Do you really need to take so many tablets after one angina attack?

[Duckylady]

My husband is working abroad and was taken to hospital last week with what has been diagnosed as angina but needs tests. That is scary enough being so far from home, but instead of giving him blood thinners (such as asprin) and a GTN spray as I understand is initially the response to a first attack he has 6 lots of tablets and GTN. I won't even take paracetamol unless desperate so this worries me. He has all these tablets which talk about reducing the number of attacks etc but he has had one!!! The CT scan 'wasn't clear'. My problem is that he never asked any questions just accepted the meds and took them!! But how can anyone test your hear if it is being affected by drugs? If he takes them and then does something like a treadmill the result will be affected by the drugs. Once you start on these tablets it is hard to get taken off I know and some it is not easy to stop. He also has prostate cancer and a thyroid problem and I worry they may affect these conditions too. Has anyone else been put straight on to so much medication after one angina attack? TYIA

[MichaelJH Heart Star]

It would be useful if you could list them as it potentially gives a better idea as to why they were prescribed. I was already on a statin and Lisinopril when I started to suffer angina and (only) had two anti-anginals added. Currently I only take the mononitrate (dose increased) as the other caused unpleasant side effects. At the end of the day they are trying to protect your husband!

[Duckylady in reply to MichaelJH]

Sorry of course it would:

Lisinopril

Clopidogrel 75mg

acetysalicylzuur cardio aurobindo 80mg

metoprololsuccinaat sundoz retard 50

promocard 30

apo-rosuvastatin 10mg

As he is in Aruba all the 'patient' leaflets were in Dutch. I translated them or found the english version on line, and the more I read the more horrified I became. It is like 'let's just give him everything we can' and not give him a chance to see how things progress.

I do understand they are trying to protect him but they haven't actually bothered to see how things might progress. If changes he makes to his lifestyle help. Once on tablets I find it hard to find a Dr who will agree to stop them

[MichaelJH Heart Star in reply to Duckylady]

Yes at first glance it does seem an awful lot initially! Was he given any numbers such as cholesterol and/or BP?

[Duckylady in reply to MichaelJH]

Nope. They initially thought heart attack then decided angina. As far as he knows his BP was fine (except when admitted when it was low - hence why they thought heart attack). Did 2 CTs. First not clear and obviously second wasn't that great either. As I said, how can a Dr now check how badly or how well his heart works when it is dosed up with this lot?? I understand needing something in case (GTN spray) and something to thin the blood, but I think it is too much straight away

[MichaelJH Heart Star in reply to Duckylady]

I will run through the meds although with a rider, some of the names are Dutch so I may be slightly wrong but I think not seriously.

Lisinopril is an ace inhibitor used to treat blood pressure

Clopidogrel 75mg is an anti-platelet medication to reduce the risk of blood clots

acetysalicylzuur cardio aurobindo 80mg is I believe a form of aspirin, again to prevent clots

metoprololsuccinaat sundoz retard 50 is a beta-blocker used to reduced blood pressure and treat angina

promocard 30 is isosorbide mononitrate an anti-angina agent. The aim is to prevent angina attacks rather than treat with a GTN spray. I am on 50mg.

apo-rosuvastatin 10mg is a statin, used to lower cholesterol, and he is on quite a low dose.

I suspect (note I am a physicist and not a doctor) that he has a blood pressure issue and that they feel a higher than average risk of a blood clot. He does seriously need to ask more questions to understand what id going on. Two BP medications are often used as the body's response tends not to be linear - doubling the dose does not double the effect. Besides reducing the dose this approach also reduces chances of side effects. If he is back in the UK any time soon it may be worth him having a chat with his own GP.

[Duckylady in reply to MichaelJH]

Thank you MichaelJH. He doesn't mind taking them all (never questions anything) just me that thinks it is excessive to have 2 medications to lower BP and 2 to stop blood clots but it was more the whole thing of the medication advising against using if you have a thyroid problem (he has) and his prostate cancer is currently very contained so I didn't want to risk 'aggravating' things. I guess it was the 'take these' with no question or explanation that I rebel against. Dr says he needs tests when home in 3 weeks but (again being simplistic) any results won't be true results because there are so many drugs already in his body. Surely makes sense to test before medicating? Will have to see what happens. I am going out there and will see his Dr before we fly so maybe he won't just fob me off - but I expect to get the 'this is what we do accept it' reply.

Thank you again for your help

[MichaelJH Heart Star in reply to Duckylady]

If his angina is due to narrowed arteries the medication can only stabilise it not reduce it. This is why he needs more tests to establish if he needs stents or, even, a bypass.

[Duckylady in reply to MichaelJH]

Yep. I have seen the report from the hospital ............everything says 'normal', no sign of heart failure........ I did ask about his BP in hospital (it was fine before) and he says it wasn't high. So I am at a loss. Thank you for all your help though. Been feeling a bit all at sea and looking for answers but finding none

[Jessicacc2 in reply to Duckylady]

Have another chat with a more reasonable go I was put on medication which is not pertinent to my condition! Ie blood pressure tablets when my blood pressure after a 24 hour heart monitor test was fine.

I have Arteriolosclerosis but no narrowing of the arteries

Having talked this through with one of the good doctors in the surgery and changed my life style since July last year.

aerobic exercise 1/2 hour 5 days a week put myself on a non meat no dairy meal planner cut down dramatically with alcohol and taken artichoke juice daily my cholesterol has dropped to 3 and my gp has advised the consultant was over cautious and has taken me off all meds and reviews my bloods 6 monthly.

Look at dramatic real life changes that you can achieve I am sure at some stage I may be on meds but for the moment and with this life change I feel good and am pleased a little reading on the net and a good chat with a good gp has prevented me taking statins blood pressure tablets and aspirins

I have read and use an alternative blood thinner which is lemon juice mixed with apple cider vinegar garlic and ginger

I blend 5 whole lemons ( make sure you wash them thoroughly first ) large knuckle of ginger a whole bulb of garlic and a 1/4 cup of apple cider vinegar with 3 litres of spring water drain it refrigerate it and drink a small amount several times a day usually an hour before meals

I also use artichoke tincture

( I get this from a herbalist doctor and pay £40 every three months )

I can’t say this works for everyone it’s not easy changing your life and sticking to the change and yes always listen to your gp, but it’s kept me off meds and I feel better for it.

Oh good veg recipes can be grabbed from the deliciously Ella blog or books this has made my transformation to veggie food easy and the food is ace.

If anyone knows of a support group in Southend on sea or other information about reducing artherialsclerosis please let me know

I hope this message is useful to others

I

[Duckylady in reply to Jessicacc2]

Thank you Jessicacc2. This is exactly what I mean. You were given the opportunity to make changes to your lifestyle rather than pop pills! I have heard of the lemon/ginger/garlic/cider vinegar drink before. Glad this has all worked for you. So far he has just been more careful with portion control and looking again at diet. However, we have been a low fat household for 35 years and a sugar free (as far as possible) one for 30 years. Very little salt consumed either. He has had no pain whatsoever apart from this one episode. I am more concerned about the 'overkill' of so many tablets and the affect they could have on other organs. Nobody has checked his blood since he started the blood thinners either. He has an appt with Dr tomorrow before going home next week. I will be asking questions but am sure we will be fobbed off. Then GP next week who will probably be reluctant to stop tablets until cardiologist says. Husband has PSA check booked too for his prostate cancer but that is useless as statins can lower your PSA!

Thanks for your reply . Hope things stay good for you

[Jessicacc2 in reply to Duckylady]

Your welcome good luck with the gp

[Fortepiano]

It must be so stressful for you to have your husband unwell so far away. I would actually be encouraged by the way they are putting him on the standard medications to reduce his risk of heart attack (ACE inhibitors and beta-blockers do a lot more than reduce blood pressure). I would be much more worried if he was just given aspirin and a GTN spray, which would be really inadequate treatment! The thing is all these drugs work together to reduce his risk. As Michael says, they are being given to protect your husband.

Doctors performing any tests will be well aware if any of the drugs need to be stopped beforehand - honestly, it's not a problem. Maybe the tests will show he doesn't need all the drugs and they can be reduced, but it's better to be safe than sorry.

Lifestyle changes are really important , but they aren't a substitute for medications - they work in tandem.

Maybe phone the BHF nurses if you are still concerned?

[Duckylady in reply to Fortepiano]

Thank you Fortepiano. It has been a nightmare. I was quite calm to start with - until I found out the hospital wouldn't take my number as next of kin and insisted on someone on the island. I couldn't stop thinking what if? A stranger would have known he died before I did! I think that has made me overreact about everything including the tablets ( plus he is so useless at asking questions). In days we have gone from nothing wrong to ........ well who knows? having to take so many tablets just makes it seem so much more real.

Thank you again for your message

[Fortepiano in reply to Duckylady]

I'm not surprised you find it absolutely overwhelming. I'm sure you'll feel better when you actually see your husband and the doctor. I found it difficult going from no tablets to a handful, but that's the way with heart medications - you do get used to it pretty quickly and learn to swallow them all at once!

[Prada47]

Hi Ducks

I have also worked abroad and found the Drs to be as good as they are here, it's not like Aruba is a third world country, so I would be inclined to trust the medical advice.

Without his past medical history the Drs would only have what was in front of them to work on, so it looks like they are covering all aspects. Was your husband admitted or did he go to ER ?? There are so many questions like did the " Angina Attack " happen whilst he was working ( manual ) or was he stressed ( anxiety ) that's why I say the Drs can only work on what is in front of them.

Medication as Michael has pointed out cover most heart related problems just some Cardiologists like some more than others. Please try to stay relaxed we don't want you to be needing the Medication as well !!

Take Care

Frank W

[Duckylady in reply to Prada47]

Hi Frank. He was taken to ER by a work colleague (who was then apparently promoted to next of kin!). He had been swimming and was preparing his evening meal when the pain started. He has been as right as rain ever since except taking all these tablets has turned him into 'invalid' mode. Yes, I know he needs to be careful until he is seen, but until discharged with said meds he was his usual self.

My husband is also rubbish at passing on information - both to me and the Dr - so they didn't know about his partial thyroidectomy when prescribing (he forgot !) and never asks questions. 🤔

Thank you for your message though. I do feel better having come to this site. Maybe it was just being able to vent to someone I don't know? 😀

Thanks again

[Prada47 in reply to Duckylady]

Nothing like a good vent to clear the head LOL I need to take my wife with me to the Hospital she says I don't listen and tell ! I think most of us men are a little like that.

Take care

|Frank W

[Duckylady]

Thank you to everyone who has replied to me. It does help just being able to put your concerns and fears 'out there' rather than keep them to yourself. I have been reading other posts on this site from angina sufferers to learn more. Since the initial attack just over 2 weeks ago my husband has had no pains at all - he never had any prior to the chest pain that evening either. He has gone back to swimming (just not as fast and hard as before) and basically doing everything he was doing before - but avoiding heavy lifting. Whilst grateful he has no symptons is this the norm? I notice a lot of people mention having to use their spray but so far he hasn't. I worry we are being led into a false sense of security here. Can't wait to get him back home and get all these tablets reviewed too!

[Duckylady]

Thanks to all who have previouslyou replied. I have been I the sun with my husband for just over a week now and encouraged him to be more 'normal' 😃 I did bring our BP meter with us (had it for a while as he tended to 'run' on the high side of normal. I am now concerned things are going too far the other way! His BP DIASTOLIC levels are usually hypertensive according to all the 'check your BP' websites - 59 or less, while his systolic is also down to 'normal' levels. I understand low diastolic is as dangerous as high. He is feeling more tired than usual too. Hoping Dr will agree to reduce his tablets before we go home. Has this ever happened to anyone else? Thanks for reading this.

[Duckylady]

Well that was a waste of time! In Aruba with husband do he has company on first flight following his attack. Went to see Dr today to get ok for flight home. I had so many questions but not 1 was answered. Firstly when we walked in he asked my husband 'was she with you last time?'. I should have taken my cue and left then! My husband doesn'the ask questions. That is why I am there! I asked about 1 tablet that says not to take if you have thyroid problem, are taking clopidogrel or any other blood thinner (all 3 apply). He just turned away. All I wanted was reassurance as husband had omitted to tell them about his thyroid. I had other questions as he has prostate cancer that is being monitored by PSA and some statins can lower your PSA. I wondered if his was one that would. Nothing!! So it went on. He even ignored the couple of things my husband said. So there we go. 'Keep taking the tablets' but don'the ask why. So annoyed that we have to wait another 9 days tI'll back in UK and see GP. (Sorry.....another rant!)

[Duckylady]

Just a quick update (no rant involved ☺). Finally got back to UK and husband saw GP the next day. Gone from 6 tablets to 3 and have cardiologist appt tomorrow (work pay for health care so they can get you back to earning money for them asap). Had no ill effects from dropping the other 3 tablets. Never had a pain since that 1 episode and gone back to swimming and pretty much doing all as before the episode happened. Fingers crossed things won't be as bad as Aruban Dr seemed to think. Thank you to everyone who has taken time to reply to my rants and reassure me.

[Duckylady]

Final update. Today my husband had his angiogram - nothing needed. Yes there are some deposits but no more than most people have when they are in their 60s. Still on a few tablets but we can work on that. Cholesterol is low so I need to understand why he needs tablets to lower it (just wish it had been checked when the original episode happened. Lifestyle changes already in place). I said all along it was 'big bloke syndrome'. Take one look and assume he has high cholesterol, at a minimum needs stents, but probably bypass surgery ... Just goes to show - everything isn't all it seems! Thanks for all the replies you sent and allowing me to let off a lot of steam!

[Zena166 in reply to Duckylady]

Hi Ducky

Really pleased to hear that about your husband. What a relief for you both. So glad. As to the cholesterol it’s not just the overall number it’s individual ones as well. So they probably feel with one bout of angina it’s better to keep it lower. Along with the lifestyle changes he should be going along fine. Brilliant news. I hope you’re getting some relaxing time as well as this has been extremely stressful for you. So take care of yourself and hopefully you can both put this behind you. Take care Zena

[Duckylady in reply to Zena166]

Thank you Zena 166. I wish everyone on here the best and am grateful for all the support and comments. Hope you keep well x

[Duckylady]

It has been a VERY long time since I posted on here so thought I would come back and update my post.

Well, my husband is fine. He no longer takes any tablets. His cholesterol levels are brilliant as is his BP. After another severe pain and an ultrasound in UK (Aruban Dr insisted for 3 days it was a heart problem despite having all results and reports from Papworth consultant.....) he was diagnosed with gallstones! Thank God from that day on (about 18 months) he has had no problem. He was supposed to have his gall bladder removed but for various reasons it didn't happen and he has had no attacks since.

Thank you to all who replied to my rants and moans when we thought it was his heart and he was so far from home. I hope you are all enjoying good health.

[080311 in reply to Duckylady]

Great to read everything is ok now I wish you both the best of health.

Pauline