Mechanicals - Need your feedback....

[Rush20]

Hi. For all you "mechanical aortic valvers" out there, I have a questions on medication...

How many of you are on/off other types of meds? With the exception of the Coumadin, are you on any other medication? The reason I ask is that I had my AVR surgery 2.5 years ago. I was very intent on trying to live my life with as little medication as possible and I was curious if my expectations are within reason.

I moved from Chicago to Sarasota during the last year and my new cardio and physician were surprised I was off all meds with the exception of the Coumadin.

Immediatly post surgery, I was on various beta and alpha blockers to help the heart recover and was eventually placed on Toprol XL. I talked my cardio into weaning me off the med slowly as I wanted to try and live med free.

Over the past 6 months, my career has really kept me busy and I think the stress and travel might be catching up. I'm 42, in good shape weight and exercise wise, however my BP is averaging about 142/100 and I've noticed some stress-initiated palpitations. Last Friday evening after a long work week, I was sitting at my desk and experiened a 30-second racing heartbeat. Scared me because it was the first real, non-regular, heartbeat I had experienced post-surgery.

My next cardio appointment is in April and I have an Echo (first one post-op) prior. Any advise is appreciated.

 

[sue943]

Immediately after surgery I was taking digoxin and amiodarone. Dogoxin was stopped soon after because of problems, amiodarone after about three months. Apart from warfarin, diurectics and a statin all my other medication is nothing to do with my heart, I take quinine for cramp, an anti-ulcer medication and thyroid.

 

[Marty]

After my surgery in 1998 my cardiologist gradually took me off digitalis, toprol, lisinopril, diuretics, etc.. For the last seven years I have taken nothing but coumadin except for an occasional tylenol or Ambien. If your echo is OK, your heartbeat regular,cholesterol low, and your blood pressure normal you do not need anything else.

 

[Ross]

It's possible for some folks, but if they can find no cause for your bp being that high, please don't be he man and think you can do without taking something for it. I made that mistake and caused my aneursym to blow, so it's a pretty lame excuse for not taking pills. I can assure you, it's not worth it!

 

[Dennis S]

Medications

Medications

I take my daily coumadin & baby aspirin, and that's it. But we are in a remote location, and I never see a Dr., so they haven't had a chance to catch up with me yet. I did buy a really good blood pressure pulse monitor, and watch it closely.

 

[Rush20]

It's possible for some folks, but if they can find no cause for your bp being that high, please don't be he man and think you can do without taking something for it. I made that mistake and caused my aneursym to blow, so it's a pretty lame excuse for not taking pills. I can assure you, it's not worth it!

Thanks Ross. Were you aware of your aneurysm prior to the dissection? In reviewing your history, your valve surgery was after the aneurysm correct?

What's crazy, is that I never had high BP until after my surgery. Is it too simplistic to think that the BP is higher due to a stronger valve pumping the blood?

 

[KAJ]

In addition to coumadin, I was on 2 or 3 other meds for about 8 weeks after my surgery. I now off all those meds. However, this past July, to my suprise, my cardiologist put me on Zocor for high cholesterol. I asked my cardiologist why is my cholestrol is high after the surgery when it was okay before the surgery. He could not give me an answer. I would rather not be on the stuff.

Karl

 

[Natanni]

My husband is 5 months post op and on Cozaar and Toprol XL. The Cozaar will more than likely be for good. He was started on Toprol XL for two reasons; First it was the alternative to Amiodarone at his 3 month check up, and second it is to boost the effectiveness of Cozaar. I am wondering if his cardio won't take him off the Toprol at his next check up in June, if he remains in normal sinus.

 

[tobagotwo]

Your surgery date was in '03, so you're past the healing/remodelling stage. You're probably going to have to get used to one more prescription. You're over the grey area and into high blood pressure. If there were something we could tell you that would really fix that without drugs, this would be the most visited site on the web, for sure.

However, there might be something you can do for your stumbling heartbeat. It's beginning to sound like you're tied to your desk most of the time. I can sympathize with that. However, I have found that rhythmic exercise, such as walking, has a good effect on minor arrhythmias. If you're like me, you probably could use some more exercise anyway.

I get up at least once an hour and do some laps inside the building. People think I'm going somewhere, and I get blood to places that are starved for it. It also keeps me more able to focus and produce.

You might also want to check your diet for magnesium, and even calcium, as these minerals are important to your heart's function.

Best wishes,

 

[PJmomrunner]

I can't speak from personal experience, but a cardiologist I consulted (he's my hubby's cardio and specializes in CAD/ischemia, but didn't seem to be the guy for me) recommended an FDA approved biofeedback device and claims he's had patients who have done very well with it. I have to admit that I was not confident that I would use it reliably enough to rely on it or to invest in it, but perhaps you would be more consistent with it.

http://lifematters.com/resperate.asp

 

[MarkU]

Had my AVR five years ago at Sarasota Memorial. Coumadin is the only thing I've ever taken, in addition to my daily Centrum Silver (lower % of vitamin K compared to regular Centrum).

I'm a relatively healthy 52-year-old triathlete, with a resting HR of 47bpm and BP of 120/80, an no other significant medical problems.

Who are you doctors here in Sarasota? Dr. Rick Yaryura at the Intercoastal Group is my cardiologist - great doc.

Mark

 

[RandyL]

Hi there I am 7 weeks post op and only take coumadin. I don't even know what all those different meds are. I never had high blood pressure and did have some at home but when I went to the cardiologists office it was normal.

I do take a high rate 7.5 mg of coumidin per day. This keeps me in the 2.5-3.0
INR.
well I guess things could change in the future but for now I take no meds except the coumiden.

 

[MrP]

Besides coumadin, I take atenolol daily to reduce blood pressure and thereby minimize risks of another aortic aneurysm....not uncommon for those with congenital bicuspid aortic valve (even after valve replacement). My cardiologist also recommended lipitor for statin benefits.

 

[Rush20]

Thanks for all the feeback. I knew I could count on this forum for some answers and clarifications.

I think my issues stems from simply trying to do too much. I work in Corporate America and if you aren't Type A going in, you eventually change.

In addition to working, I commute 90 miles/day, play mens softball, coach little league, stay active in my church/community, bike, lift weights and try being the best husband/father I can be. As a result, I tend to blow off sleep/rest.

Last night I decided to skip my planned workout and went to bed at 9PM. I fell asleep pretty quickly and woke up at 6AM. That was the first night in a very long time I remember getting at least 8 hours of sleep. After waking up, I sat down and went through some mail on my desk. I decided to take my BP and wow - 122 over 82 average on 3 attempts. I know this doesn't represent a full day, however it is encouraging. I also notice that my heart doesn't seem to be pounding like it does when I'm tired and stressed.

Funny, it seems as though post surgery, my heart serves as a barometer of my overall health. When I overdue anything, I tend to be more aware of my heartbeat. When I get more rest and reduce the stress, I hardly notice my heartbeat.