Help:)!

Hello all!
I had my pacemaker placed last Monday the 15th. All went well with the surgery minus a little allergic reaction to some relaxation meds;) anyways I'm writing because I have to have hope someone will know how to help me.
My dr started me on metoprolol 60mg the day of surgery. First of all I have pots so I am extremely sensitive to any medications. A few too many ibeprofens even have a bad effect. Anyways te medication gave me horrible migraines to the point of debilitating, no sleep, and screwed with my moods horribly. Still I stayed on it for 5 days. At the same point I developed supine hypertension. I already have orthostatic hypotension so it was very weird. Once I discontinued.. The supine hypertension started letting go. Then they started me on cartia 120mg and same blood pressure problems happened. I went from having Bp standing of 90/44 to laying down 165/112. I couldn't sleep it caused so much chest pressure. In school I know that causes of oh/sh are either medications, MSA, diabetes, and ideopathic Parkinson's. my cardiologist does not seem to want to help me and he is te only in my region. My neurologist wants to see me Monday and I'm hoping he can find a answer.. And not another horrible diagnosis. Meanwhile my internal doctor has put me on large amounts of magnesium and vitamin d trying to help. I did have my pacer checked yesterday and I only had 4 episode sod tachycardia- all sinus less than 170 beats and all self terminated within 11 seconds. But I did have 1000 pvcs and a few pacs. That's what those feelings were! I thought I was dying:( anyways so for right now I have to deal w the fast beats.. Or take dangerous high Bp when I lay down:( so I guess my questions are has anyone dealt with this also? And is that' many pvcs normal? I'm only 8 days post implant and do they ever stop?! They are quite scary. Sigh. Sorry for the long message and I look forward to any thoughts any might have:)

3 Comments

Frustrated

by Ryaleigh - 2013-04-26 01:04:23

Hey thanks for your reply its always good to hear from someone else who has pots. No midodrine or any other med was used:( ugh it makes me so frustrated! I have an appt w my neurologist Monday to see if he has any idea why the hell it happened, because I'm stumped. I really wanted to try atenelol also, and start with a baby dose and move up, but I'm scared to ask my cardiologist. Monday I think I am going to ask. Do you take it in the morning or night?
The supine hypertension has happened both of a beta blocker and a calcium channel blocker so I'm quite nervous. But I really am more scared of these fast beats. I'm not having a great time with this pacemaker so it's a learning experience.
Sorry for the horrible spelling I am on my phone:)

Metopropol Side Effects

by jenny97 - 2013-04-26 09:04:51

I'm a little surprised that you developed supine hypertension on metopropol as it is supposed to have the opposite effect. A more common side effect is lowering the blood pressure too low.

The symptoms you describe are commonly associated with midodrine, which is also used as a treatment for POTS. Were you taking that at the same time?

In general, if you get migraines from some medications as you are just starting them, it may be that the beginning doses are too high. Sometimes it helps to back the dosage down a bit and slowly titrate up.

Some medications, like midodrine, do cause supine hypertension, and therefore there are instructions included that you should not lie down after taking them.

All that said, if you had these symptoms on metopropol, which is a beta blocker, you might talk to your doctor about trying some of the other beta blockers available. I had good results with atenolol. (I also have POTS - heart rate in 160s when standing, 240s when exercising.)

As far as the PVCs, they are scary, but generally not life threatening. If you had 1000 PVCs all in a row, that would probably be problematic, but 1000 PVCs over the course of a week or a month, etc. probably won't do more than scare you. Don will probably post his PVC discussion to you shortly. He's done some good math to give you a sense of how few most people's PVCs actually are in comparison to their total heart beats.

For me, when the PVCs come, it's normally when I've become dehydrated and have exerted myself too much. I drink a sports drink and breathe deeply until they pass. Then I work to build up my sodium levels and rest a bit to prevent an immediate recurrence.

Anyway, good luck to you!

Jenny

Have you had a settings adjustment yet?

by jenny97 - 2013-05-09 01:05:42

Some of the weird beats you are feeling could be associated with the settings that your PM came with. It sometimes takes a while to get the right settings, so talk to your dr. and your tech and see if they can adjust them down.

I hope your neurology appointment went well and that they were able to get you going on something that is helping you.

As far as the atenolol, I'm not on it anymore. My blood pressure was just too low so we had to stop it about a year ago. Fortunately, my condition has improved a lot at the moment, so I'm ok without it for now.

How are you doing with some of the other lifestyle changes that can help with POTS? Are you drinking a lot of fluid, strengthening your leg muscles? I won't ask about sodium intake, since you are having the supine hypertension issue. Do you wear compression stockings? What is your overall fitness level? The stronger you can make your body, the better it can deal with changes in position. At Mayo Clinic, they told me to start riding a recumbent stationary bike and keep my heart rate under 160. It was frustrating and annoying, given that I was used to running for miles and that even taking a shower would often boot it above 160, but I think it was helpful, if only because it gave me something to focus on for the several months I was housebound.

One more thing to consider is that stress and worry can really exacerbate the condition, so coming up with coping skills and mechanisms to help you stay calm can really be beneficial.

In any event, I know it's a tough road, but I hope you have a good team of doctors to work with and that you find the peace and good health you seek.

All the best,

Jenny

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My pacemaker was installed in 1998 and I have not felt better. The mental part is the toughest.