Eventful Weekend

[Fight-the-good-fight]

Afternoon AF Warriors.

Thought I would update you with my introduction to Dabigatron and Bisoprolol.

Commenced DG on Wednesday, so far so good. Friday afternoon experienced facial flush and generally felt peculiar. Checked my BP it was high 187/110 HR 69.

Wondering if this was a side effect of DG I managed to get an urgent appointment to see the doctor at 5pm.

On examination, my BP was (200/112) HR 77 Advised to go home, start 2.5mg of Bisoprolol.

Told If BP was not going down within a couple of hours contact 111.

Anyway, three hours after taking Biso, BP was increasing; and I had a burning sensation in the middle of my chest - BP (210/120) HR 66

Contacted 111, told to report to A&E. Triaged on arrival - bloods, ECG, BP etc. waiting time to see doc 4 hours.

Finally, 4 am Saturday morning seen by doctor who confirmed the following:

> EGG - normal >Bloods normal - >Troponin - normal (no trauma to heart) Oxygen saturation 100% BP (200/107 )then (180/100 )after relaxing 😬.

By this point the burning sensation was gone (possibly indigestion).

Doctor, said there was nothing in my results or, what I told him to raise his concern.

He said we are all fixated on BP numbers and not the symptoms.

Unless I presented with severe excruciating headaches, vomiting, blurred vision, and confusion , he was not unduly concerned. He said BP numbers fluctuate wildly with our lifestyle and stress…

Well suffice to say, I was shattered and slept most of Saturday.

Continuing with drugs. This morning BP (142/93 ) HR (59.) So it appear Biso is starting to work.

Only thing is, I do not like the initial side effects, headache and lethargy.

Suppose this is a small price to pay to help AF.

Stay well folks…

Thanks for your support.

[mjames1]

I am not aware that DG increases bp. If you go by this premise, then your bp before DG might be a better marker to make a medication decision, than the bp spike mentioned.

As one of your doctor's said -- and so did one of mine -- bp can fluctuate greatly for many reasons including hydration and stress. I remember calling up my GP at night once with a very high bp and he said, just take another tablet of "x" until it comes down and then go back to your previous dose. I did that and low and behold, after this particular high bp episode, my bp returned to baseline. It was a spike, not a change in my overall bp metrics that required different treatment.

What also can tend to happen is a variation of the White Coat Syndrome, where YOU are the white coat (doctor) when you use a home machine. So you get a high reading for whatever reason and that stresses you out so you take it again and it goes even higher. And you take it again and it goes even higher. The initial stressor could be so many things and possibly in your case it was that facial flush and feeling off. That would be enough to make my bp shoot up

I'm not saying that is what happened to you, but the point is that you want to keep your bp controlled, but not over controlled in the sense of taking unnecessary medications.

Once my GP calmed me down by saying that he wasn't concerned because most of the time my bp was normal, my bp started coming down. Maybe it was the extra temporary dose, or maybe it came down because I was now more relaxed.

I'm a big fan of home monitoring, be it with ekg's or bp, however there can be a downside where we end up scaring ourselves needlessly on occasion, because we fail to take into account normal variances.

Your doctor seems to understand all this, so once things calm down, ask for a trial back on your old bp dose to see if you really need more medications.

Jim

[Fight-the-good-fight in reply to mjames1]

Thank you mjames1 for your response.

The reason I have started on DG and Biso meds is because I have been diagnosed with Atrial Fibrillation.

I do suffer from “white coat syndrome” hence the reason I have a home monitor.

I do believe, the initial stress on the night in question was based on my own GP telling me Biso would start to reduce my BP within a couple of hours; of course it didn’t.

I will continue to monitor my BP at home in the hope I can reduce my dose to 1.25mg of Biso from 2.5mg.

Stay well