Health Service in Goa - India

[BernardS]

I have permanent AF for 10 years but one of the very lucky ones with no symptoms whatsoever. Whilst on holiday in Goa on Sunday 2 February my heart rate dropped below 40 - my Watch BP machine does not register a heart rate below 40. If I had not taken the machine I would never have known because I had no symptoms. On the Monday evening I went to see the local doctor at 6-30pm and he gave me an ECG which he discussed over the phone with his heart specialist doctor friend who in turn asked me If could hop into a taxi and come to see him - which I did within half an hour. He checked my ECG and asked me for my medication which at the time was Digoxin; Enalapril; Carvedilol; Bumetanide and Warfarin (1½mg). He looked at them and told me to stop the Digoxin immediately ( I won't say what he said about Digoxin and UK doctors.) Arrived back in UK on 26 February, and after a lot of hassle, managed to see my own doctor on 28th who arranged for another ECG and blood test which were done on 4March but I am still waiting to be seen about the results. It cost the equivalent of £8 to see the Doctor have an ECG and see the Heart Specialist but it was all within a couple of hours and to be honest since stopping the Digoxin I have never felt better in myself since starting on it months ago.

[CDreamer]

I have to say I have had similar experiences in countries such as S Africa, Spain and Portugal. A bit concerning about our health system, although I have nothing but ultimate praise for our GP surgery.

Best wishes CD.

[jeanjeannie50]

Digoxin totally pulled me down, making me feel dazed, confused and weepy. For a month or so I literally became another person. I have to say I was bullied into continuing to take it by my AF nurse (despite how I felt) pre having a cardioversion. I will never, ever agree to take that drug again.

By the sound of it I think we all need to have a check up with the doctors in Goa.

Glad to hear you are feeling so well.

Jean

[Gowers in reply to jeanjeannie50]

It's amazing how different meds affect us. I have felt well on Digoxin - put on it by cardiologist when my hr was 180+ it helped but i can only tolerate the lowest 625mg dose. What dose were you on? Although it doesn't seem to have helped keep me in nsr after 2nd ablation so maybe another change of tablet will be suggested

[jeanjeannie50 in reply to Gowers]

It was a few years ago, so I'm afraid I can't remember the dose.

[Desanthony in reply to jeanjeannie50]

I had trouble with bisoprolol, verapamil and a couple of others in the first year I had AFib. When I finally saw an NHS cardiologist after I moved house, She put me on digoxin as well as apixaban prior to having a cardioversion, but the higher dose (I didn't know there was a lower dose) and to be honest didn't feel any better than I had on the other medications that had been tried. Later I had to make an urgent visit to a friend who happens to be a pharmacist as her Mum was ill and we were to look after her son and cats for a short while without time to organise a repeat prescription and she said she would get a prescription done for me and asked if I was on the same dose as her Dad who was on the lower dose. So immediately made an appointment to see emergency Doc and get my dose changed - such a difference. Unfortunately, a month later just before my first cardioversion I needed one more repeat prescription and didn't check the dose and the Doc had prescribed the higher dose again took it for about 3 weeks and was thinking to myself back to square one again I just can't take these things. It was only nearly a year later when I went back into AFib after straining to lift a heavy box that my wife looked out the digoxin - as had been told to contact cardiac nurses and go back on to digoxin if I went back into AFib and had a few days left int he box last prescribed that my wife realised that they had prescribed the higher dose for the last month prior to the CV ! It was my fault for not checking that last prescription. Apparently the boxes have a different colour on them the higher dose being a peachy colour and the lower blue - I am not colour blind honestly! I went to my GP and asked to be prescribed the low dose but he wouldn't do that and as I was sort of half under the care of the local cardiologist and had also been referred by her to the EP he was unsure what to do. I contacted the trusty Cardiac clinic nurses and was seen within 10 days by them and had my second cardioversion within 3 weeks. They didn't put me on digoxin and I have not been on it again in between cardioversions. In the first instance the cardiologist did say she thought digoxin was the wrong drug for me as she usually only prescribed it for people who are, how shall I say, less active than I am but to all intents and purposes it seemed to be the best one for me - or at least it didn't make me feel any worse as the others had. Everyone is different. It is always good to get anothers' perspective on these things which is why I like being seen by different nurses and different Doctors at the surgery.

[Gowers in reply to Desanthony]

Thank you for the information - I have been told to increase 625mg dose of Digoxin & spread out the dose. It's amazing how we react differently to the various meds. Thanks for reply

[Desanthony in reply to Gowers]

Just make sure not to ignore any side effects you may have and make sure you have any blood tests required with the medication with your GP regularly and get the results. We are all so different and react differently. After all the trouble I had early on with medication for AFib I was very wary when going on amiodorone for 3 months around the time of my 2nd ablation but had nothing that troubled me and when I had my blood testat the end of the time on the amiiodorone my thyroid reading was slightly off but at the next blood test 3 months later - 3 months after coming off the amiodorone it was back within normal limits. Just always be aware of side effects and don't put up with them thinking that the medication in general is doing you good so it doesn't matter tell your GP, cardio or EP and see if it either the dose or type of medication can be changed to one that suits you better.

Hope you get on well.

[Jalia]

I felt much the same as Jean after taking Digoxin and stopped it. Similarly I will not allow myself to be talked into taking it again.

It's good that you are feeling so much better now.

[Gowers]

What great treatment you received. I am on Digoxin & only found out recently that folk should have regular blood tests due to toxic effect. I feel fine on low dose (625mg) but, af/irregular heart is back 5 weeks after my 2nd ablation so not sure if it us that effective.

Did they swop you to another drug?

[Hidden]

I was on digoxin for a period when my AF was at it's worst and could not het HR below 120 even on 12.5mg bisoprolol per day.

I looked forward to taking it because at that time it was the only thing that calmed my heart. The pill was even heart shaped IIRC.

My EP was keen to get me off it ASAP though, so 3 months before my first cardioversion I was put on Amiodorone as a replacement, that is a whole different story though 😱

[Gowers]

Yes, my cardiologist mentioned a short course of Amiodorone but, not keen due to the many side effects that even my cardiologist mentioned. Thanks for reply

[Desanthony in reply to Gowers]

It seems this frequently happens and they put you on 3 months of amiodorone around your 2nd ablation - I had that too. I had no noticeable side effects - didn't even burn out in the sun as they say you could but I did know someone else who did so still slap on the sun cream - I did forget a couple of times but had no problems. I started mid June last year so there was plenty of sun around too at the time. At the blood test 6 weeks after my CV they found one of the thyroid readings was off slightly - though to my knowledge it had not affected me but this could have been because in August I had a Total Knee Replacement so had other things on my mind. They stopped the amiodorone then - which is what they were always going to do and at the next blood test 3 months later the thyroid reading was at normal levels. As I said before we are all different so can't say that you will have a similar experience. Unfortunately, It didn't keep me in NSR as I went back into Afib in October ( I think this was because of all the pain and strain associated with the gruelling physio after the knee and despite all the hard work I still had to have Manipulation under Anaesthetic (MUA) to get enough flexion back in my new knee. This was when I decided I would see if an ablation would work. The EPs secretary rang me to ask if I wanted an early private appointment or could wait until January to see the EP about ablation as I had consulted privately with him previously, and as things with my knee had still not settled I said an NHS appointment in January would be fine and at my appointment in January was told it would be about a 3 month wait until the ablation. Since then I have had another CV in early February which is still working well. My first CV worked for just short of a year. I asked at my pre ablation classes last evening and the nurse said she had seen me down on the list for April, May time so going to check with my EP's secretary today to see if she can give any better idea of a date as it is my wife's birthday mid April and we want to know if we can celebrate on the actual day or whether we need to celebrate beforehand. Not sure I am looking forward to the ablation to be honest and the EP has put in his letter that it is likely that I will need 2 ablations so don't like that idea at all.

[Gowers]

Yes, the meds don't seem to have a lasting effect on af patients, as it seems folk are on them for just a short while. I guess its a short course due to the side effects. I'm hoping increasing the Digoxin dose will mean I don't have to take Amiodorone for quite a while.

My cardiologist told me that folk very often need 2 ablations - I didn't think twice to have my 2nd one (6 weeks ago)

You have had a lot to cope with having your knee surgery hope you on the mend. Thank you for the information.

[Crystalbowl]

I was put on digoxin 6.25 mcg after the crt-p implant I had at the end of October last year. I also take Bisoprolol 10mg, Furosemide. Spironolactone, Riveroxaban and Candesartan. Don’t know what side effects come from what drugs. I have very low energy and problems with my circulation so very cold hands and feet. I used to do a lot of walking but now find it hard to do very much and it has to be pretty level due to breathing difficulties on exertion so no fell tops for me now!