I had a successful ablation in March 2024 and saw my EP last night. He won't take me off the Sotalol (40mg x 2 per day) or the apixaban. He told me this is a low dose and long term side effects are not an issue.This is the problem - he told me I shouldn't take the prescribed Mirtaziapine (I haven't started yet) as this is not advised with Sotalol and can affect the heart. I am under immense pressure and stress trying to look after a 97 year old mum who is no longer nice to me me (an understatement) and a brother who lives with her who is mentally sick and has limited vision and Parkinson's.
My EP told me to watch my blood pressure (it is normal to low) and to avoid stress and anxiety as a must - how on earth can I do this?
To add on top, I saw a dermatologist on Sunday who has diagnosed a small basal cell carcinoma on my shoulder which I am to treat with a cream for 6 weeks. Told to cover up and use high protection sun cream just as I am to embark on a well earned rest to Cyprus from Sunday. I love the sunshine 🌞
Sotalol seems to contradict with so many drugs I just want off it, thought that was one of the reasons to have an ablation.
I am so down and depressed 😔
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Oh I'm so sorry to read this. People who haven't had carer responsibility often don't understand the immense pressure. I really think that it is time to step back and get social services involved ( if not already ) and/or other family members. 🤔
Ask yourself' what if I wasn't here to care?' It's clear that then others would have to take over. Guilt shouldn't enter into it you have been trying your best!
It's obviously affecting your mental and probably, physical health now.
As to the little carcinoma ,perhaps also an elastoplast over it when out and about?
I think if the situation was better managed to help ALL of you,your unsurprisingly low mood and depression would improve so avoiding the compromised drug.
Enjoy your break and turn the phone off,terrible signal.in parts of Cyprus I hear (lol)
Thank you.Social services don't want to know as mum has been assessed as having capacity and she refuses any help.
I don't have any other family other than my brother who is living with her in mine and mum's house. He has early Parkinson's and lost his left periferal vision 2 years ago due to a stroke. Mum thinks she can look after him and defends him all the time hence the volatile situation I find myself in. Every time I try and help I am 'giving her orders' and she shouts at me and calls me horrible names. It's soul destroying as she used to be my best friend. According to the doctors it's not dementia.
I shall put a plaster over it, thank you for the suggestion. I will also use sun protection factor 50. I just love the sun on my face and this has really upset me. I thought I was always careful in the sun but expect it's a cumulation of holidays abroad over there years.
Sad that I will continue to worry whilst I am away. My cousin is a nurse and said she will stay in contact with them and get them anything they want.
Trouble is they rely on me too much and I shall be running around stupidly on Friday getting them loads of food, filling tablet boxes etc and I still have to pack!!
I haven't got to start the treatment until I return from holiday in 2 weeks. In fact the consultant told me they are out of stock until the end of April!
Can you find some high quality Vit C and castor oil, both very good for skin cancer. Intravenous vit c is used for cancer patients in hospitals. Castor oil is currently being published as a major healer of numerous things. Sunlight is meant to be good on the skin for 20mins earlier in the morning - natural Vit D. Numerous sunscreens are being reported as causing cancer, so if possible find a more natural one.
I can understand your stress and anxiety regarding your mother. I am dealing with similar with my father since October - the stress has definitely aged me and caused adrenal burnout. It sounds lke a holiday is just what you need.
yes when it rains it pours most of us have run into this when it is not just one thing. I am dealing with on top of everything else. My thyroid has decided to introduce itself to good. Just ask my hair for starters.
no there is no treatment get you off of medication. I have a pacemaker and AV node ablation. I will be on my blood thinner the rest of my life. I am still on my metoprolol and there’s been no mention of changing that or my losartan. I take other things. Also the things they do for us quality of I have definitely gotten that with the things I have had done. You know, of course, ablations are no even as it is being done. If it is a typical ablation, the odds of getting the right spot can be extremely difficult so it’s not that it It’s that the right spot was not hit. My former EP did not like them because of this. For the scarring that you get on your heart and the odds of it helping you, he not to do them more than once or twice same with cardioversions because of the trauma.
as far as your little spot on the shoulder, it sounds as though treatment has been prescribed. You should be fine if they have the right. It is what it is just like now finding out I have thyroid issues. All you can do is treat it and roll with it. It is not anyone’s fault when these things pop up. Do what you’re told and yes cover it. I know they have things to protect areas like that I even found a material on Amazon that protects my pacemaker from magnetic, etc. if I was still working, I think I would’ve had it behind all of my shirt pockets for Work because I always put my cell phone there.
Thank you, yes it's getting older and it scares me 😔I suppose I have been lucky with the ablation as I have had no reoccurrences since in the 12 months. My EP tells me if I needed a top up it's usually in the first year so 🤞 it stays the way it is.
Sometimes you feel alone until you read others stories ❤️
I was told by both my pharmacist and doctor that there is no interaction between anti depressants and Flecainide. Go and talk to a pharmacist who are very knowledgeable about drug interactions! u
Unfortunately it's the Sotalol that's the problem. Lots of interactions with different drugs. I can't take flecainide it caused problems arrythmia in me 😔
He wasn't keen Joy, he reduced it last follow up to 40mg x 2 per day. I will leave it until I see him again which is in 6 months. If I haven't had any episodes by then I am going to tell him I want to try a further reduction
did you ask him why he wants to keep you on it? Also, Sotalol has the potential to cause or exacerbate depression albeit at a lower risk than other beta blockers.
I'm of the opinion nobody should run themselves into the ground taking care of family members. Take care of yourself too! Wouldn't they want this? If there's any way to lighten your load, you should do it. I've found that since my ablation I've accepted that I can't and shouldn't do as much as I did before. Or else I'll end up in the same situation of becoming unhealthy down the road. You have every right to take a step back... don't get overloaded.
Thank you ❤️Mum at 97 doesn't seem to understand or think of anyone but herself now, this is totally out of character for her. She was my best friend and such a lovely, kind mum, age has certainly changed her. My brother doesn't think of anything but his own health problems, he is mentally sick.
I know I have to step back, the consultant really made a point of stressing this on Monday, it's just so difficult 😔
please do step back a be an agency that can help you whether your mom or your brother like it or not. You don’t owe them your life contrary to what they think. Remember you won’t be anyone if you kill yourself off or put yourself flat down on your back.
so many of us has been there. It’s hard one life reverses, and we become the parents. I don’t know what kind of programs you might have to assist. Maybe you need to tell both of them you’re going to put them in a home unless they cooperate in allowing you to bring in some kind of help.
I can understand your mom at her age, spring chicken either she sounds like the type that will survive everyone no offense. I was blessed with a self-sufficient mom could be until cancer took her. She wasn’t a very nice person in many ways, but she never was a burden. You have to accept that. Your mother has mental health issues also. Dementia takes a loving person and turns them into a shrew they will try to hit you and all kinds of awful things. My former mother-in-law became like that it’s very sad, but you have to protect yourself from exhaustion and running yourself into the ground and losing your life. I wish I could give you a hug. I want you to know there’s a lot of out here that through this or are going through it now. Sadly, you’re gonna have to put a harder shell around yourself. There is no easy answer for what you’re going through.
Thank you so much for your wise words and care ❤️xx I will try my best. I get anxious when I go there as I know something will make her kick off at me (usually defending my brother).
My mum has been pretty tough most of her life. She had bladder cancer when she was 62 and had her bladder removed when she was 75. She still manages the stoma to this day. Suppose I should be proud of her really ❤️❤️xx
honey we all have problems. My mom went through a lot. My dad died 11 months before her cancer long story. I was so proud of him. He beat it for 25 cancer it came beat it another nine when she lost him, she lost her world. I was in touch with someone I grew up with. She remembered my mother being tough they were a different generation, also going through war, etc. the hard way the we have had our own things to doesn’t give anyone the right to mistreat someone else. She picks on you because she can she can’t on your brother because of his mental state and her own is not any better obviously. My mom died at 72 being 72 now scares the widths out of me almost predestined, but I met my new PE yesterday and that has changed.
you have a friend right here in you can send me a or whatever if you need I am more worried about you than them. I have a way of triage with people. Sometimes you a hard one I worked law enforcement. It was part of my job. After my dad passed I stayed living with mom. I had actually moved away. I was living in Arkansas I went back to Boston when my dad was diagnosed terminal. There was no way I wouldn’t be with him. He was totally different from my mom and I am an only child. Even right now I want to cry missing him and it’s been 20 years.
you know, I always felt like my mother didn’t like me. I was a disappointment even the job. I did upset her not worry about was embarrassed that I did that kind of work. I was a paramedic as well as law enforcement. I worked juvenile for several years in a secure facility and finished out working in jail that was embarrassing to her for a short I had an office called all her friends and bragged. She thought it was so wonderful. It was always something. My hair was too long. Just always something. I never did right enough for her. it took me a long time to accept myself and I still don’t 100% not what should be done to stays with us. I was an excellent scholar. I had awards for work. Everyone liked but her I and now my daughter has turned on me since my mother died. What is ironic is my last argument with my mother was Christmas time because of my daughter and sticking up for her when my daughter was and treated at my that day. We can’t help with their like we can try to take care of them, but we can’t change them anymore than anyone can change us.
hang in there stay with us so we can help you keep yourself together. You didn’t do anything wrong. Remember that it took me a long time before I realize that about myself. Was I the perfect daughter absolutely not I am human and so are you?💕
It really is up to you which meds you take. It’s impossible to know if you still need it without reducing or stopping it for a while. My cardiologist wanted me to change meds but I refused.
The cream to put on your shoulder is sunshine sensitive. Usually you put it on in the winter. Do adhere to the instructions of cover up.
Glad you are having a break.
I thought your brother was there temporarily????
You will always need to take the anti-co.agulant.
Not sure about sotelol. I wasn't allowed it as it is an anti-arrhythmic drug with built in BB. Specific to hypertension and high Systollic.
H/Specialist team said we have never concerned about your AF rhythm - just the control of H/Rate Day. You are controlled with CCB Ditiazem. So I dropped the Bisoprolol altogether and its worked out OK.
Some Cardiologists keep you on a BB until more time has elapsed with no AF etc.
Be patient I would say. You go and have a restful time and 'leave your worries behind'.
Thank you ❤️The cream works like immunotherapy and activates to attack the cancer. It's the tiniest little spot you would never think in a million years it's a cancer, it's even the same colour as my skin!
Yes, my brother continues to stay there, sometimes I think it's for the best as mum has someone with her and I couldn't live with her now 😔 I just wish he would make himself scarce when I go over as I have no time on my own with her and she is much better when there's just the two of us.
My heart rate finally stabilised in the middle 60s but it's taken a year. My BP remains on the low side when I take it.
Good morning....if you are going on holiday I would suggest perhaps cover your shoulder and spend more time in the shade than the sun....at least you will still have the warmth. As you will be away from your Mum and brother perhaps it's a chance for you just to step back a bit when you get home and limit your time with them if your Mum is being unpleasant and unappreciative. If she can still be a little independent let her do things for your brother. Could you perhaps do some meals for them for the freezer and just see them two or three times a week to do anything else that's necessary. It would give you a little break from everything plus maybe stop your mum being so grumpy with you. Easier said than done I know but if it's affecting your health you have to think about yourself as well. If your Mum refuses any outside help she needs to realise in that case that you won't be there all the time. Does she have an emergency call bracelet? That would possibly alleviate your concerns knowing that she would be able to get in immediate contact with emergency services if she needs them when you aren't around. I'm saying all of this as we've had to look at some alternatives for my partner's mother who is 94 since our own health hasn't been at it's best. I hope you enjoy your holiday and that things ease for you when you get home. Take care x
Yes, I am going to stick a plaster over it and use sun protection factor 50. We like to walk so I will stay under a brolly when we relax in the sun ( hopefully it will be sunny).My mum is very difficult now and won't help me by being more patient and nice (I don't think she understands). I fetch a lot of ready meals etc from M & S and order Wiltshire Farm Foods. I make them a meal when I go over but I do begrudge having to do this for my brother as he is perfectly able bodied! Do you know he never asks me how I am even though he knows I have been to the hospital!
It's a 60 mile round trip for me to go to mum's and I live on the edge of a city so the traffic is horrendous, tiring in itself when I have ran around for both of them 😔
Mum has had 3 alert bracelets now, I am not sure what she is doing with them but she shouts at me and accuses me of taking them. She won't wear it anyway. I have tried and tried and she just won't. I put all of this in place including a keysafe but it makes no difference, I am fighting a losing battle xx
Oh dear...it does sound like you are fighting a losing battle doesn't it and it's upsetting that your Mum seems so ungrateful. Also bad for your brother not to be pulling his weight with things if he is more than able. I know how you feel with regard to the distance to your mum. Ours is a 3 hour round trip.....I take food that I have cooked and frozen, do the housework but she did finally give in and accept carers in to do her medication and wash her daily plus make her bed which has been an enormous help to us. If your mum is being really unpleasant and upsetting you then I suggest you withdraw a little and if she asks why you aren't going , explain that you feel what you are doing for her is more of an annoyance than a help. I think you really do have to start thinking about your own wellbeing in all of this. Go and enjoy your holiday a perhaps have a rethink about the situation when you get back. All the best xx
Thank you ❤️I don't know why he wants me to stay on it. I just think it's his way of trying to maintain the NSR and take no chances. Belt and braces is what he says
Thanks for replying. Since you have side effects, would you consider p.i.p. (Pill in your pocket) which I learned about on this helpful site? See how you feel when you don’t take it, take it again if you feel it’s needed. It’s your body!
I will discuss this with him at next review which should be the last one if I have no more episodes. Not convinced he would advise it to be honest. I have to put trust in him ❤️
Thanks for reply. I understand, especially since he is an EP. Hope your holiday in Cyprus helps you relax and do let us know how you get on -both there and with the EP.
I had a successful ablation in August last year and my EP at review took me off all medications. I'm a 68 year old man and had been on apixiban and a beta blocker. Whilst I was dubious about coming off the apixiban he was clear in his advice. I also had a basal cell cancer on my neck which was removed by the dermatology team when I saw the dermatologist. It's a very minor procedure to have it removed only takes a few minutes and you might find that there's a local skincare provider in your area that would remove it so at least you wouldn't have that worry
I am 68 too.My EP says I will be on apixaban for life. Perhaps all of this is because I was very symptomatic before the ablation. My episodes used to last 36 hours with high heart rate
I was highly symptomatic too with HR up to 180bpm. Shortest episode was 8hrs, longest 48 hrs. The EP told me at review that my ablation was a complete success, that all the AF pathways had been successfully ablated and that one of the awful things about Afib was that it left healthy people believing that they were unhealthy. .So his view is pretty much you're cured and get on with your life. I'm a bit less optimistic but think yes I'm cured, at least until it reappears, and he's right that I should get on with my life (though I never go anywhere without a supply of betablockers and anticoagulant just in case it should reoccur). And happy enough to be off all the meds as if you really don't need them you're much better off without them .
I am on the same dose of Sotalol as you. It is the lowest dose. I tried to stop it, but it caused my blood pressure to rise, as Sotalol lowers your blood pressure, so I had to go back on it, as the blood pressure medication didn’t suit me. They say it is ok to take it long term. The Dr must have a reason to leave you on it. Enjoy your holiday. Sounds like you need it.
I don’t get side effects from it. I’ve been on it a long time. I had to stay in hospital for a couple of days when first put on it, as it can cause a heart rhythm disturbance in some people when you start taking it, so they have to monitor you. (I believe it’s not common );and I did feel a bit lightheaded for a short while., but it went away quickly. I was put on it for SVT, which I’d had since my 20’s on and off. I could usually stop that in a few mins, by lying on the floor with my feet against the wall, so I wasn’t on anything for it until one time when I couldn’t stop it and had to go to hospital and that’s when they put me on Sotalol, which worked quite well. I don’t know if they still monitor you these days when you first go on Sotalol. My Afib started in 2014, when I caught a nasty coughing virus at my sons wedding.The Drs kept me on Sotalol and just put me on a higher dose. When I had my ablation, they ablated me for the SVT as well as the AFib, so hopefully neither will rear their ugly heads again. They do say an ablation is more successful for SVT than AFib. I would love to come off Sotalol, but after my experience of trying to stop it, I doubt I’ll ever be able to. (If you remember I posted about that) I do keep a list of drug reactions, that I got from the NICE website and if given any new drug or even over the counter medications, I always check if it mixes ok with the Sotalol and tell the dentist or drs you are on it, if you have to have any treatment. Take care and have well earned break.
First - the skin problem will resolve with the cream, likely Efudex. Some people get quite a reaction to this, but many don't. It will be sorted and a thing of the past soon enough.
Second, mirtazapine isn't a wonder drug and could leave your days a bit zombie like. Do try to find some "talking therapy" as it is called. That will help you more than any tablet (not that tablets don;t help - people vary). A good book that will comfort and help you is called "Self help for the nerves" by the late Dr Claire Weeks. It can be got cheaply second hand from Amazon. It just might help you a very great deal.
This... sotalol is an older drug and many say flecainide is better. The truth is, there's no answer. What symptoms do you have from your heart these days? Any? What did you have before the ablation?
Fourthly... what can I say about your poor mother and brother that will help you? Nothing. How tragic life can be. You are younger and need to be able to cope. The book and if you can get it, some talking therapy will be some help and give you tools to cope when things look bleak.
So sorry about rhe challenges and depression. Perhaps at this time in your life, keeling some of the meds is a good option since it will help you maintain stability. Nervous systems under challenge (something we cannot avoid in life) tend to upset the metabolism. How is your heart behaving generally? Perhaps this is a good marker to go by for now.
If the ablation was "successful" there should be no reason for an AAD (Sotalol) after a certain point (it's been a year). Were you aware before your procedure the EP intended to keep you on an AAD indefinitely regardless of outcome?
You may or may not need Apixaban, but it should be driven by your ChadsVasc score, assuming you are NOT going in and out of AFib.
As someone else mentioned, maybe the AAD can be used as a PIP if and when it's needed. This will test the true success of the ablation and allow you to test the stress medication for the other issues in your life.
It sounds like your heart is in decent shape at this point but you could always consider an alternate opinion given the questions you have.
Sorry what's going on. A trial off Soltalol sounds quite reasonable. If you have the kind of doctor where it's my way or the highway, then take the highway and find a new doctor for a second opinion. Life's too short to put up with those kinds of doctors.
Thanks Jim but I can't get much better than the EP I have, he is really well known in this Country and internationally. He is also President of the British Cardiovascular Society and trains other EPs. I N disappointed though. I will ask again at my next review, then it will be 18 months
So sorry you have so much on your plate . My childhood friend was in a similar situation with her mum, she lived with her and her mum was nice, much loved but very frail and demented . Friend has a new lease of life since her mum died ,
Now to the drugs . I am not entirely a conformist . You say the bb is not for rate control or bp control it’s a kind of insurance policy to give your EP peace of mind . A bit like asking you to wear your seatbelt while your car is parked in the drive . Sounds like your EP is very conservative in his approach
My episodes are very symptomatic and last 24 hours but fortunately so far have averaged two years apart . After a short brush with bisoprolol after the first episode, I have normal/low BP and normal resting pulse rate of 60 I told my cardiologist I wasn’t taking something that made me feel awful every day because of something that happened every two years. She said she couldn’t argue with my logic . I am on Edoxaban but the Prof said if the ablation goes well he wants me off it a couple of months after the ablation . Same guy did my 84 year old mother in law s ablation a few months ago and took her off her beta blocker . She asked to stay on her Apixaban because of her age . If you can manage the £200 see someone privately and get a second opinion as Jim said
Don’t worry about the bcc it’s virtually unknown for them to spread and go and have a lovely holiday . If you do decide to come off your BBs at any point do it very very slowly to try and minimise any withdrawal effect . Keep us posted x
Thank you so much for your reply which I read with interest. I think the apixaban will stay for the rest of my life. My score is over 2 because of my age (I am fast approaching 68). My mum had a stroke from afib and my brother the same, he didn't know he had AF and drove into 2 stationary cars because the stroke took his left periferal vision. It seems strokes are in the family so I don't want to take that risk. Apparently you can be in AF and not feel it which is the danger, this is what happened to mum she didn't know she had AF. For me, it was awful pre ablation, my episodes were coming every 2 months and lasting over 36 hours and the medication was not controlling it so really I had no option as I had no quality of life. I think this is probably the reason my EP wants me to stay on it. I am still disappointed though. have had it reduced from 40mg 3 times a day to twice a day. I see my EP privately anyway and have done so since I was diagnosed 5 years ago (work used to pay but since I retired I am self funding). I had the ablation on the NHS and waited 16 months.
My EP is very well respected and highly skilled on his field, he is also the President of the British Cardiovascular Society and is known both in this Country and internationally. He also trains other EPs. I have the utmost respect for him so I really think he has my best interests at heart.
Maybe if I am still free of AF (oh, forgot to say I had flutter as well) I will ask again if I can stop taking the Sotalol.
Thanks for the confidence ref the skin cancer ❤️❤️
Yes, I am 70 in August , I know the feeling ! You must do what you feel is the best thing for you . I have no experience of flutter, I can see why you wouldn’t want to risk such an unpleasant experience coming back and maybe the Solatol is the price you feel you must pay . Meanwhile look after yourself , you are carrying a lot, and try to switch off when on holiday ❤️❤️
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Am I really an 'enigma'?
Sotalol for Atrial Flutter
update to my previous posts. Cali
Almost 3 Months Post Ablation and Getting increased Blood Pressure.
