my 91 year old grandmother who has atrial fibrillation, hypothyroidism and pernicious anaemia suffered a TIA mini stroke three years ago and was put on bisoprolol 1.25mg for heart rate control. The last three she has been in a zombie confused state, shortness of breath, headaches, dizziness and muscle and joint pain/swelling.
I, being her carer was told constantly by 2 hospitals and our own GPS that she had dementia due to stroke and heart failure.
two days ago finally our GP listened and sent us to the hospital to be told that the bisoprolol 1.25mg dose was causing her heart to be too low at around 45/52 bpm. This in turn meant that her heart had to work harder especially as she is very active and goes walking up to 6 times a day. This caused fluid overload.
on examination chest xray heart scan and lots of blood test, finally showed that her problems were due to bisoprolol 1.25mg and also causing delirium.
I'm also a trained nurse and the phrase heart failure is a medical branch term. Many good doctors don't like to use the phrase heart failure.
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ben102011
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Hi Ben, I think side-effects of all meds can become more problematic as we age generally. Clearly the Bisoprolol was too much for your grandmother but, on the other hand, my mother is on 5mg of Bisoprolol per day without any problem and has been for 10 years. She’s only a couple of years younger then your grandmother. My own thought is that they should be more closely monitored by their GPs but sadly that doesn’t happen these days!
I hope your grandmother is improving now and kudos to her for being able to walk up to six times a day whilst in that physical and mental state. That generation is made of strong stuff😊
Interesting, I have just finished a book about getting older written by a local geriatrician which had a chapter about medication. Also explained delirium which I didn’t know anything about. So I was looking up my blood pressure meds on the BNF website and pleased to see they have a whole section of advice re prescription for the elderly (and should be for people sensitive meds in general), now we just need doctors to read it…..
The Book About Getting Older by Dr Lucy Pollock. More about getting very old really - I got it because I’ve found caring for my husband quite difficult and have ‘getting older’ problems myself. I can’t recommend it highly enough, it’s actually an ‘easy read’ with anecdotes about situations and has useful references at the end of every chapter.
Thank you Buffafly that sounds really interesting and I think will be helpful for me in looking after Mum, too, not to mention I’ve started getting some “getting older” problems as well🙄
Thanks for the rec, Buffafly. I took your suggestion to heart and am reading the first chapter of Dr. Pollock's book now (or will resume reading it after I finish writing this post!)
Yours is the second of two books mentioned in these forums that seemed pertinent. The first was Bessel van der Kolk's The Body Keeps the Score and I am still learning important things from that book -- shattering things, but also productive solutions and revelatory insights about trauma's neurological effects.
Hi, for totally different perspective on Aging try reading Life Force by Tony Robbins or Superhuman by Dav Asprey. While there is no cure for aging there are lots of things outside what your GP will tell how about how to maximize health span.
Your Grandmother is a very lucky lady to have a Grandson like you. I’m sure she appreciates everything you do for her. Cannot add to what’s already been said, just hope she continues to do well ….
Doesn’t surprise me, I hated being on it and eventually had to stop because it exacerbated an underlying condition. Get a Red Alert on her medical notes never to be given.
I just hate how doctors think it’s a solution, causes more problems.
Hi Ben. So sorry to hear about your grandmother but so very pleased she has you for a grandson to care for her and at long last getting things sorted. Off to order book and thank you for sharing that. x
Congratulations on being the stellar kind of person who would care for a 91-year-old woman. I know someone whose brother still lives in their mother's house but doesn't have enough interest in her welfare to research her care (since he refuses to help her himself). His sister, who lives in a different state, is having to travel there to find full-time care for their mother or, failing that, to leave a lucrative job in New York to take care of her.
Since your GP has identified the source of your grandmother's direst issues, has a change of medicine or reduction in dosage helped to alleviate her enervation, confusion and/or shortness of breath?
My late grandmother was similarly diagnosed with dementia and my plea that dementia doesn't come on in an hour wasn't listened too until I forced the issue and did my own investigation of what had happened. In fact, she was suffering with electrolyte imbalance brought on by a switch of diuretic the previous day. Stopping the diuretic reversed her "dementia" within hours.
Reading your story reminded of this. I wonder whether it wasn't the direct result of her being given bisoprolol in her case, rather the effects of this on her heart causing, as you say, bradycardia and heart failure, leading to oedema which itself caused electrolyte imbalance?
I hope it resolves well and your mother is soon restored to health. What a worrying time.
HIi still take Bisoprolol 2.5 at night, CCB Diltiazem 120mg a.m.
The Bisprolol does nothing for my h/r at night and it is avge 47h/b per minute.
The Diltiazem takes my avg day rate down to 77-88 h/r.
My BP is 123/72
On Metroprolol I was @ 186h/r per min avge Day.
On Bisoprolol only this was brought down only to 156h/r per day.
180mg Diltiazem was too much. I was light. headed and h/r dropped to 51 day.
I dont know we are all different.
I've had a ischemic stroke - clot related due to AF from undiagnosed thyroid cancer. 2 clear scans, no RAI and refused suppression. TSH is kept @ 2.0-3.0. It is regularly tested as 125mcg is not quite enough and I creep up so occasionally take 150mcg SYNTHROD which is reliable which has a kiddy proof lid, expiry date and has a anti moisture piece inside. I take my meds under the tongue at between 5-7am, no food for 1/2 - 1 hr, then heart pill with food, then PRADAXA an anti co-agulant.
The thyroid needs to be normal out of hypo or hyper thyroidism.\
No issues with Bisoprolol except NOT CONTROLLING my rapid. persistent heart rate.
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