Chronicles of the Heart, Part 51 – Nebivolol means progress…

And that’s 3 words I never thought I’d write…

For some weeks now I’ve been taking a micro-dose of Nebivolol, 0.625mg, a quarter of the dose prescribed by my cardiologist (and who is probably my ex cardiologist), and it’s been very successful at calming down my tachycardia and smoothing out the PVCs and assorted buggeration that my heart is capable of, including the 3 or 4 second flatline that’s all too frequent. That effect is beginning to wear off, though, and I’ve noticed that while my heart rate mostly remains sensible, it’s been getting increasingly erratic.

I have a suspicion that the cut tablets degrade quickly when exposed to air (and there’s the innate difficulty of getting an accurate dose when cutting a small tablet into 4), but there’s always the problem that Nebivolol, in some people, has a very short half-life, and I appear to be one of them, so it “wears off” quickly.

Today, then, at 06.00 I increased the dose to 1.25mg. The most noticeable effect of which was that by 09.30 I was able to hit the bathroom, for the first time in far too long – I simply haven’t had the energy – and shear and shave to oblivion almost 3 months of beard and hair growth!  I was getting really tired of the Ben Gunn look.

I think the reason for that is that my heart rate is in the high 70s (low for me), but the big difference is that it doesn’t head for the stratosphere at the slightest hint of exertion. I haven’t got the numbers, but it doesn’t feel much faster if, for example, I go to the fridge for a glass of water, a return journey of approximately 12 feet, which normally sends my HR up into 3 figures.

And I don’t doubt that it’s that which is causing the feeling of – almost – wellbeing. And, apart from the fact that my beard and moustache are thicker and very much whiter, I’m looking, once again, more like my avi photo.

Who knows, if this improvement is maintained, I might actually be able to have a social life again!

That won’t, however, involve drinking absurd amounts of beer – those days are quite definitely gone, not least because it often caused me to miss my evening meds, something I simply daren’t do now. Missing even the micro-dose of Nebivolol in the evening messes with my heart, big-time.

So, finally, I seems to be making progress, but I wonder just how different, how much better, my life would have been these past 5 interminable, fucked-up, months, if the bloody cardiologist had done what the Nebivolol literature says he should have done in heart failure – and what I’m now doing – started low and worked up, instead of going for a high dose from the start? I believe, as I think I’ve said before, that he was simply medicating my hypertension, and completely ignored my heart failure. That sort of cock-up can kill.

In fact, by taking 1.25mg every 12 hours I get the same dose as prescribed – 2.5mg per day, but taking it in divided doses is very much more effective (the half-life problem being overcome , presumably.

I do, in fact, feel remarkably good seeing I didn’t get to sleep until well after 04.00 and was up again at 08.30. My breathing is better, too, perversely, as the lower dose messed with it quite badly and – not to extrapolate too recklessly from one morning – this might well prove to be the optimum dose.

And – Sod’s Law strikes again – as I type this, my heart’s throwing PVCs again (not badly – the really bad ones are like being punched in the chest). Still, I have  fix for that, Potassium chloride, currently 100mg, it took 200mg in total.

For now, at least, it’s all looking pretty promising. OK, my legs are still hugely swollen, hurt like a bastard and I can’t walk worth a damn, but I’m still a hell of a lot better than I was just 24 hours ago, which has to be worth something…

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8 thoughts on “Chronicles of the Heart, Part 51 – Nebivolol means progress…

  1. It’s damned disgusting that you have to do this alone and that you know how to treat yourself better than a top cardiologist! The big problem with all these docs is that they don’t like laymen telling them what is right and what is wrong for their own bodies! I hope you enjoy the good feeling for a few days (dare I say weeks?) – you deserve some break from all you have gone through this past months, and more recently, the past few weeks. Bet you feel great after having that trim and shave 🙂

    • Cardiologist maybe, top absolutely not – he’s an idiot. On the day I saw him I wore a fishing vest. These things are designed so that, when you wade waist deep, they don’t trail in the water, being cut short. That, and loads of pockets, makes them perfect for wheelchair use. Mine has the maker’s logo “Ron Thompson” embroidered in a curly script on a pocket.

      He looked at me, looked at my file, and said “So, is Ron Thompson your real name then?

      At that point I lost what little faith I had.

      Then later, we argued about this beta-blocker, Nebivolol, he said it was safe for use in COPD, I argued that there was no such thing as safe in COPD (I have access to the same literature he does, something which most doctors fail to realise when they’re in bullshit mode). What the literature said was that it was considered safer than most others, but should still be treated with caution. Anyway, we eventually agreed that I’d try it, as I already knew that there were no real options.

      Then he forgot to prescribe it!

      Yep – I do feel a lot better and I really must keep on top of it now. I still feel pretty good, even though my heart’s a lot more erratic that it’s been in a while. But, it’s been that way since about 1985, so it’s probably not serious (ha!).

  2. So good to hear you have an upbeat tone and positive outlook Ron, it has been a long hall for you. I’m so low on spoons right now that it has taken me over an hour and half to read your blog today, I keep falling asleep and now my daughter is yelling for her tea. I’ll have to set the timer to ring and wake me up in case a fall asleep.

    • Cheers Bev. If it’s any consolation, I crashed this afternoon too. My own fault, I had the temerity to eat a small pork pie for lunch!

  3. See you are still battling on with your self-medication, it’s good job you are so aware of your medical requirements/condition.
    Keep up the good work Ron.
    Fred.

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