Beta Blockers

[Marge]

Beta blockers, anybody?

I am taking Coreg (carvedilol). This is supposed to be the latest thing for people with CHF/DCM. Prolongs their survival, mitigates their symptoms, etc.

I just progressed to the top level of the dosage for people of my weight -- 25 mg. 2X a day. I know that compared to many other people on this medication, my side-effects have been fairly minimal, so I really shouldn't *****.

According to what the cardiologists are telling me, I am going to have to be on this stuff for the rest of my life, even after the mitral valve surgery, since the surgery won't cure the damage already done to the left ventricle.

I just hope that, once the medication is fully stabilized, its "heart lowering" effect will also stop affecting things like short term memory and concentration.

Sometimes I feel like I'm going into Alzheimer's. Then I get thoroughly depressed & feel like telling the cardio: Look, doc, I know this stuff is supposed to be a wonder drug in terms of prolonging CHF patients' survival, but if at the same time it also mimics senile dementia, I'm not sure a longer life is worth it.
(I'll feel different tomorrow. I hope.)

 

[Nancy]

Temporary memory impairment could also be caused by your CHF when it's active. Joe's had CHF for many years, and as you know it comes and goes. What he's found is that when his fluid retention is high, and he's SOB, his memory suffers. This, I assume, is because the oxygen level is diminished.

Once he sheds the fluid, he's much better.

We try very hard to not let his weight gain go over 5 pounds. That's the point that he starts taking the mild increase in Lasix and K-Dur that the cardiologist recommended.

 

[Marge]

I don't think it's fluid retention. My weight's been stationary for weeks. I don't have swelling. Weight gain and edema are among the things I'm being monitored for. I check for them every day and call in to the Heart Failure Management Program along with my BP, heart rate & a few other things.

They haven't prescribed Lasix for me (yet). One thing that my cardio says probably has helped me is that I never did have a very high sodium diet. (And now I am positively fanatical about sodium).

I am also not feeling shortness of breath. I actually think the Coreg is helping me. I was fairly asymptomatic at the time of diagnosis, but I did get some SOB and chest pressure when I walked longer distances too fast, or ran up a flight of stairs to catch a BART train pulling out. I'm not having that any more.

I really do think the problems I've had with ability to concentrate, etc., occur most when I've gone up a level on the beta blocker. This last level is a pretty hefty jump -- from 25 mg. a day to 50 mg a day in one fell swoop and I am really feeling it.

I am trying to appreciate that so much is being done for me. I should not be feeling sorry for myself -- but, hey, there it is!

It's also grey and rainy, and it's New Year's Day, and people are looking FORWARD while I look backward and think to times just a few short months ago when I didn't have to live with this damn thing. And my husband is watching a football game on the TV and I can't escape it.

So it is probably not the beta blocker at all. Or if it is the beta blocker, it is probably temporary relating to the increase in dosage.

It is the whole mess and I am just having a pity party and I am just glad there is somewhere to vent. Please don't mind me!

TOMORROW WILL BE BETTER!

 

[JimChicago]

Personally I'm taking a much lower dose of Coreg than you are but I would still like to get off it - thye say my resting heart rate is too fast (around 100) but my heart has had the same pulse rate for 15 years and even the Coreg lowers it only slightly.
Here's an excerpt on some of the potential side effects of some beta blockers:
http://explorehealth.sentara.com/library/healthguide/IllnessConditions/topic.asp?HWID=ps1411
>>>>
How Well It Works
Beta-blockers are very effective at slowing the heart rate. Some of the medications have also been shown to be helpful for people with coronary artery disease or heart failure.

Side Effects
Side effects of beta-blockers include:

Fatigue.
Dizziness.
Inability to get or maintain an erection (impotence).
Cold arms, hands, legs, or feet due to poor blood flow to these areas.
Lack of awareness of severe low blood sugar levels in people with diabetes who take insulin or oral hypoglycemics.
Depression.
Slow heart rate.
Shortness of breath.
Wheezing in people with asthma.
See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What to Think About
Beta-blockers can sometimes slow down the heart rate too much. They can also worsen long-term (chronic) heart failure. Close monitoring during treatment is important, although most people do not have serious side effects from this medication.

Some of these medications may cause symptoms to worsen in people who have asthma, chronic obstructive pulmonary disease (COPD), and some types of heart failure.
>>>>

I get the fatigue one somewhat. I'd like to find an alternative to this medication eventually.

 

[Mb]

Hello all!

I clicked on this one right away, as my husband has been having some pretty severe "fogginess" lately. Of course, I never did have heart surgery, but do get memory lapses at times each day.

He also takes a beta blocker - atenenol.

His heart rate is still not controlled well. I just heard from his cardio yesterday, and his resting rate is mid 50's with 2 second pauses. When he "moves around" it goes up to 150. He is a dual valve recipient. His Dr. wants him to get a pacemaker now, even though for 2 years, since an echo found severe tricuspid regurgitation, he recommended against it. (He is also in chronic a-fib). Last night it was so bad, I almost thought he was having a stroke, and frankly this is the first time I considered that. I arranged for us to play cards, thinking that if he could adequately understand and play a hand of cards, he couldn't be having a stroke. He has had TIA's in the past, pre surgery.

I think the one thought I'd like to leave you with, that memory lapses are truly not the worst thing. You aren't short of breath, you aren't retaining fluid. These signs could mean that your heart is in worse condition than it is.....and it WILL be better once the mitral is replaced.

Please note that one of the side affects from the meds is depression. Perhaps you might consider telling your Dr. how you are feeling, as there are things that can be done to help you.

Wishing you the very best.

Marybeth

 

[M&M]

Hi Marge, I read your post and I thought - YUP, I hate my beta blocker. Wish I could go off it - I tried several weeks ago only my ventricular tachy's (vt's) were so excited that I had gone off the med they decided to come out and 'play' . I said: OOooops I think I better go back on the beta blocker. I've had terrible side effects on the med - on and off - one thing I did notice is that the more 'stressed' I am the more the side effects I get. I do take a 150 mg of wellbutrin (anti-depressant) - and its only half the recommended dose for depression - normal dose is 300 mg. but I find the 150 mg does offset the 'weepies' I get from the drug. I tried to go without the wellbutrin drug as well - it was awful - I was back on it in a couple of weeks. I keep trying to wean myself off these drugs - only to get 'stuck' going back on. I never took any drugs for 8 years - and then I got shocked from my ICD and then the drugs came and its not been the same for me since. I get frustrated - I get angry and I threaten to stop all meds.. I can't - I can't even breath if I don't take my meds. So I keep telling myself the alternative is worse - so 'relax' and take your meds Marilyn. I've been on atenolol now for 2 years. Just a couple months ago I developed the cold hands and feet symptoms. It was awful - my hands were like 'ice' - but I do think I was more 'stressed' out with the holidays coming and some stressful things going on in the office - I notice they get worse. I know its crazy - but I think 'stress' really brings out alot of things. I have discovered that for ME - if I can control my stress I can almost tolerate the drugs. By the way - I've put on 10 pounds since going on this beta blocker. I think it really reduces your metabolism and even though I exercise alot - I don't burn the calories as well. The 10 pounds came on very slowly - took about 6 mos.

Now for the good news - this drug has literally helped to make my life alot better as far a quality of life. This beta blocker along with mexiletine (antiarrhythmia) med has kept the vt's away and I can breath great with no shortness of breath virtually.

I know sometimes people will say I told you Marilyn about such and such and they'll say - don't you remember - I don't remember anything about it. Now its not just one person or two - lots - sometimes I wonder if I'm losing it. I really don't remember people saying those things to me. I am on the smallest doesage possible. 12.5 mg twice a day - Yes, I cut that tiny white pill in half.. and its very strong for me. I'm being paced 50% of the time with my pacemaker - because the drugs bring my heart rate down so low. The pacemaker keeps it from falling below 50 bpm. Well normally I run 72 - but if I get the pacemaker programmed to 72 bpm - then I would be getting paced even more and perhaps making my heart work harder than it needs to when just resting. I do exercise daily to help make sure my heart doesn't get tooo lazy. The pacemaker is vital in making sure the drug doesn't bring my heart rate to low. I would think without it - I would feel alot of fatigue and lightheaded. Pacemakers really give me a better quality of life - My machine is programmed with a rate response so that I can exercise - in other words - it registers that I'm being 'active' and will give me my needed heart beats to exert myself to a level of fitness. I was virtually 100% dependent on it at first - but now only 50% and that's at night when I'm resting. There's alot to this stuff - but in end result - IT WORKS.. and I'm able to run half marathons.
I just hope when I get my new mitral valve that it will want to 'run' races.. Maybe not half marathons but a couple 5 and 10k's would be nice. It won't be much longer and I don't think my 'feet' problems could take the longer distances. My heart would be fine - I have a great heart doc - but its the rest of me that's falling apart !!!

Life is Good

Marilyn and **** (runner)

 

[Marge]

I was feeling really "DOWN" when I posted before. I am normally a much more positive person! Or at least I try.

Thank you all for the responses and for your understanding.

I'm feeling MUCH MUCH better today. It is, after all, only the fourth day of going up to the top dosage and I need to give it time.

They have been very careful gradually increasing the dosage & monitoring me as it goes up. I have had to call in my BP, heart rate and some other things each day for the last few weeks, to make sure I am not having untoward effects.

I think I panicked a bit, because until this last increase I hadn't had very many of the side-effects they tell you about.

In many ways I know the coreg has already helped me a lot. It has to be the coreg, because I am not on anything else except cozaar, an ARB (because I cannot take ACE inhibitors like lisinopril). I was on cozaar (for high blood pressure) well before I was diagnosed with DCM/CHF. I'm not taking lasix or any other diuretic because I've not been having fluid retention.