I didn't expect this at age 47.

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sdifox

No Lifer
Sep 30, 2005
96,212
15,787
126
well, I guess I don't get to ask for that climbing wall after all

:awe:
 

NuclearNed

Raconteur
May 18, 2001
7,837
310
126
well, I guess I don't get to ask for that climbing wall after all

:awe:

Yeah - it looks like I'm going to survive a little while longer. But consider this a standing invitation to come over and play any time.
 

iroast

Golden Member
May 5, 2005
1,364
3
81
heart issues - any idea if it's due to diet and eating red meats often?

No doctor, but heart conditions are caused by many factors. Main one is bad diet, stress and lack of exercise. Genetics play an important part too. You can only minimize your risk by eating right, exercising and learning to control your stress level. Don't overdo it with exercising, because that could be wear your body down quickly. Everything in moderation....except for smoking, drugs, drinking and other vices. Vices should be minimized, or eliminated from your life
 
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GeekDrew

Diamond Member
Jun 7, 2000
9,100
13
81
I'm glad to hear good news!

Vices should be minimized, or eliminated from your life

Unless doing so significantly diminishes your quality of life. There's little point in optimizing for life duration if you're going to be miserable the entire time.
 
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Charmonium

Diamond Member
May 15, 2015
9,594
2,957
136
UPDATE 20171108: I saw the cardiologist yesterday & the news is pretty good. First, my primary physician slightly misdiagnosed me... instead of a PVC, I have a PAC which is the same condition but in a different section of the heart. This is good news; a PVC can indicate that something worse may be going on, but a PAC is almost completely benign. The cardiologist is going to ultrasound my heart in a couple of weeks just to be sure nothing else is going on. He isn't going to put me on any medicines. He said the available medicines would make me feel worse than the PAC is making me feel, and I mostly feel pretty good now that I've cut out all food & drink that contain caffeine.
There are beta blockers that cause your heart to contract more forcefully and regulate your heart rate. Those are pretty benign for most people although some do get muscle aches from them. Atenelol and Sotalol I think are 2 that work that way.
 

NuclearNed

Raconteur
May 18, 2001
7,837
310
126

Trust me - it could have been a whole lot worse. Through experimentation I've found that most alcohols are OK, with the exception of red wine, which is still a bummer. So if I have to drink decaf coffee the rest of my life, I can live with that. If I had to go the rest of my life without an occasional shot of something... I would be, I think the word is *upset*
 

highland145

Lifer
Oct 12, 2009
43,563
5,966
136
Trust me - it could have been a whole lot worse. Through experimentation I've found that most alcohols are OK, with the exception of red wine, which is still a bummer. So if I have to drink decaf coffee the rest of my life, I can live with that. If I had to go the rest of my life without an occasional shot of something... I would be, I think the word is *upset*
That is a blessing for sure.
 

BoomerD

No Lifer
Feb 26, 2006
63,428
11,757
136
But....but...but Mrs. Ned and I had such wonderful plans........

<sigh> back to the drawing board...
 

John Connor

Lifer
Nov 30, 2012
22,840
617
121
Great news.

I was worrying about my heart recently as it seemed like it was pumping harder and I had a moment of heavyness in my chest . So the doctor did an EKG and I guess it's fine. Heart disease runs in my mom's side of the family and I'm more related to my mom in a lot of ways. She actually had a quadruple bypass last year. Not fun at all seeing your own mom in a hospital bed with tubes going out all which way like a cyborg.

I should cut caffeine from my diet as well. Only problem is that I prefer Excedrin which has caffeine in it.
 

TheVrolok

Lifer
Dec 11, 2000
24,254
4,077
136
There are beta blockers that cause your heart to contract more forcefully and regulate your heart rate. Those are pretty benign for most people although some do get muscle aches from them. Atenelol and Sotalol I think are 2 that work that way.

Beta blockers actually make your heart contract less forcefully (and rapidly). They're also really not that benign and have a fairly significant side effect profile. Muscle aches generally come from cholesterol pills, the statins. Atenolol and Sotalol are certainly beta blockers (although Sotalol actually has class III arrhythmic properties unlike the other beta blockers which are class IIs which makes it a whole different animal) but neither is used much without fairly specific indications. Just as a PSA, if you're on atenolol for high blood pressure or coronary artery disease (and if you are, you probably have been for years), please talk to your doctor about changing drugs.

Glad to hear all is well with NN!
 
Reactions: Charmonium

BoomerD

No Lifer
Feb 26, 2006
63,428
11,757
136
Beta blockers actually make your heart contract less forcefully (and rapidly). They're also really not that benign and have a fairly significant side effect profile. Muscle aches generally come from cholesterol pills, the statins. Atenolol and Sotalol are certainly beta blockers (although Sotalol actually has class III arrhythmic properties unlike the other beta blockers which are class IIs which makes it a whole different animal) but neither is used much without fairly specific indications. Just as a PSA, if you're on atenolol for high blood pressure or coronary artery disease (and if you are, you probably have been for years), please talk to your doctor about changing drugs.

Glad to hear all is well with NN!

I've been on atenolol for over 10 years. I just saw my doc on Monday...he said to keep taking them...the only thing he said was that there's apparently a nationwide shortage...which would explain why the prescription price nearly tripled over the past year.
 

TheVrolok

Lifer
Dec 11, 2000
24,254
4,077
136
I've been on atenolol for over 10 years. I just saw my doc on Monday...he said to keep taking them...the only thing he said was that there's apparently a nationwide shortage...which would explain why the prescription price nearly tripled over the past year.
If I may be so bold, what are you taking it for? Plain old high blood pressure? Feel free to take it to PMs, or ignore me entirely, if you want, but it's just a drug without a whole lot of efficacy (and some evidence of increased mortality in the case of atenolol, actually) and it isn't used much outside certain circumstances.. Unfortunately, due to medical inertia, many people remain on it despite it being obsolete in the treatment of high blood pressure.
 
Last edited:

BoomerD

No Lifer
Feb 26, 2006
63,428
11,757
136
If I may be so bold, what are you taking it for? Plain old high blood pressure? Feel free to take it to PMs, or ignore me entirely, if you want, but it's just a drug without a whole lot of efficacy (and some evidence of increased mortality in the case of atenolol, actually) and it isn't used much outside certain circumstances.. Unfortunately, due to medical inertia, many people remain on it despite it being obsolete in the treatment of high blood pressure.

Yeah, just plain old hypertension...and without insurance that would cover prescriptions, whatever I take has to be low cost. Until recently, atenolol was running me less than $7.00 for 90 days. The refill last week was $20.
 

TheVrolok

Lifer
Dec 11, 2000
24,254
4,077
136
Yeah, just plain old hypertension...and without insurance that would cover prescriptions, whatever I take has to be low cost. Until recently, atenolol was running me less than $7.00 for 90 days. The refill last week was $20.
If that's the case, absent contraindications, you'd be better served on something like an ACE inhibitor or thiazide diuretic. Obviously I don't know you're regimen and you may already been on these classes.

My concern with atenolol is that it doesn't seem to offer the stroke reduction benefit that the other classes have (this is true of all beta blockers) and there is some evidence that atenolol specifically actually increases risk of death after the age of 60.

Off the top of my head, lisinopril is on the Walmart 4 dollar list so that's 10 bucks for three months. Most people, statistically, will require more than one class of drug to control blood pressure, and ACE plus thiazide combo is quite common. Walmart actually has a combo version (admittedly the lower dose version) for 10 bucks per 90 days.

If cost of medications is an issue, I also find a lot of value in GoodRx.com to look around for local, cash (or with coupon), drug prices.
 

BoomerD

No Lifer
Feb 26, 2006
63,428
11,757
136
If that's the case, absent contraindications, you'd be better served on something like an ACE inhibitor or thiazide diuretic. Obviously I don't know you're regimen and you may already been on these classes.

My concern with atenolol is that it doesn't seem to offer the stroke reduction benefit that the other classes have (this is true of all beta blockers) and there is some evidence that atenolol specifically actually increases risk of death after the age of 60.

Off the top of my head, lisinopril is on the Walmart 4 dollar list so that's 10 bucks for three months. Most people, statistically, will require more than one class of drug to control blood pressure, and ACE plus thiazide combo is quite common. Walmart actually has a combo version (admittedly the lower dose version) for 10 bucks per 90 days.

If cost of medications is an issue, I also find a lot of value in GoodRx.com to look around for local, cash (or with coupon), drug prices.

I was on zestril at first...but I ended up with the zestril cough. (didn't even know that was a thing)...doc switched me to atenolol. Some of the meds he had me try at first had...side effects, like my hands swelling up like Mickey Mouse's...apparently that's bad.
 

TheVrolok

Lifer
Dec 11, 2000
24,254
4,077
136
I was on zestril at first...but I ended up with the zestril cough. (didn't even know that was a thing)...doc switched me to atenolol. Some of the meds he had me try at first had...side effects, like my hands swelling up like Mickey Mouse's...apparently that's bad.
Personally I think it's adorable!

Lisinopril was certainly a good first choice, but the coughs do happen. Unfortunately, there are no ARBs on the cheap lists that I can think of as they are nice alternatives for patients who develop a cough on ACEs.

Thiazides would be a reasonable option, hydrochlorothiazide is on Walmarts list, and a pretty common first line medication in monotherapy in hypertension.

If you're tolerating the beta blocker (which it sounds like you are), it's not totally unreasonable to stay on one of its working (it's just generally not a current recommendation to use them as monotherapy), but I would consider switching to something that doesn't have the little bit of evidence for increasing death.

Carvedilol and metoprolol tartrate are both on the Walmart list, I prefer Carvedilol, but unfortunately they're both twice daily drugs unlike atenolol which is often dosed once daily.

Just some thoughts.
 

Charmonium

Diamond Member
May 15, 2015
9,594
2,957
136
If I may be so bold, what are you taking it for? Plain old high blood pressure? Feel free to take it to PMs, or ignore me entirely, if you want, but it's just a drug without a whole lot of efficacy (and some evidence of increased mortality in the case of atenolol, actually) and it isn't used much outside certain circumstances.. Unfortunately, due to medical inertia, many people remain on it despite it being obsolete in the treatment of high blood pressure.
I take an amphetamine and use atenelol to reduce the increased heart rate the drugs cause. But I'd be interested in any sources you have regarding the increased risk of death and some of the other statements you've made. Not trying to be a dick or anything, I'd just like more information.
 

TheVrolok

Lifer
Dec 11, 2000
24,254
4,077
136
I take an amphetamine and use atenelol to reduce the increased heart rate the drugs cause. But I'd be interested in any sources you have regarding the increased risk of death and some of the other statements you've made. Not trying to be a dick or anything, I'd just like more information.

Information is a good thing (provided it's "quality information"), I never take that personally. It sounds like the literature is unlikely to be incredibly germane to your personal situation. The increased mortality risk is primarily associated with atenolol as monotherapy in treatment of lone hypertension in aging adults. That said, there are many times better options now so in general we have phased out use of atenolol (although there are certain contexts in which it's still a first line drug - hyperthyroidism, for example). The literature is fairly robust as this has been looked at extensively (and a lot of this information is a decade old - medical inertia is a real beast), there are many, many, many more papers but below are a few systemic reviews (that evaluate multiple other papers). These are scientific papers, so they do require some critical analysis.

I didn't actually read this paper, and it's from a Japanese society so generalizability may be limited, but it follows the theme: https://www.ncbi.nlm.nih.gov/pubmed/23581644
A systemic review with metanalysis: http://www.sciencedirect.com/science/article/pii/S1744224905000586
AAFP has a systematic review: http://www.aafp.org/afp/2005/0315/p1177.html
Form JACC: http://www.onlinejacc.org/content/53/22/2102.2
Another systematic review and metanalysis: http://hellenicjcardiol.org/archive/full_text/2006/5/2006_5_298.pdf
 
Reactions: Charmonium

Charmonium

Diamond Member
May 15, 2015
9,594
2,957
136
Thanks for that. But getting back to the original question of managing an irregular heart beat, what drugs are generally recommended for that type of situation since that relates more to the OP.
 

TheVrolok

Lifer
Dec 11, 2000
24,254
4,077
136
Thanks for that. But getting back to the original question of managing an irregular heart beat, what drugs are generally recommended for that type of situation since that relates more to the OP.

Certainly depends on the irregular rhythm, as not all rhythms that are technically irregular are "abnormal." PACs, PVCs, and other types of atrial/ventricular ectopy are quite common and generally benign which mean you may have some irregularity, but nothing concerning or even really "abnormal" when you look at the big picture.

More germane to the OP, provided PACs (Or APBs as they're often called as well) are not "too frequent" and asymptomatic, nothing is generally done. If they are "too frequent," associated with symptoms, or associated with triggering more abnormal rhythms (something like atrial fibrillation), then medical or procedural therapy is considered. At that point, as you've mentioned we often used beta blockers which have better data (at least with regard to symptoms) than other classes of drugs.

Of course, beta blockers have no role in another "irregular rhythms" particular if they're already slow rhythms. It's all sorts of fun.
 
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