Appreciation (and metoprolol question)

[lilyofthewest]

Been reading this board for several weeks and want to thank all of you who take the time to answer questions and make helpful comments and send out encouragement. Only regret I didn't find this site sooner. Could have really used the reassurances during the very difficult and panic stricken first weeks post surgery. Am now about 15 weeks out and feeling most of the way back. There have been times when my current cardiologist reacted as if I was nuts thinking something was related, only to come here and read that it's not at all uncommon. Like the optic migraine vision issue. So thank you all so much. Just one question for the moment. How long on average does one stay on Metoprolol?

 

[DachsieMom]

I only stayed on it a few weeks. I think 5 weeks. It was making my hands turn to leather and peel- and at times my blood pressure was down to 70 or 80 over 50. You have to decrease gradually - can’t stop cold turkey. Others stay on it for longer I think.

 

[LondonAndy]

Welcome Lilyofthewest. In my case I am told I will be on a beta blocker permanently, though (a) I moved from Metoprolol to Nebivolol as I found that affected me less and (b) I do wish I could come off them, as they make me feel very tired I am told it is for 'protective reasons' to reduce risks from atrial fibrillation.

 

[epstns]

Hi, lily, and welcome to our happy family.

I've been taking metoprolol ever since my valve surgery 7 years ago. Whether you need the beta blocker long term or not probably depends upon why it has been prescribed for you. Many surgeons prescribe a certain "pack" of meds for the first few months post-op, then re-evaluate later on. Others only prescribe what they feel each patient needs.

In my case, after aortic valve replacement, I had all sorts of heart rhythm and rate issues. I had afib (atrial fibrillation), missed beats, extra beats, even looong pauses of up to 20-30 seconds. I ended up with a pacemaker to protect against those pauses and metoprolol to help protect against afib. Originally, I was prescribed a dose of 100 mg/day of metoprolol. That was rough. I told my cardio that it felt like I was dragging a sled full of boulders around all day. At about 4 to 6 months post-op, I convinced him to cut my dose to 50 mg/day. I noticed an immediate improvement, with no recurrence of afib. A few months later, I again discussed it with him, and we agreed to try reducing my dose to 25 mg/day. That was a huge improvement, and that is the dosage I still take.

I'm a confirmed gym rat, and watch my heart rate during exercise. Before the surgery, I could easily run my heart rate up to the mid-160's under peak load. After surgery and rehab, but with the 100 mg/day metoprolol dose, I could barely get over 100. Couldn't do much at that rate. These days, 67 years after valve surgery and with only 25 mg/day of metoprolol, I can get my heart rate up to the mid-140's. My cardio and I (reluctantly) agree that at my age (now 70), that is a realistic limit to set.

If the beta blocker is getting in the way of your life, I would discuss it with your cardio to see if it may be worthwhile to try a reduced dose for a bit to see if it helps you in activities without allowing anything unusual to happen to your heart rate or blood pressure. (You don't mention any lingering atrial fibrillation, so my suggestion presumes that they are just trying to limit your max heart rate.)

 

[ottagal]

You are welcome. That's what we are all here for you...to support and encourage one another. I was on the metropolol for a year. Leading up to the year, my dose was reduced and I was eventually weaned off of it. Hope that helps...

 

[Paleowoman]

Hi Lily - I was on a betablocker (Atenolol) for six to eight weeks after AVR. Initially the dose was reduced after three weeks and then totally stopped. I was very glad too.

I still get those migraine auras without headaches - they started the day after surgery, four years ago, and I get them now a couple of times a month, though actually had one yesterday and another this morning - they last about 20 minutes each. Sometimes I get double vision too, plus daily bright sparkles of light crossing vision. I believe it's a side effect to do with the cardio pulmonary machine used during surgery. I've not done anything about it but discovered several people here have, or had, it, going right back to much older threads from years ago.

 

[epstns]

Yeah -- I occasionally get the "double-vision" bouts, but mine are quite random and erratic in the time between them. Usually months between, and my episodes only last a minute or so. Haven't had any longer ones, and haven't had any of my activities impacted by them. Just annoying. . .

 

[DachsieMom]

I started getting migraine with aura too. However, if I take a Tylenol within 5 minutes of seeing floaty sparkles I don’t get a headache.

 

[lilyofthewest]

I certainly did come home from the hospital with a "packet" of meds. So I'm still not sure which of my problems the first couple weeks (like being on the edge of passing out multiple times) were caused by the surgery or med side affects, or afib. I had no afib when I left the hospital but it was there when getting my staples out at 2 weeks. So they put me back in the hospital and did a cardioversion. Going by how I was feeling afterward, I really believe that took care of it. But was put on warfarin. That stuff really scares me. My aunt died from a warfarin bleed out and my brother almost followed her. (Bicuspid valves are epidemic in our family which doesn't bode well for my kids and grandson who've all been diagnosed with "murmurs") So when the warfarin perscription ran out after a month and I was out in Calif visiting my son, I just quit it. Now I'm on a heart monitor until the end of the month to see if there's any re-occurrence of the afib. Fingers crossed.

 

[lilyofthewest]

I don't really mind the metoprolol now the dose is lower, because it also prevents migraines, which I've had all my life. Not a one since the surgery. The cardiologist said it's for dilating blood vessels so the blood flows through easier and not that effective for lowering my borderline high blood pressure, which is what I thought it was for.

The double vision and lightning flashes have gradually let up so that now there's just the occasional sparkling. Indeed annoying but ok.

A couple other things I've noticed since surgery is much relief from my extremely cracking dry skin and scalp and from bouts of numbness in my hands. Probably due to better circulation?

Getting back to exercise routine though still not able to lift more than half the weights as before but endurance walking etc is gradually building.

Thanks again for all the support

 

[pellicle]

Hi

But was put on warfarin. That stuff really scares me.

Don't be, its important for the first few months after a tissue prosthetic (and life with a mechanical).

The ​​​​problems center around mismanagement of the dose and INR in the vast majority of cases.

Best Wishes

 

[tom in MO]

Short term warfarin is common. You might not need it any more; that's could be why you weren't given a long term dose.

Per metoprolol I didn't like that stuff, calmed down too much (a positive thing when the wife and daughter argue )and affected my amorous abilities. When I discussed it with my cardio right after surgery, he told me to stay on it until the prescription ran out, about 6-10 weeks total. I've never needed it since.

 

[Carnelian]

Interesting thread. I am still taking Metorpol 50 mg a day and am almost 6 months after surgery for mitral valve replacement
and double bipass. I don't have any side effects, fortunately, but I tire very easily all the time. Is that a side effect? Or is it
my asthma? Because I take Advair every day. I get tired just thinking about getting tired! Not much exercise for that reason.
Doctor has not told me when to stop it. He never told me the purpose of the med.
Am very grateful my life resumed normalcy. Except for chronic depression,

 

[Superman]

I’ve been on Warfarin since my first open heart in 1990. I added low dose aspirin and metoprolol after my second in 2009. 25 mg 2x daily. Have stayed on them ever since. Haven’t noticed any side effects other than my resting pulse is probably lower than it would otherwise be. Between 58 and 62. Can still get up over 160 in spin class. Depending on how reliable you think wrist heart rate monitors are, I’ve recorded over 190. Other “performance” related side effects (tmi?) have not been an issue either.

My blood pressure is typically below 120/80. My wife says the med is more to avoid the spikes in BP then to maintain a lower overall level. She’s a pharmacist. Lucky me, given my issues!

 

[tom in MO]

Interesting thread. I am still taking Metorpol 50 mg a day and am almost 6 months after surgery for mitral valve replacement
and double bipass. I don't have any side effects, fortunately, but I tire very easily all the time. Is that a side effect? Or is it
my asthma? Because I take Advair every day. I get tired just thinking about getting tired! Not much exercise for that reason.
Doctor has not told me when to stop it. He never told me the purpose of the med.
Am very grateful my life resumed normalcy. Except for chronic depression,

Per the NIH fatigue is a side effect of metoprolol. I'd talk to my cardiologist if I was you.

I hate the term "side effect" because it makes one think that it's not important. I like the term "non-therapeutic" effect instead. All drugs have a spectrum of effects, you take them for the therapeutic effect, but the non-therapeutic ones can be just as "effecting". Viagra and Cialis are good examples of where the modern-day therapeutic effect was once a "side effect" of what was originally going to be hyper-tension drugs but they were not "effective" in their intended first use.

 

[Rob88]

I started out taking 25mg metoprolol post op. On a 2 month follow up my cardiologist changed me over to 2.5 bisoprolol. Just recently after I asked if I would be able to get off the bisoprolol he decided to reduce the dose to 1.25 (about 8 months post op).