Less than two weeks to go...concern about Amiodarone

[markwel]

Well, my date for surgery has been set for 1/06/2005....alot of sleepless nights at this point. I have a bicuspid aortic valve plus will need aorta repair. I am asymptomatic and having the valve/aorta replaced at 50 years old is the hardest decesion of my life.

I do have a question about Amiodarone. My surgeon is putting me on 200mg begining 12/31/2004..taking me off Toprol and adding an aspirin a day. I take 50mg of Toprol XL per day. I also take 10mG of Lisinopril and I'm not sure if he's taking me off this or not..I will call him. Why is he putting me on Amiodarone before surgery? I've heard some bad things about this drug and I'm very concerned about it. What are some of the questions I should ask him about this?

Thanks everyone for all the comments and for such a wonderful site.

 

[ALCapshaw2]

I *assume* you have some sort of arrythmias BUT, I would ask your surgeon WHY he wants you on Amiodarone for starters.

Before calling / asking, I would do a SEARCH on VR.com and Google for Amiodarone so that you will KNOW the side effects beforehand and can express your concerns based on that knowledge. Also ask your Pharmacist for an information sheet on Amiodarone.

Second, ask your surgeon if he expects you to STAY on Amiodarone AFTER your surgery, and if so, for HOW LONG?

IF you have Atrial Fibrilation, there are other drugs that may resolve those such as BetaPace or other Beta Blockers. Your Cardiologist should be able to advise you on arrhythmia management, or a cardiologist who specializes in ElectroPhysiology (EP).

I share your concern over amiodarone, I am on the generic equivalent of BetaPace (Sotalol) to control my A-Fib.

'AL'

 

[Granbonny]

Hi

Hi

Being the Xmas weekend..you may find few replies..but wait a few days..and I am sure.. You will have many I have your date..1-6 05for your surgery.....We are a very caring family and will follow you up....Just post any questions you need...and we will be here to answer them....Any pre-op. ect. Bonnie

 

[Mary]

Mark,
I'm wondering where in Kentucky you are and where the surgery is being done. I can't answer any of your questions, but I can relate to the decision about having surgery done. I imagine it is difficult when you're asymptomatic.
Best wishes as you wait.
Mary

 

[EVELYN]

Hi Mark

My husband, Tyce, was put on Amiodarone when he went into afib....about a month preop. He then continued on it for 5 months post op. He began weaning off the drug in December of 2002.....our cardio wanted him in NSR with no problems. He was able to go off it with no return of the arrythmia. He was on a beta blocker, but it didn't stop the afib.

I do believe most importantly that you are weaned off the amio post op, and that is definitely something you should discuss with your cardio, as Al mentioned. I do believe it is a good drug, but must be monitored majorly.

Good luck.

Evelyn

 

[Guest]

Well, my date for surgery has been set for 1/06/2005....alot of sleepless nights at this point.

*raises eyebrow*

My last surgery was 01/06/2003.

I know about the sleepless nights. Just do your best to relax...and keep yourself busy with stuff you ENJOY doing.

Take care...and, of course, GOOD LUCK!


Cort, "Mr MC" / "Mr Road Trip", 31swm/pig valve/pacemaker
'72/'6/'9/'81/'7, train/models = http://www.chevyasylum.com/cort/
MC Guide = http://www.chevyasylum.com/mcspotter/main.html

 

[mile high]

Mark,

I cannot answer the question concerning the drugs. However I just wanted to tell I also was asymptomatic. I had my bicuspid valve and ascending aorta replaced in early 2002 at the age of 47. It clearly was the right thing to do and I did it. This is not to say that there were times of great anxiety involved, but you get through all of it just fine.

One thing that I would like to mention is to watch for depression post surgery. This is more common in men. It seems to be rarely talked about. Not having suffered from this before, it is quite sneaky. It did not hit me full force until a year and a half after my surgery. Lethargy, the inability to think things thru, at work I would look for the easiest thing to do and put aside anything that seemed difficult.

All in all, it is great to be alive.

Good luck. I am sure all will go well.

 

[hensylee]

Mark, you can find so much discussion in the site about amiodarone (Cordarone) - going back several years. Pro and con. Mine are all con. Brother was put on it in preparation for cardioversion for a-fib and then the dr forgot about it! He was left on it a yr and 4 months and has permanent damage. About 5 wks ago I took brother to ER because of a bleed (coumadin, you know) and they found he was in a-fib. The dr said he would put brother on Cordarone - I always am present when bro sees a dr, because bro can't take all the stuff in - so I said 'NO - you will NOT put him on that medicine. You are a doctor, you KNOW the side effects, there are several other medicines that will do the same job'. He was surprised by my outburst, but put bro on something else and entered in bro's records - NO AMIODARONE. If you are put on this, please be sure its administration is short-lived. It might NOT do you any harm, but it might. Some here in VR are on it and had no ill effects. It's a strange ball game. The half-life is very long (that means it takes forever to get out of your system). You have to make the choice, but please study before you agree.

Mile High, we have done lots of discussions about depression; you just have to search in VR to find it. Depression goes right along with any heart issue. Some, after surgery, have been seriously depressed but eventually it passes. If you are having some, please put it in a separate thread and let us discuss it with you. Many have been there and will tell you their experiences - besides, it needs to be refreshed for newcomers.

God bless.........

 

[Gemma]

I know there are some meds which you need to stop taking a week or so before surgery (presumably because they can affect blood pressure, bleeding etc during surgery) - ACE-inhibitors are one, which Jim was taking prior to his surgery and was advised to stop 1 week in advance. This may be the reason your surgeon wants you to stop taking the beta-blocker, however if you are asymptomatic I'd wonder why you need to be taking amioderone.

 

[markwel]

Talked to Surgeon about Amiodarone

Talked to Surgeon about Amiodarone

Well...finally spoke with my surgeon about why he's giving me Amiodarone before surgery. He says it's to prevent afib before during and after surgery. I'll only be on it six days right before my surgery date 01/06/2005. He's says this is standard protocol for all his patients. He's never had anyone experience side effects with this short period of time. I was just concerned about this drug after reading some info here and other places on the net....

What would you do? (He says if I don't feel comfortable taking it not to take it.)

 

[pillarpaul]

Hopefully, I can clear up some misconceptions. I was on amiodarone for six months and during that time I did about as much research as a lay person could do. I believe this to be (in Fox News's words, "fair and balanced"). Here's what I've gleaned from sitting in front of the computer on the net for hours about this drug, talking to pharmacists (including a PM with our own Al Lodwick), various doctor opinions, etc, etc:

1) Amiodarone should almost never be taken longer than six months. Do everything you can to get off it in six months;

2) Amiodarone frequently shows side effets within two weeks of starting, especially if taking the large dosage required for conversion. If you have no side efects the first two weeks, odds are very good you'll have no side effects for the rest of the six months (but no guarantee beyond - see #1 above);

3) Once converted, you can stay on a maintenance dosage;

4) Yes, you can indeed turn blue, get lung problems and liver problems. However, 85% of all people who take the drug suffer NO side effects;

5) Amiodarone is generally considered the drug of LAST resort for people with "normal" a-fib, i.e., the a-fib is not due directly to an insult to the heart such as open-heart surgery.

6) Amiodarone is sometimes the drug of FIRST resort (depending upon the cardio) when the a-fib is a result of an insult and if it is considered very serious;

7) While on amiodarone, stay very in tuned with your body and have your PCP monitor your blood levels.

8) The half-life of amiodarone is 45 days, not 4, 5 or 6 months as some members have stated.

I am not making a recommendation for or against. It appears to be a strong weapon albeit one with potentially devastating side effects. I watched very, very carefully while on it and hope I never have to take it again. I also stayed completely out of a-fib since my post-op episode.

Paul

 

[Bryan B]

Thanks for the info Paul.

I was on amiodarone post-op for three weeks. I went into a-fib while I was still in the OR (never had a-fib before surgery & have never had it since). Your discription of "insult" is excatly what caused my a-fib...I now better understand why my surgeon used amiodarone and insisted I continue it for 3 weeks when I questioned whether or not I needed to stay on it.

Thanks