I am 5 months post up from an aorta valve and ascending aorta replacements. I have been signed off from the local hospital cardiology department review and check up programme as my heart efficiency has improved by over 100%. I have also been signed off my cardiac rehab programme again because I have made such good progress.
The concern I have is that I'm on a number of heart medicines (8 in total) which all have complex interactions and some side effects. I can feel that my heart efficiency and strength continues to improve but I am still on the same medicines and dosages that I was discharged with. I don't expect my GPs to have the knowledge or the understanding required to tweak my medicines either to reduce the dosage or stop any of my medicines but who is going to monitor this now I have been signed off by the specialists.
Any advice or experience would be welcomed.
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Freshorangejuice
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I sympathise. My heart surgeon said that I didn't need an antacid, my GP insisted that I did and initially prescribed Omeprazole, which is contra-indicated if one is taking Clopidogrel!After two or three months of stomach discomfort post-TAVI, I started taking Lanzoprazole which very quickly eased the discomfort. And though Lanzoprazole appears to be much recommended, it can lessen the efficacy of Clopidogrel and can reduce one's magnesium levels.
Then there are effects of over-the-counter supplements and certain foods. A friend all but insisted that I buy the (expensive) Omega 3 pills that she sells, though one needs to be careful with these if one's on Clopidogrel.
I spend a lot of time Googling various combinations of drugs, supplements and food, making notes from authoritative websites of how they get on with each other and any side-effects.
But then one has the problem of persuading one's GP to change one's medication, probably taxing their patience with patients who Google!
ALL THE ABOVE INTERPRETATIONS ARE MINE, AND OTHERS MAY COME UP WITH DIFFERENT ONES!
I am on the same tablets and dosages from 3 year ago with one exception, I was changed from amioderon to digoxin after 3 months I think.I had the same procedure as you.
As discussed with the surgery's pharmacist, a few of the drugs are precautionary and therefore I was advised to take them.
I am still here cycling, walking daily and still hiking up the Wainwrights 😁
Glad to hear you are making good progress. The only way I have found to be confident of the meds as I hadn’t seen my Gp face to face for 3 years was to pay to see a good Consultant Cardiologist. It’s worth paying out, the NHS although there for me during the HA certainly were not there after leaving hospital.
Don’t underestimate the knowledge of your doctor and/or practice pharmacist, they also have access to information that Dr Google does not have.
However, saying that we unfortunately don’t live in 1950s so doctors don’t have time to be proactive. Try and work with them as they are responsible for titration to ensure you are on best dose.
If your cardiologist thought you would need to come off a medication after a period of time, a year in my case, they should have said when they discharged you.
My local surgery’s prescription system prompts a review of my medication at 6 months, this is usually a box ticking exercise by the admin staff but can be a cue to discuss them.
My GP practice employs a part-time Pharmacist. After discussing and having a disagreement with my GP over a couple of my medications, I was passed on to the Pharmacist who sat down with me and agreed some changes subject to monitoring. That all worked out well. I have since suggested a couple of tweaks which have been agreed with the Pharmacist, even adding Nifedipine to deal with the symptoms of my Raynauds. I now have medication that suits me and does the job that it is intended to.
I had an AVR in 2022 & within a few months my cardiologist said I could safely come off all post-Op Meds, inc anti-coags as I had a Tissue valve replacement. He’s continued to review me annually, inc echocardiogram scans. It seems odd if you have been fully discharged by cardiology after only a few months & with no plan to review/reduce Meds, if all is now ok. You don’t say which 8 Meds & for what specific conditions? Personally I would prefer to rely on a cardiologist rather than GP to decide on future Med needs, so I’d probably try to push for a further cardiologist review, or if need be seek a private consultation? It’s never good to stay on meds longer than necessary & normally prescription reviews are built into the process, even with GPs.
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