After 4 days taking the beta-blocker, Nebivolol, in conjunction with a calcium-channel blocker, Adizem (Diltiazem), a potentially risky combination in itself, never mind the damage wrought by Nebivolol on its own (which, I admit, started well, but rapidly got worse), I now find myself back to exactly where I was 18 months ago, with my legs and feet so swollen that if I take my socks off there’s every chance I won’t be able to get them on again. Never mind being unable to get my boots on.
And I feel so appallingly ill I can barely function, not helped by the fact that eating makes me feel very much worse. Frankly, I probably should be in hospital, but hey, it’s Arrowe Park, so no way!)
It’s beginning to look as if the cardiologist I saw 10 days ago has just treated my high blood pressure, with total, and highly dangerous, disregard for my heart failure which, as this could have killed me, borders on the criminally neglectful. (See footnote 1.)
Had I been an average patient, I have little doubt that had I blindly continued to take Nebivolol as prescribed, I would be, at best, in hospital by now, and, at worst, dead.** This is because the average patient is liable to do exactly as he or she is told, not question a consultant’s advice and, more importantly, wouldn’t have the means to monitor what the drugs were doing to them.
**This is because Nebivolol didn’t just reduce my tachycardia, it drove me deep into dangerously low bradycardia, with a resting heart rate of 50bpm at one stage (normal is 72bpm; at 50 or below it can trigger cardiac arrest). It was also extremely unpredictable in its effect, something I frequently find with generic drugs – quality control is abysmal. (See footnote 2)
Yesterday I decided to just take Adizem on its own, and for most of the day that kept my resting heart rate between the mid 60s and mid 70s. I also took a second Adizem in the evening (as I used to), but that, for reasons which elude me, had no effect on the increasing tachycardia, which eventually settled in the mid 80s.
As I’ve said, my tachycardia is drug-induced and, presumably, the drugs in my system trying to push up my heart rate, by evening exceed any that attempt to reduce it. As this drug-induced tachycardia has been going on since the 60s, and no-one, including me, has been particularly worried by it, I doubt that worrying about it now will accomplish much.
Far more important is my blood pressure which, right now, is 140/79, pulse 69. Which is good for me, and holding steady over the past 3 days.
It might be possible, with other drugs, to bring down my BP even more, but looking at the havoc of the past week, I’m not even going to consider that. Ideal systolic pressure in a normally healthy person is 120, but I’m not a normally healthy person, never have been, so what’s important is what’s normal for me, which is generally too high (162 at APH ). So, for me, 140 is actually pretty good.
There’s just one fly in the ointment – as I said, I feel absolutely awful.
And – bearing that in mind, I’d like to refer you to this post, the day after I’d been to the hospital, when I felt fine.
I’d expect Nebivolol to be out of my system by now, and Diltiazem I took for years with no problems. It does, however, have the capacity to cause a lot of problems, and perhaps having had a long break from it has given it the chance to do so. I really don’t know. All I know for sure in that in the week I’ve had these new meds, I’ve become a hell of a lot sicker than I was prior to my cardio appointment on July 12.
Tomorrow, then, I’m reverting to Losartan, and giving up on the Adizem too, for now at least (it does benefit my breathing so I might bring it back when I’m stabilised – if that ever happens – god knows what damage Nebivolol might have done.
Yes, Losartan causes some deeply unpleasant side effects, but none which actually impact on how I feel physically or mentally. I don’t think it’s a drug for the long term, but I’m hoping it’ll drag me out of this crisis that Nebivolol has tipped me into.
If it doesn’t, I am, to put it bluntly, seriously fucked.
So, in future, I’m minded never to go near Arrowe Park Hospital again (really, is there one doctor there who can actually make me better, not either be simply useless or even make me a bloody sight worse?), and screw the tachycardia, too. I’ve lived with it most of my sodding life and it seems to have done me no harm while, this past week, the drug intended to bring it down to a normal level has simply made me a hell of a lot sicker than I was.
I really don’t need this shit… And I know damned well – though I’ll never be able to prove it – that this is because the witless consultant ignore utterly the fact that I have heart failure.
And frankly, having complained about Newall, I expected nothing better.
The first thing the cardiologist said was “I’ve been reading through your correspondence, and I see you disagree with the diagnosis.” Assuming he was referring to Dr. Newall, I said, no, what I’d disagreed with were his conclusions based on the diagnosis – that I needed a battery of tests, some dangerous, one very.
But, remember I said I saw the idiot doctor from St. Cath’s Hospital on the clinic? The one who despite accepting that I had all the symptoms of heart failure, tried to claim they had some other cause but, when pressed, was unable to suggest any other cause?
Well, it’s just occurred to me that the only diagnosis I’d disagreed with was hers, because it was too goddamn stupid to be credible – even Newall accepted that I did have heart failure – and I don’t think it’s too much of a leap to wonder if she was there to interfere in my case. If I ever find she was, I’ll crucify the bitch.
The Nebivolol patient information leaflet says that, in a clinical study for chronic heart failure, the following occurred in up to 10% of users, all of which I have:-
Worsening of heart failure
Inability to tolerate this medicine
Swelling of the lower limbs (in my case, ankles and feet)
I also have arguably more than my fair share of items from the normal side-effects list – see below.
So I ask you, should any doctor with the requisite number of brain cells needed to read the available information – and he should have easier access to more comprehensive information than I do – have even considered giving this drug to someone with my history? Unless someone else had convinced him I didn’t have heart failure.
And as I’ve said previously, Nebivolol is licensed for use in mild to moderate** heart failure in patients over 70 – in the light of Footnote 2, how is that possible?
**Mild to moderate is nothing to do with a condition being chronic or not. Chronic simply means you’ve had it a long time, as in my case having had heart failure for over 18 months.
NEBIVOLOL SIDE EFFECTS
(Those in bold affect me.)
Shortness of breath
Swollen hands or feet
Slow heart beat (bradycardia) or other heart problems
Low blood pressure (hypotension)
Difficulty getting an erection (impotence)
Being sick (In the event I sat up half the night hugging a bucket, but didn’t actually vomit p perhaps I’d have felt better if I had.
Tightening of the chest, difficulty breathing or wheezing
Indigestion and gas
Skin rash or itchiness
Problems with sight
Worsening of psoriasis
Worsening of heart failure is common in those being treated for the condition
Swelling of legs and ankles is common in those being treated for heart failure
Dizziness and light-headedness when going from lying down to sitting or standing (postural hypotension) in those treated for heart failure
If any of these persist or you consider them severe then inform your doctor or pharmacist.
Tell your doctor immediately if you develop any of the following symptoms:
Swelling of ankles or feet
Unexplained or sudden weight gain
Symptoms of asthma, such as a tight feeling in the chest, shortness of breath, cough and wheezing
All of which is why I’ve spent days trying to make this useless crap work, before it dawned on me that it should never have been prescribed in the first place.
And the reason I didn’t tell my doctor is that I was so ill by yesterday (it didn’t all go to hell, seriously, until the weekend), he’d have probably sent me off to Arrowe Park – better off cutting out the middle man and sending me straight to Landican! (Local cemetery, for non-Wirralians).