Mended Hearts Open Forum

 View Only
  • 1.  2 weeks post CABGx4

    Posted 09-17-2018 10:11
    Hello,

    My husband, 53 years old, underwent a planned open heart surgery to by pass four blocked arteries, on August 31st, 2018.

    Surgery was a success! However, he is suffering from multiple side effects of medications. 

    He never was on any blood pressure medication, statin, aspirin, etc., until he was diagnosed with the multiple blockages (about a month prior to surgery). His pressure was always normal, total cholesterol on the higher end. He has always led a very active lifestyle. 

    His BP nowadays tends to stay low and falls as low as 80/50. We had to request the surgeons office to reduce his metropol dosage to one instead of two. They finally agreed to it. His systolic BP with one 12.5 mg dose, ranges anywhere between 95 to 135 during a 24 hrs period.

    My question to the group: Is it very common to suffer these symptoms from the multiple medications he is on (metropol 12.5 mg, clopidogrel 75 mg, amiodarone 200 mg, Atorvastatin 40 mg, aspirin 325 mg)?
         general weakness,
         chills (no fever),
         abdominal discomfort,
         metallic taste in mouth, 
         nausea,
         general itchiness at night times
         low apetite

    If you had these symptoms, did your doc/surgeon change your medications or dosages? When do they wean you off from these medications (metropol, amiodarone, clopidogrel), if your heart functions right?      

    I am sure I will find these answers from browsing through the multiple discussions that I am yet to go through (just joined the group:-)), so thought this would probably give us the mental relief much quicker. 

    Thank you for your feedback.

    ------------------------------
    Piki
    Novi, MI

    ------------------------------


  • 2.  RE: 2 weeks post CABGx4

    Posted 09-18-2018 01:37
    I had open heart Mitral Valve repair. When I got home I felt dizzy and weak. My husband placed several calls to the doctor about reducing my medication. He was told no each time.  A week after being at home the visiting nurse was at the house for a visit. I told her I was super thirsty and just didn't feel right. She instructed me to go lie on the couch and she would check my vitals. I fainted before reaching the couch. The nurse called 911. I was transported to the hospital even though I didn't feel I needed to go, After being in the ER for six hours, my husband went to find out why I was just sitting there. The doctor finally came and said to stop the metoprolol since my blood pressure was too low and make an appointment with my cardiologist. I saw my cardiologist later that week and he removed me from all the other medications (I was greatly annoyed because I had a full prescription of Colcrys which cost several hundred dollars and for some reason was not covered by insurance)
    Call your surgeon or cardiologist office to get an appointment and discuss the way you are feeling. Our body has been through a huge trauma. It may be our body healing or that we don't need the medication any longer. We have to be our own advocate sometimes since we are the only one who knows what doesn't feel quite right.

    ------------------------------
    Julie Jezowski
    Mended Hearts Accredited Visitor
    Marina, CA
    831-760-9241
    ------------------------------



  • 3.  RE: 2 weeks post CABGx4

    Posted 09-18-2018 07:42
    Hi Piki. I live in Tampa now, but I grew up in Milford, MI. I think physicians place post CABG patients on a blood pressure lowering medication because the survival rates are much better for those taking the meds.  I got my cardiologist to lower my dose, eventually.



    ------------------------------
    Ralph Fortson
    Tampa, Florida
    ------------------------------



  • 4.  RE: 2 weeks post CABGx4

    Posted 09-18-2018 12:30
    Piki,

    If you look online for the side effects of these drugs, you will see that almost all of the discomfort your husband is having is from them. Please contact your doctor to let him know that he is suffering and ask for different meds. There are other choices. Now, to address your question about how long he will be on the medicine, that is also something you should ask the doctor. I don't know his medical history. But, I think that one of them may only be for a short period of time following surgery. But, the bp and statins may be for life. I also had no bp issues before Mitral valve replacement. The cardiologist says that it is to keep the heart at optimal pumping without over working it.

    At Mended Hearts, we encourage patients with questions and multiple side efffects to consult their cardiologist promptly. Just looking at the side effects, I think the abdominal pain and nausea are of some concern.

    Thanks!

    Heartfully,

    Phyllis Lendon
    President
    Mended Hearts of Northeast Mississippi
    Tupelo Chapter 97

    615-403-6614







  • 5.  RE: 2 weeks post CABGx4

    Posted 09-18-2018 13:05
    ​Dear Piki,

    I am not a doctor, but I am a CABGx5 survivor and had my own medication issues that I resolved with my cardiologist.  Perhaps my story will help you and your husband.

    I had my surgery on an emergency basis around seven months ago after suffering what they called a "mild" heart attack.  Is any heart attack "mild"?  You don't hear people talk about having a "mild" cancer.  Anyway, the angiogram disclosed major blockage in five coronary arteries and surgery was scheduled the very next morning.  I was an athlete up till the time of my heart attack and never had any symptoms until the actual heart attack.  I had been on blood pressure medication for the previous ten years.  The surgery was very successful, just like your husband's, although I remained intubated and sedated for two weeks due to pneumonia complications.

    After I awoke, I could barely feed myself or stand and, after another week, I was sent to an inpatient rehab hospital to regain my strength and learn to walk again.  I remained there for another three weeks.  During my approximately six weeks hospitalized, I did not experience any medication problems.  I also lost 25 pounds during the six week period.  My goal was to get extremely fit for a 67 year old and to become a distance runner and strength athlete again.

    It was when I was discharged and got home that my medication problems began.  I was taking 20 mg of Furosemide (Lasix) (reduced from 40 mg given at the hospital), 25 mg of Metoprolol 2x a day, 2.5 mg of Lisinopril, 80 mg of Atorvastatin (Lipitor) and a low dose (81 mg) aspirin per day.  I also had a warfarin prescription (later changed to Elequis) for a blood clot that later dissolved.  I also was getting so lightheaded that I was afraid I would faint whenever I stood or changed position. The lightheadedness was accompanied by a mild sense of nausea and I had no appetite.  My blood pressure varied from 90/60 to 110/75.  I called my cardiologist to complain that the blood pressure medication was way too strong, and we wound up experimenting.  Eventually, we reduced my Metoprolol dosage to 12.5 mg 2x per day.  It worked, but the process took several weeks. 

     I think part of the problem was that I had lost so much weight it had an effect on my blood pressure medication dosage tolerance.  One important thing I learned from the cardiologist was that, unlike prior to my heart attack when the only purpose of my blood pressure medication was to control blood pressure, the primary purpose now was the beneficial effect that beta blocker medication has on slowing heart rate and easing its pumping burden.

    I hope this is at least somewhat helpful to you and your husband.  Just keep the dialogue going with his cardiologist and you will get things right eventually.

    Best of luck and welcome to Mended Hearts,

    Ira

    ------------------------------
    Ira Reid
    Hoboken NJ
    ------------------------------



  • 6.  RE: 2 weeks post CABGx4

    Posted 09-18-2018 15:15
    I can tell you that I experienced some of the same symptoms after my surgery to replace my aortic valve plus 1xCABG in Dec 2015.
    One thing to remember is that while everyone is unique, doctors treat and prescribe meds based on the nominal patient until you give them feedback about how you feel.
    In my case I was OK when I first started my rehab/recovery but as I got stronger the meds needed to be adjusted because they were dropping my blood pressure too much and I actually felt like I was getting worse.
    Over the course of the 1st year my meds were reduced or eliminated to the point that I went from 9 meds to only 3(atenolol, warfarin and synthroid which is for an existing thyroid issue).
    Some of the taste issues I had went away but it took a few months, some of it I believe was due to the anesthesia and some of the meds I'm no longer taking.
    I do exercise regularly and watch most of what I eat.
    In your situation I can only say that you need to provide as much feedback to your doc because if you don't tell him the specifics of how you feel he will continue to treat you as the nominal patient.
    You should organize your medical history and log your med changes and how you felt after the med is adjusted as well as a log of your activity. Then write down any questions you have before your visit and bring all that info when you see your doc . It's also helpful if someone goes with you to take notes, etc while you and the doc talk .
    Don't expect to see changes on a day to day basis. There will be good days and not so good days but as you continue to recover the good days will outweigh the bad.
    If your insurance covers rehab be sure to take the maximum number of sessions they authorize, it is my understanding that people who do their rehab in a facility do much better in the long run than those who try to do it alone.

    I wish you a speedy recovery but also remember you need to recognize when your body needs rest and take a nap or sit for a time.

    Bill
    MH 296 Orlando
    Hospital visitor since Oct 2016







  • 7.  RE: 2 weeks post CABGx4

    Posted 09-18-2018 18:44
    Piki ~
    Your husband is early in the recovery process from his surgery and many of the "symptoms" you are describing could well be a result of the surgery and not his medications, it takes time, have some patience. Yes many of the heart meds he's taking can cause symptoms but many of those go away as his body adjusts to them.

    Meds like his Metoprolol are important for his treatment regimen. That's a Beta Blocker which reduces his blood pressure reducing how hard his heart has to work allowing it to rejuvenate and get stronger. At 12.5 mg that's a pretty low dose and unlikely to be the problem however that's one medication that takes about 30 days to build up in the system. The Atorvastatin is a statin (generic Lipitor)used to treat high cholesterol, but is also proven to be highly effective in reducing heart attacks in people prone to them. The clopidogral is for reduction of the risk of blood clots in combination with a daily aspirin. I must say I'm surprised they have him on a 325mg aspirin. They usually prescribe a low dose 81mg, often called baby aspirin. All US pharmacies are required to provide a spec sheet with prescriptions describing the drug, it's use, and possible side effects. Additionally, you can call the Pharmacist and they will answer any questions you may have. 

    What ever you do don't stop any of his meds without a doctors guidance. Many require you step down off of them slowly so it can be dangerous. And please work with your Cardiologist to sort out whether it's a medication reaction or something else. It takes time and patience, believe me I know from experience, but as someone else said, there are other options available, work with the doctor. 

    His condition will dictate whether he can ever get off any of these medications but the important thing is to help his heart recover and possibly rejuvenate. Anyway I've babbled long enough. Good luck to you both and welcome we're sorry you had to join us, but glad you did

    ------------------------------
    Warren
    TucsonAZ
    ------------------------------



  • 8.  RE: 2 weeks post CABGx4

    Posted 09-18-2018 18:56
    I forgot to mention we are all different but just by way of information, normal blood pressure is 120/80. My Cardiologist wants to keep mine at 90/60 and it often falls to 80/50 and that's fine, he told me to just stand up slowly. Again the important thing is to help the heart by reducing the workload. I've been on all these drugs for over 11 years now and none the worse for wear. 

    I strongly recommend you and your husband educate yourselves on his condition so you can understand what is going on and what his Cardiologist is saying. Just don't panic if/when you read some negative information as it changes constantly. My prognosis was less than a year and here tis over 11.5 years and still annoying my wife and kids.

    Find a local Mended Hearts chapter and attend. It's wonderful to be able to talk peer to peer about these issues.

    ------------------------------
    Warren
    TucsonAZ
    ------------------------------



  • 9.  RE: 2 weeks post CABGx4

    Posted 09-20-2018 15:46
    Thank you all for your promising words. These assures us that we are not alone in this long journey to recovery.

    The cardiologist/surgeon took him off the metroprolol and amiodarone. We were a little surprised, but I guess they know what is best for the patient based on their prognosis. 

    We are monitoring his BP and heart rate very closely for any sudden changes/fluctuations. 



    ------------------------------
    Piki
    NOVI MI

    ------------------------------