I've crossed the line into severe and need to make a decision

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Chuck C

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Metoprolol also is prescribed for arrhythmias/supraventricular tachycardia, which is why I’m still taking it.. but I guess you don’t have any of that?
Hi Amy.
I had afib after surgery, while in the hospital. I was put on Metoprolol and amiodarone. I know that the amiodarone was for the afib, the metoprolol may have also been for this- not sure. It may have also been to control blood pressure, as it does both control blood pressure and keeps pulse low. Right after my cardio said I could go off amiodarone, they had me wear a halter monitor for 2 weeks. It showed my heart rhythm as normal, so I was fine to stay off of the amiodarone. I'm not sure if this weighed into my cardiologist's green light for me to go off of metoprolol. But, so far, no sign of the afib returning.
 
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Amy

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Also, just a heads up, but a couple doctors told me that if/when I do come off metoprolol, I should taper off, taking half a pill a day for a week (so 12.5 mg) before stopping completely. Don’t know how much truth there is to this, and it may be too late if you’ve already stopped, but I just thought I’d put it out there, seeing as your care team didn’t know about the amiodarone/warfarin interaction.

You sound so well-recovered though, it probably doesn’t even matter. : )
 

cldlhd

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Update- 9 1/2 weeks post surgery- Back on top of the mountain!

I've been feeling about 100% back to normal for several weeks now.

A week ago I messaged my cardiologist and asked if it would be ok if I went off of Metoprolol, if I agreed to closely monitor my blood pressure and get back to him. He agreed. My BP numbers, while not as good as pre-surgery, have been good enough for me to stay off of it. I'm usually about 125/75. Very glad to be off all of the surgery related meds! My pulse is still high, at rest its about 78 to 88, but my cardiologist says that this is normal post surgery and will come down in time. I also did some research on VR and found that over the years almost everyone shares that their post surgery pulse was elevated, so I am not concerned about it and expect it to normalize in time.

Back to the top of the mountain.

As I have shared earlier in the thread, pre-surgery I was briskly walking up a mountain 5 days a week. It is a challenge with a 1,200 foot elevation gain and a very steep 14.2% grade. Well, today was my first day hiking back to the top of the mountain! I felt great during and after the climb. I purposely held back and took it slower than normal, making sure to keep my pulse under 140, but felt like I could have charged up it if I wanted to. I'll wait for clearance by cardio before I attempt that- looking forward to trying to beat my own PR soon!

This thread was started with a question seeking whether I should get surgery or wait for symptoms, having crossed the line into severe per my February echo. Thanks to all who gave input. I'm very glad that I decided to get surgery immediately and not wait for symptoms. I suspect that this has played a role in my speedy recovery. And, as I've shared previously, after opening me up, Dr. Shemin indicated that my valve was actually beyond severe- it was critical. So, this is another reason that I'm glad that I did not wait, as, per Dr. Sheman's words, I was a ticking time bomb and I might not be here had I waited.

Back on top of the mountain!

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Great to hear. I clearly remember being glad to get off of those post surgery meds , these days it's only a daily pravastatin and baby aspirin ( and a couple of supplements). I'm sure you're heart rate will go back to normal sooner rather than later, I can't remember exactly how far out mine did but shortly after surgery it was in the 90's now my resting rate us around 60.
 

Chuck C

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Also, just a heads up, but a couple doctors told me that if/when I do come off metoprolol, I should taper off, taking half a pill a day for a week (so 12.5 mg) before stopping completely. Don’t know how much truth there is to this, and it may be too late if you’ve already stopped, but I just thought I’d put it out there, seeing as your care team didn’t know about the amiodarone/warfarin interaction.

You sound so well-recovered though, it probably doesn’t even matter. : )
Thanks for the heads up. I was unaware of this and my cardiologist did not mention it. I am now 9 days off of it, so it appears I am past the taper down phase at this point.
 

Chuck C

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That is awesome! What is the mountain that you are 'owning'? Am 13 days out from surgery and hope to take on the mountains around me too. Great to see how well you are recovering!
Thanks
The mountain is Mt. Monserate in Fallbrook. It is very steep, with an average 14.2% grade. As a frame of reference, the notoriously grueling Mont du Chat in the Tour de France is an average 10.5% grade, so this is hike one heck of a workout. The trail head is only 15 minutes from my home, so it is easy to make this a part of my daily routine.

 
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Chuck C

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I can't remember exactly how far out mine did but shortly after surgery it was in the 90's now my resting rate us around 60.
That is great feedback, thanks for sharing that. Before surgery mine was typically 55-60, so my current pulse rate of 78-88 is significantly above normal for me. Although this morning it was 75, which was the lowest I have seen it since going off of metoprolol.
 

BillDaThrill

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Thanks
The mountain is Mt. Monserate in Fallbrook. It is very steep, with an average 14.2% grade. As a frame of reference, the notoriously grueling Mont du Chat in the Tour de France is an average 10.5% grade, so this is hike one heck of a workout. The trail head is only 15 minutes from my home, so it is easy to make this a part of my daily routine.

Ooohweeee' that is steep, great work!!! Just incredible that you are doing so well, real inspirational - so thank you for the posts! I have some great hiking options in town - some I can hit right from my front door (I live 100' from a national forest) - with the extra challenge of high altitude. My home is at 7300' and some of the mountains in my town top out at 10,000'+. Will be fun/interesting to try out the new valve on that here in a couple months.
 

Chuck C

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I have some great hiking options in town - some I can hit right from my front door (I live 100' from a national forest) - with the extra challenge of high altitude
Altitude makes a huge difference!
Years ago I participated in a run called the Mt. Baldy Run to the Top. It's an 8 mile run that starts at 6,000 feet and ends at 10,064 feet at the top of the dome of Mt. Baldy- ran it 3 times. So, you're dealing with lower oxygen from the very start, but it really becomes a factor past 8,000 feet. The folks who win it typically train at elevation to adapt.

That great that you have so many hiking options in town! Have fun in recovery!
 

Chuck C

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Great to hear. I clearly remember being glad to get off of those post surgery meds , these days it's only a daily pravastatin and baby aspirin ( and a couple of supplements). I'm sure you're heart rate will go back to normal sooner rather than later, I can't remember exactly how far out mine did but shortly after surgery it was in the 90's now my resting rate us around 60.
I've had some very interesting pulse readings the past two mornings that I thought I'd share.

My pulse has been about 78 to 90 since going off all meds 10 days ago.

Thursday I went up the mountain. I pushed but held myself back. Still, it was by far the most challenging cardio work out I've done since the operation. Up the mountain in 45 minutes.

Friday morning: Pulse 75- have not see it this low since going off of the meds.

Friday I climbed the mountain again and this time I really felt like opening the throttle a bit, so I did. Did not push 100%, but much more strenuous work out that Thursday- up the mountain in 35 minutes.

Saturday morning resting pulse: 69 Pleasant surprise.

I can't help but wonder if testing my cardio and putting a little stress on the pipes is causing my pulse to normalize more rapidly than it otherwise would.

It is a bit early to theorize on any connection, but I was sure glad to see the 69 pulse reading and can't help but wonder.
 

Amy

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So, when you’re exercising, do you feel your pec muscles kinda moving around a bit, or any sharp short pangs, or anything to remind you that you just had heart surgery? I often feel these things on a walk. So.. just curious about others.

Great news about your pulse. You’re really good at recovering! : )
 

Chuck C

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So, when you’re exercising, do you feel your pec muscles kinda moving around a bit, or any sharp short pangs, or anything to remind you that you just had heart surgery? I often feel these things on a walk. So.. just curious about others.

Great news about your pulse. You’re really good at recovering! : )
Yes, I do sometimes feel something like this. It is not something that I would describe as painful, but a little pang kind of does describe it. Just on my left side, right were my pec meets my sternum. It's hard to tell if the feeling is coming from the muscle or inside the bone.
 
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Chuck C

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Great news about your pulse
It looks as though the couple of low readings I had may have been an aberration. It is back in the high range again today. It was too much to hope for to have it return to normal this quickly. However, I'm sure in time it will.
 
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Amy

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Hi Chuck,
Did you notice feeling any differently when you came off the Metoprolol? Just curious.
 

Chuck C

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Hi Chuck,
Did you notice feeling any differently when you came off the Metoprolol? Just curious.
I didn't notice feeling any different. The only difference that I noticed was that I was able to work out more intensely without getting out of breath, once I was off of Metoprolol. Metoprolol keeps blood pressure and pulse low, and while I was on it if tried a hard cardio work out I would get out of breath. The shortness of breath seemed to go away once I went off of it and I have since been able to push my cardio work outs somewhat.
 
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bizinsider

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Whoa, climbing a mountain? Did I tell you that given your shape this recovery would be mind-blowingly crazy? FWIW, I'm on 25mg of Metoprolol and probably will be forever - just to help keep my BP in check. I seem to tolerate it well. Then again, I've been on bp meds, including beta blockers, for so many years that I have no idea what normal is. 🤪 But in general I have energy and feel great. Not climbing any mountains, however! I'm also about 20+ years older than you are! 😱 Congrats on the progress.
 

Amy

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Interesting....

I went off Metoprolol for just a day, and my nice low 50s heart rate jumped up to 115 at rest this morning. The out-of-breath feeling I hadn’t really felt since before surgery was back! Only without exertion! It scared me into taking a pill... Maybe I’ll try again next month.....
 
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