good sign that could indicate the need for both.
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I am not going to get totally off of it Coreg. For me, Coreg is an extremely important and necessary medication for my particular heart and health problems. It works great. The problem that I had was that, at 25mg, it worked too great!
Prescription and OTC drugs are both toxic and therapeutic at the same time. No drug causes only a single, specific effect. The problem lies in determining the level of the drug at which is stops being therapeutic in each individual and starts being toxic. It is the toxicity of the drugs that results in our adverse reactions. Sometimes the suggested dose necessary for a maximum benefit of the drug is not tolerated and results in unacceptable reactions. Why were you aiming for 25mg Coreg dose? Is that the maximum recommened daily dose?
I don't blame you for wanting to eliminate one of your medications. I wonder though if a higher dose of a beta blocker would have made a suitable substitute for the other drug, Digoxin. Beta blockers and digoxin have different pharmacological consequences. This may be a silly question, given your history of experimenting with medication , but have you discussed this change with your doctor or a pharmacist? It wouldn't hurt to get their opinion.
I have a couple of questions. I know that your diet is as healthy as can be and, thanks mostly to that, so is your blood pressure. What, if any, supplements do you take? Do you have your calcium and magnesium levels checked occassionally, and are you on a low sodium diet? My next question is regarding the effects of your medications and diet on your EF. If there has been an improvement in your ejection fraction, do you attribute it primarily to your medication, your healthy lifestyle, or a combination of things? How in the world do you manage to keep track of all this data? Charts and spreadsheets? Do you do the data entry only once a day? I tried to keep a handwritten diary of the side effects of my blood pressure medication once, just so I could keep track of when they'd first started, their duration and in some cases tendency to come back, and to look for a pattern. Unfortunately, it didn't work out. Documenting your daily progress and recording your blood pressure measurements and other data must take a while. But, look at the results!
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
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Originally Posted by Editor
Machaon,
You are a walking Brittanica...for those who are too young, this was an Encyclopedia.....something you consulted....oh just forget it.
Let's see if I can get this right. You are comparing me, nearing 70, to an obsolete source of useless information.... hmmmmm!? I'll bet that there will be those who agree with that!
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Anyway, I was curious about one thing. You mentioned "weak" heart beat as opposed to "firm". How can you tell? Is it just how it feels, or can you tell via some instrument? Just curious.
I use my stethoscope, usually over the upper left chest area, where the heartbeat is at it's loudest. Usually if I am having breathing problems, I'll listen to my heart and expect the heartbeat to be soft and weak. When that happens, I use deep, slow breathing, which will strengthen the heartbeat, after about four times, and usually improves the breathing, and can bring down the blood pressure.
If I am having breathing problems, and my heart sounds forceful and too loud, the deep breathing doesn't help.
In either case, if the breathing problems persist, I check my blood pressure to see if it is safe to take a nitro. If I take a nitro, and the breathing problems persist, I'll take an inhalation of my Asthma med.
A heathly heartbeat, IMHO, through a stethoscope, should be loud, clear and "unforced". The two heart beat sounds, per heart beat, should be at the same sound level. If the first part of the heart beat is much louder, and more pronounced, than the second part, then I know that my heart is not happy, and is probably the cause of the breathing difficulties and/or tiredness and/or fatigue and/or chest pains.
It's taken a while to be able to tell when my heart sounds unhappy (stressed out). My heart works best when it sounds loud, firm and relaxed, with two equal sounds per beat.
The weak heart is real easy to tell.
In my case, I've got mild valve problems. If I move the stethoscope near the center upper chest area, I can hear a raspy sounding second part of the heart beat, which is indicative of valve problems. If my heart is beating well, the raspy sound is almost not noticeable. The worse my heart is beating, the more noticeable the raspy second sound.
Probably more than you needed to know!
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Keep up the good work!
Regards, Brenden.
Thanks!
I've had heart failure for over 20 years. In conversation with my wife during this morning's 30 minute power-walk, we discussed that, even after 20 years, I am still making changes to my medication and diet. It's a never-ending ordeal, keeping up with Heart Failure, Atrial Fibrillation and Immune Dysfunction in an aging body.
I intend to add the effects on my blood pressure, from increasing or decreasing blood pressure/heart medications, to this thread. Thought that might be of interest.
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
Hi Machaon,
Thanks for the info. However, in my case, were I to start using a stethoscope on myself, not only would I obsess over it, but my wife would likely strangle me with it....LOL!
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
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Originally Posted by flowergirl2day
Interesting post. Thanks for giving us a very detailed insight into the problems that may arise from increasing and decreasing one's blood pressure and heart medications (with or without your doctors' knowledge )
My Cardiologist thinks that I am on seven heart medications. I take only three of them and soon will be on only two. Is that because I am just dumb and reckless? Why do I go against the professional advice and judgement of my Cardiologist? Well..... a Cardiologist is just another guy, just like me, who, instead, decided to work on bodies rather than cars, computers or stocks, etc. He can't possibly have the depth of knowledge about my health, or my overall well-being, environment and lifestyle, as I do. As such, a doctor can only make an educated guess, based on partial information, limited experience and what is best for his business.
As a result of closely monitoring my own health gauge (blood pressure), over 27,000 times since 1998, I have experienced significant improvements in my health despite chronic, debilitatiing disease.
Plus.... If I called him every time I experimented with my meds, he would have put a block against my phone number over ten years ago.
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The fact that things are slowly returning to "normal" on your current doses of each of the drugs is a good sign that could indicate the need for both.
Thanks for your thoughts on this. I find it somewhat confusing and overwhelming, at times, trying to connect the dots and figure out which way is up? So, I appreciate your help and thoughts.
The one drug that I will absolutely take, because it is soooooo magnificent and effective, is Coreg. Tis wonderful stuff. It really works well at blocking Neurohormonal and Immune System chemicals. Everything I read indicates that Coreg will also suppress tachycardias caused by Atrial Fibrillation WITHOUT the need for Digoxin.
However..... Digoxin also has a blocking effect against Neurohormonal and Immune System chemicals. By reducing or stopping Digoxin, will I be losing important Neurohormonal and Immune System blockade, or are the blocking effects somewhat overlapping? Only time will tell. I hope to be completely off Digoxin by July.
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Why were you aiming for 25mg Coreg dose? Is that the maximum recommened daily dose?
I have Immune Dysfunction along with Heart Failure, so I need more Neurohormonal and Immune System blockade than the "normal" heart failure patient. With heart failure, or, for that matter, any heart disease including valve disease, the NeuroHormonal and Immune Systems increase the production of body chemicals, to make up for a heart, and circulatory system, that is not functioning at 100%. Those excess body chemicals, over time, are very damaging to one's body. In my case, I have an over-active Immune System, which adds even more body chemicals. If I want to survive my diseases, I MUST reduce these body chemicals, either by blocking them, or avoiding the things (triggers) which cause NeuroHormonal or Immune System reactions.
So, in answer to your question, I was interested in seeing the effects of stronger blockade by increasing the Coreg and then seeing how well it worked.
50mg is the maximum.
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I don't blame you for wanting to eliminate one of your medications.
Digoxin is a nervous system poison. As one ages, it is harsher on the body, especially the liver, and doctors are advised to cut back on Digoxin for elderly patients. Also...... I am toying with the idea that, could this nervous system poison (Digoxin) be causing some of my Immune System Dysfunction?
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I wonder though if a higher dose of a beta blocker would have made a suitable substitute for the other drug, Digoxin. Beta blockers and digoxin have different pharmacological consequences. This may be a silly question, given your history of experimenting with medication , but have you discussed this change with your doctor or a pharmacist? It wouldn't hurt to get their opinion.
I don't want to sound too egotistical, but in my many discussions with my Cardiologist, I have discovered that he doesn't have the knowledge, comprehension or understanding that could help me improve my health. He certainly has more book knowledge, training and education about cardiology than I, who have no formal training or education, but as far as putting it into practice, I find him lacking. Plus...... he disagrees with me on many issues. I might be the dumbest, most contrary, stubborn, pig-headed patient, he has ever had, but, by doing it my way, my health has improved in leaps and bounds.
I would never discuss my medical decisions with a pharmacist, most of whom have much less medical knowledge, and practical medical experience, than a Cardiologist. They wouldn't know, or want to know, what I was talking about.
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I have a couple of questions. I know that your diet is as healthy as can be and, thanks mostly to that, so is your blood pressure. What, if any, supplements do you take?
I take a multi-vitamin, a Vitamin B Complex 50, 500 mgs of Vitamin C, 1000 mg of Omega 3 fish oil, and, in the winter an occasional 2000iu of Vitamin D-3.
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Do you have your calcium and magnesium levels checked occassionally, and are you on a low sodium diet?
I get a CBC every six months, which includes calcium, sodium, potassium, etc., but not magnesium.
I don't watch my sodium at all, but my diet, by nature, is somewhat lower sodium. I do eat some salty foods.
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My next question is regarding the effects of your medications and diet on your EF. If there has been an improvement in your ejection fraction, do you attribute it primarily to your medication, your healthy lifestyle, or a combination of things?
I have Diastolic Heart Failure, which means that the ventricles are pumping fairly well. However, in the past few years before I changed my diet, my EF had dropped somewhat, but is still at fairly good levels, and my ventricle walls were thickening. My heart function has improved significantly, since the start of the diet, and as a result of avoiding things that trigger over-activity by my NeuroHormonal and Immune Systems, and much increased exercise. Plus..... in the past year, I've experienced significant additional improvements in my overall health because of Coreg. I LOVE Coreg!!! I kick myself for not being on it a long, long time ago! It angers me that I listened to so many negative opinions about Coreg, without looking into it further!
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How in the world do you manage to keep track of all this data?
I don't. I have papers, and pads and notes and test results, all over the place, in drawers, in my filing cabinet, scanned into my computer. Plus..... with my aging memory difficulties, I have to read, and reread all the time.
I do keep track of blood pressure, and comments and notes using my Windows Works Database Program.
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Charts and spreadsheets?
Windows Works Database and Spreadsheet, which comes free along with Windows, is great for storing data, like blood pressure readings and notes, and for doing charts and spreadsheets. Also..... with aging memory problems, charts are worth, and better than, a million words.
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Do you do the data entry only once a day?
Sometimes every other day. With an average of seven readings a day, I don't want to get too backed up.
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I tried to keep a handwritten diary of the side effects of my blood pressure medication once, just so I could keep track of when they'd first started, their duration and in some cases tendency to come back, and to look for a pattern. Unfortunately, it didn't work out.
My biggest payback, from keeping my records, is not the results of searching for patterns, but being able to look back at the data, to see what happened last time I tried something, or to keep me from trying something that had already failed in the past. It is also invaluable for keeping track of what caused spikes in my blood pressure, although it is not usually possible to tie "one" thing to a spike in BP. It isn't like I sat and reviewed a weeks worth of bp readings and notes and analysed it and evaluated it and BINGO, I got an answer. After 27,000+ BP readings, the times that I have experienced "BINGO, that's it!!!" have been far and few. Gradually over the years, the pieces have come into place. But..... it hasn't been easy, and I have been wrong many times about the "triggers" of higher blood pressure, heart palpitations, heart rhythm problems, and ill health. Even today, I doubt some of my findings. But, overall, I know that I am heading in the right direction. Otherwise, I would be dead, or worse, right now, right!?
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Documenting your daily progress and recording your blood pressure measurements and other data must take a while. But, look at the results!
flowergirl
I didn't chose this path. I was getting so very sick and weak during 2003-2004, that I had to do something. What was being done, at that time, wasn't working, and I was deteriorating on a daily basis. I was looking at a very bleak and nasty future.
Sorry about the length of this response. You ask very probing, searching and thought provoking questions, and once I get started working on a response, I find that I can't stop.
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
Machaon,
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I find it somewhat confusing and overwhelming, at times, trying to connect the dots and figure out which way is up?
Many people, myself included, are on the same boat. Seeking answers that might help us improve our health and quality of life can be exhausting and frustrating. It is difficult to judge whether we are on the right track for isolating the triggers of various imbalances which affect our health. New information usually raises more questions. So, it is an ongoing process.
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in my many discussions with my Cardiologist, I have discovered that he doesn't have the knowledge, comprehension or understanding that could help me improve my health. He certainly has more book knowledge, training and education about cardiology than I, who have no formal training or education, but as far as putting it into practice, I find him lacking. Plus...... he disagrees with me
My doctor compared looking for the right drug combination to cooking without a recipe. Take a bunçh of ingredients, throw them together, wait a while and see what happens. That sounds about right, doesn't it? Even the most knowledgable doctors cannot predict our reactions to any given drug combinations. The only thing that is certain is that the occurrence and severity of side effects of the drugs will increase with their number.
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Sorry about the length of this response. You ask very probing, searching and thought provoking questions, and once I get started working on a response, I find that I can't stop.
I am glad that is the case!
I have a reason for asking these questions. Thank you for answering them! The dose of one of my diuretics-a potassium-sparing spironolactone- has been doubled recently. I have been having difficulties adjusting and don't quite know what to do. The diuretic causes the body to retain potassium, as does my maximum dose of ACE inhibitor. This, in addition to reduced kidney function, requires (in theory) close monitoring of the potassium level. My problems could stem from a change in potassium level, decreased tolerance for this drug in a higher dose, or something else entirely. Who knows. I think I will reduce the diuretic dose to what it used to be. So, you see, my questions were rather self-serving in nature.
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
Hi Machaon,
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I would never discuss my medical decisions with a pharmacist, most of whom have much less medical knowledge, and practical medical experience, than a Cardiologist. They wouldn't know, or want to know, what I was talking about.
Two interesting studies were published recently (April 2009) in Archives of Internal Medicine. Researchers compared strategies to reduce adverse drug events caused by medication errors. One of the studies involved 800 hypertensive patients, some with heart failure and other complications. The name of the study: Effect of pharmacist on adverse drug events and medication errors in outpatients with cardiovascular disease. The conclusion is predictable - pharmacist's intervention improves medication use, and reduces medication errors and adverse drug events. That has also been my experience. I consult them seeking only a drug-related advice, not a medical treatment strategy. The pharmacists have caught my previous doctor's errors and even advised against the use of contraindicated medication. I find them very helpful. It pays to be careful.
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
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Originally Posted by flowergirl2day
Hi Machaon,
Effect of pharmacist on adverse drug events and medication errors in outpatients with cardiovascular disease. The conclusion is predictable - pharmacist's intervention improves medication use, and reduces medication errors and adverse drug events. That has also been my experience.
I agree. Pharmacists can do a great job preventing patients, especially the elderly, from adding medicines that would interact badly with their "known" other medications. We are in total agreement about this.
But...... you had asked me if I had consulted with a Pharmacist regarding my current adjustments to my Coreg and Digoxin doses. A Pharmacist would have little experience, knowledge or credible input regarding how an adjustment to these medications would effect my medical health.
As an example of why:
I spend countless hours researching clinical trials and various meta-analyses about Blood Pressure and Heart Failure and Diabetes and Immune System medications. A Pharmacist might know if Coreg and Digoxin would interact well or badly, for most patients, but would not have much knowledge of the medical complexities behind the combined use of these two medications.
For instance, lately, I have been studying three research papers regarding the use of Coreg and/or Digoxin.
One stated that Coreg effectively controls the ventricular rate response in AFib, and along with several other studies that I have read, states that Coreg reduces hospitalization and death among those with heart failure, and has special properties have been under-appreciated.
One stated that Coreg taken with Digoxin is more effective than either drug taken alone, for those with CHF and AFib, but that Coreg, by itself, reduces blood pressure much more than the combination of Coreg and Digoxin.
One stated that lower doses of Digoxin results in lower rates of death and hospitalization, than the normally accepted required dose of Digoxin, especially in the elderly.
Other studies I have read, have stated that Coreg tends to rebuild damaged heart muscle, along with all kinds of other positive effects on health.
So..... I've got to put all this info together, along with other studies, and along with my multiple health problems, and try to figure out the best way to survive, with a good quality of life. Not an easy task, since I don't feel that I can get any kind of helpful response from my Cardiologist, and certainly not from a Pharmacist. So far, I've been doing very well, so I gotta figure that I am doing something right.
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
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So..... I've got to put all this info together, along with other studies, and along with my multiple health problems, and try to figure out the best way to survive, with a good quality of life. Not an easy task, since I don't feel that I can get any kind of helpful response from my Cardiologist, and certainly not from a Pharmacist. So far, I've been doing very well, so I gotta figure that I am doing something right.
I agree! You've been doing a lot of things right. Accomplishing your goal required a lot of effort, an incredible amount of information, skills and knowledge. Thank you for sharing some of the steps and experiences via your posts. Keep up the good work.
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
Flowergirl, Thanks, again, for your feedback.
Of particular interest to me is the fact that there are fewer hospitalizations and deaths when taking lower doses of Digoxin.
Digoxin attempts to block certain Metabolic/NeuroHormonal/Immune pathways. My immune system over-reacts to seemingly innocuous things, and I have got to avoid many MANY things in order to keep my blood pressure at healthy levels and to avoid worsening of the condition of my damaged heart.
If Digoxin helps to block those over-reactions, then why is a lower dose of Digoxin better?! If a regular dose of Digoxin results in more deaths and hospitalization, could it be because somehow, someway, it also causes untested, unobserved immune system over-reactions at the same time?!
Now...... even though I throw around all these terms, and test results, but it doesn't mean that I totally understand them, especially lacking any formal education or training. So, to read and try to understand all those stuff, is slow and difficult, and it has taken months, or even years, for some of this stuff to sink in.
That is why 11 years and 27,500 blood pressure readings later, and I am still asking questions, WHY, WHY, WHY?! I may never get the answers I seek, but at least, after 20+ years of heart failure, AFib and Immune System Dysfunction, I am alive with a good quality of life, even though I must live each day in a virtual bubble.
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
In keeping with the subject of this thread.......
It has now been 10 days since I cut Digoxin down from .18 mg per day to .125 mg per day; and 25 days since I first started cutting Coreg down from 25mg per day to 12.5 mg per day. The last, and final, reduction in Coreg was down from 15.675mg per day to the current 12.5mg per day, 17 days ago.
I've been having increased breathing problems, and increased difficulty doing my pushups and my weight lifts during this time. I've also had increases in feeling my heart jumping around in my chest and seemingly a faster and more erratic heart beat.
Over the past few days, my exercise tolerance has improved, and today seems somewhat better. I can complete my 150 pushups per day, 400 steppers per day, 280 weight lifts per day and one hour power walk per day, but it takes more effort and causes increased breathing problems.
My average Diastolic Blood Pressure, during this time, is also up two points, from 73 to 75, but still at a seemingly healthy level. I say "seemingly" because if the low Diastolic blood pressure is now as a result of a heart that is not beating properly, then all bets are off.
I'm going to go about a month at these medicine levels before I decide whether or not I want to, once again, increase the Coreg, this time to see what happens with the reduced level of Digoxin.
I've been dancing this dance, with my various medicines, for over 20+ years. Constantly, over the past 20+ years, I've been adjusting and experimenting with my medicines because of either nasty side effects, or because they just weren't working well enough. I would bounce nasty side effects off my cardiologist, and all I would get back is that the meds weren't supposed to do that. Oh yeah! Well the meds WERE DOING THAT!!
Oh well. Just wanted to post a little about my experience, just in case others are going through the same thing, and wanted to compare notes.
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
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My immune system over-reacts to seemingly innocuous things, and I have got to avoid many MANY things in order to keep my blood pressure at healthy levels and to avoid worsening of the condition of my damaged heart.
Hypertension is characterized by high blood pressure and inflammation. I wonder how many of these over-reactions and derangements could be linked to inflammatory responses via inflammatory signaling, intercellular signaling and increased oxidant signaling. I think that is where some of the answers we seek can be found. Inflammation has such a huge role in cardiovascular disease, there should be more threads about it.
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Now...... even though I throw around all these terms, and test results, but it doesn't mean that I totally understand them, especially lacking any formal education or training. So, to read and try to understand all those stuff, is slow and difficult, and it has taken months, or even years, for some of this stuff to sink in.
Same here. I find that using reliable sources with the most recent medical information helps eliminate the guesswork and the need to sift through piles of contradictory information, thus getting faster and more accurate results.
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I may never get the answers I seek
This may be true, but seeking answers, rather than the answers themselves, is the fun part, isn't it?
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
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Originally Posted by flowergirl2day
I wonder how many of these over-reactions and derangements ...
Derangements?
Is that a "polite" way of saying that I am NUTS!!!
Hmmmmm!? You could be right.
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... could be linked to inflammatory responses via inflammatory signaling, intercellular signaling and increased oxidant signaling.
I have little idea what that stuff means and how it relates to my "derangements" or what I have learned, so you are completely safe from me disagreeing with your point!
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I think that is where some of the answers we seek can be found. Inflammation has such a huge role in cardiovascular disease, there should be more threads about it.
Systemic inflammation plays a big part in most diseases. It's a subject I know little about. I would be interesting to learn other's experiences with inflammation regarding their own health problems.
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Same here. I find that using reliable sources with the most recent medical information helps eliminate the guesswork and the need to sift through piles of contradictory information, thus getting faster and more accurate results.
Yes, but just because something is more recent, doesn't mean that it is the best choice or the best source. Most of the most recent research shows a significant amount of conflicting views and opinions.
I have greatly improved my health and quality of life through researching clinical trial results and medical research papers, but mostly by closely monitoring my blood pressure 27,500 times since 1998 and making changes to my medication, my lifestyle and my environment directly because of the results of my blood pressure tracking. The results have been a huge surprise to me. If someone had told me, back in 1998, that taking my blood pressure frequently during the day, would result in such a rebound in my health and heart failure and heart disease and immune disease, I would have ignored him. I would have asked: What does a blood pressure reading have to do with someone's health, other than you don't want high blood pressure?!
Blood Pressure is a gauge of the metabolic imbalance of the body, with the exception that, if the circulatory system is not working too well, a low blood pressure could signal worsening disease state.
The worse the metabolism is out of balance then the more hell breaks loose in one's body and health. That theory of mine is backup up, somewhat, by the fact that most blood pressure/heart disease meds attempt to block or inhibit imbalance in one's metabolism.
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..., but seeking answers, rather than the answers themselves, is the fun part, isn't it?
flowergirl
Not to me. I was sick and getting worse day by day, and the quality of my life was suffering. I desperately wanted answers and solutions. Even today, after significant improvement in my health, I still have to struggle with infrequent breathing problems and, at times, tiredness, weakness, etc.
I also have occasional problems coping with my health problems. In order for me to live a good quality of life, I've got to live in a bubble... a very restricted environment.
But...... it's all good, isn't it!?
Well...... you certainly provoked some thought, and discussion, as usual.
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
Machaon,
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Derangements?
Is that a "polite" way of saying that I am NUTS!!!
I am sorry about the choice of words!!! Derangements is a term also used in medical literature to indicate abnormalities and disturbances of bodily processes or functions, such as a metabolic derangement. This is the kind of derangements I meant - inflammatory states, electrolyte imbalances, circulatory disorders - basically, anything that is not in its normal state!!! So, my apologies.
Machaon, I admire your persistence, great resourcefulness and achievements to date. Your informative and motivating posts are always a pleasure to read. Thank you for sharing your knowledge.
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
It has now been 12 days since I cut Digoxin down from .18 mg per day to .125 mg per day; and 27 days since I first started cutting Coreg down from 25mg per day to 12.5 mg per day. The last, and final, reduction in Coreg was down from 15.675mg per day to the current 12.5mg per day, 19 days ago.
I am back to total strength and feel pretty damn good so far today, and felt pretty good yesterday. No breathing problems. No labored breathing. I'm not only back to doing my normal 150 pushups, 400 steppers, 280 weight lifts and one hour power walk, per day, I'm already up to 100 pushups this morning, without being overly tired, weak, and without any breathing difficulties.
So...... if my body has totally adjusted to withdrawal, as it seems to be, it has taken my body 12 days to adjust to the lower dose of Digoxin and, at the same time, 19 days to adjust to the lower dose of Coreg. It's confusing because I was cutting both at the same time. But, this is an example of the length of time it can take to reduce blood pressure/heart medications.
One must also consider that I first started cutting Coreg almost a month ago. It takes time for the effects of a reduction in medications to get out of one's system. At the same time, one has to wonder if an increase in symptoms is caused by the withdrawal from medication, or because the medication was needed, and the body was having difficulties because of the lack of medication, and not the withdrawal from the medication.
In this case, I feel very strongly that the weakness I experienced, along with the difficulty breathing, heart rhythm dysfunction and increased "mild" chest pains were due mostly to withdrawal and not a need for the meds.
Blood Pressure average for the month is 122/74 based on 63 readings, or about 7 readings per day. Not bad for someone who suffered from chronic, difficult to control blood pressure of 152/97 for 1998, and 146/92 over the entire year of 1999, continuing to be bad through the entire year of 2003, when it averaged 151/96. That was at least six continuous years of worsening health and worsening heart failure and uncontrolled high blood pressure before being able to get my blood pressure and heart disease under control and on the road to recovery. Approaching my 70th year, it just goes to show that it is never too late!
Now to decide how long to stay at the current dosages. Should I try to totally get off of Digoxin? Should I start slowly increasing the marvelous, wonderful, miraculous, medical discovery: Coreg? Hmmm!? What to do next???
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
Quote:
Originally Posted by flowergirl2day
Machaon,
I am sorry about the choice of words!!! Derangements is a term also used in medical literature to indicate abnormalities and disturbances of bodily processes or functions, such as a metabolic derangement. This is the kind of derangements I meant - inflammatory states, electrolyte imbalances, circulatory disorders - basically, anything that is not in its normal state!!! So, my apologies.
Machaon, I admire your persistence, great resourcefulness and achievements to date. Your informative and motivating posts are always a pleasure to read. Thank you for sharing your knowledge.
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
Machaon, your posts are very informative and detailed. I was wondering if you are working with a doctor to make these adjustments too? And if not, I was wondering why not? Obviously these adjustments were really significant and had major affects on your health. Also, are you tracking your blood pressure online or using a journal? My mother has recently been diagnosed with high blood pressure and she is very worried about the medications that she has been prescribed. She checks her blood pressure twice a day, and I am going to set her computer up so that she can download her information into a HealthVault account and then she and I can both review it online, as we are both quite worried. Good luck with your progress. Yours is an amazing story. I look forward to hearing more.
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
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Originally Posted by 1yogamom
Machaon, your posts are very informative and detailed.
Hi Yogamom! Thanks for the positive feedback! I'm happy that you find the posts interesting and somewhat helpful.
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I was wondering if you are working with a doctor to make these adjustments too? And if not, I was wondering why not?
I've completely given up on doctors, except for getting prescriptions and having complete blood counts (CBC). During 2003-2004 my heart failure, from which I have suffered since 1987, was getting progressively worse, despite being on a ton of meds and having a ton of tests run, and many doctor/specialist/cardiologist appointments.
The Cardiologists, GPs and specialists that I have seen all want to go by the book, and get you in and out of the office as fast as possible. Anytime I would bring up that an encounter with various things (irritants, pollutants, allergens, foods, drinks, etc.) would cause a rise in my blood pressure, an increase in my heart palpitations, and cause increased weakness, tiredness and fatigue, they would all ignore me.
I've tested my blood pressure 27,500 times, or about seven times per day, since 1998. I know for a fact what items cause my blood pressure to go higher, and my symptoms to get worse. They don't want to believe me. My Cardiologist looked at my blood presure charts and reports and ignored them, telling me that he was only interested in the blood pressures taken at his office. Hell!, even if I wasn't taking my blood pressure completely correct, at home, the variations and increases and decreases shown on my reports were very informative.
But...... in essence, they all told me that, if I wanted to get better, and not progressively worse like many of their other patients, I was on my own.
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Obviously these adjustments were really significant and had major affects on your health.
Yes, but........ Many make health claims on the Internet. Who can you, or I believe, and who not to believe!?
That is why I post in such detail, and am very specific. It adds credibility to my story. Plus....... I've got nothing to sell. All of my health claims are based on having a good diet, exercise, avoiding "triggers" of bad health and using the most effective medication. It's not rocket science. But it works great for me, and it would work, without any doubt, for anyone else who is suffering from any kind of health problems.
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Also, are you tracking your blood pressure online or using a journal?
I use Microsoft Works Database to store my blood pressure readings and to do my reports by year, by month, by day and by hour. I use Microsoft Works spreadsheet to do my yearly, monthly and hourly charts. Microsoft Works is included with any version of the Windows operating system.
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My mother has recently been diagnosed with high blood pressure and she is very worried about the medications that she has been prescribed.
How much does her blood pressure vary throughout the day? What types of meds is she on, and at what doses? Are the meds making her tired? Sluggish? Lack of energy or pep? Nauseous? Light-headed? Dizzy? Mentally confused?
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She checks her blood pressure twice a day, and I am going to set her computer up so that she can download her information into a HealthVault account and then she and I can both review it online, as we are both quite worried.
Sounds like a good approach. I love it when someone posts that they are going to be more pro-active in their own health matters. Many don't like to track their blood pressure. It makes them too nervous. But..... how are you going to know if you really have blood pressure problems, if you don't find out more about how much your blood pressure varies each day? Plus...... how do you know if the blood pressure medications are working well enough to endure the often nasty side effects, if you don't monitor your blood pressure? If you find out that, despite a handful of meds, your blood pressure and side effects are not acceptable, somethings got to change!
I don't know anything about HealthVault, but you have peaked my curiosity, so I think that I will find out more about it.
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Good luck with your progress. Yours is an amazing story. I look forward to hearing more.
Best of regards and good luck to you and your mother. It's heartening to hear that you are taking such a close interest in your mother's health. Your mother is very lucky in having a loving and caring daughter like you. It'll turn out, in the long run, that the best medication for your mother, was YOU!
Re: Example of problems when increasing/decreasing Blood Pressure/Heart meds.
Quote:
Originally Posted by Machaon
It has now been 12 days since I cut Digoxin down from .18 mg per day to .125 mg per day; and 27 days since I first started cutting Coreg down from 25mg per day to 12.5 mg per day. The last, and final, reduction in Coreg was down from 15.675mg per day to the current 12.5mg per day, 19 days ago.
I am back to total strength and feel pretty damn good so far today, and felt pretty good yesterday. No breathing problems. No labored breathing. I'm not only back to doing my normal 150 pushups, 400 steppers, 280 weight lifts and one hour power walk, per day, I'm already up to 100 pushups this morning, without being overly tired, weak, and without any breathing difficulties.
So...... if my body has totally adjusted to withdrawal, as it seems to be, it has taken my body 12 days to adjust to the lower dose of Digoxin and, at the same time, 19 days to adjust to the lower dose of Coreg. It's confusing because I was cutting both at the same time. But, this is an example of the length of time it can take to reduce blood pressure/heart medications.
It has now been 18 days since I cut Digoxin down from .18 mg per day to .125 mg per day; and 33 days since I first started cutting Coreg down from 25mg per day to 12.5 mg per day. The last, and final, reduction in Coreg was down from 15.675mg per day to the current 12.5mg per day, 25 days ago.
In my previous post, on June 10th, I said: I am back to total strength and feel pretty damn good so far today, and felt pretty good yesterday. No breathing problems.
Sure looked like my body had adjusted to the reduction in meds, and that I was home free, with full strength, and feeling pretty good, despite major health problems.
Not so fast................................
BAM!!! The next day, June 11th (Thursday), I had breathing problems most of the day, my heart was more erratic and felt like it was "mildly" jumping around in my chest, and I felt warmer than normal.
The next few days, June 12 (Friday) through June 14th (Sunday), I continued to have breathing problems, general weakness, overheating, higher blood pressure and an erratic, jumping heartbeat.
The night of the 14th (Sunday) was especially bad. I had to try to sleep sitting up all night, due to "labored" breathing and an erratic heartbeat. It was a nasty miserable night.
On the 15th (Monday), I was wondering if the reduction in the Digoxin was too much. Perhaps I needed more than .125mg Digoxin to stabilize my heartbeat, which, in turn, would alleviate my breathing problems? Perhaps, after two weeks, the full effects of the Digoxin reduction were finally kicking in, and I wasn't taking enough Digoxin? I had also worked on my roof with some very smelly stuff, which always bothers me. I had also changed my diet somewhat. I had also come into contact with something that always irritates my heart. I had also plugged in some electronic pest repellers. Could any of those things have caused me to feel so bad, or was it the reduced Digoxin?! What to do???
I decided to continue with the reduced level of Digoxin for a few more days, and if things didn't get better, and if I couldn't get to the source of my problems, I would increase the Digoxin back to .18mg, even though everything that I read indicated that, for someone my age, it was far better to be on the lower dose of .125mg of Digoxin, FAR BETTER!
Well...... today, June 16th, I am feeling pretty good, have full strength, heart is beating nice and relaxed, and I slept very well last night without any breathing problems. I found out what happened. It was a result of something I newly added to my diet. I threw that food out, yesterday, and my health slowly returned to "normal", whatever that is?
I felt that my awful experience would make for a good post, since it shows how difficult it is to determine the cause(s) for increased health problems, especially when experimenting, or changing one's medication. There are too many factors that can also influence one's health, especially, while at the same time, making a change to one's medication. After all, we don't live in a clinically pure bubble. Our health and metabolism can always be negatively effected by our foods, drinks, supplements, stress, pollens, pollutants, odors, chemicals, etc.
I am doing very well, with a good quality of life, but living with Heart Failure, AFib and Immune Dysfunction is a full time job!
)
, but have you discussed this change with your doctor or a pharmacist? It wouldn't hurt to get their opinion.
