I have a history of a myocardial infarction and afib

Hello @motiger,

Welcome to Connect. That sounds very impressive! First, I'd like to invite our Mentors @hopeful33250 and @predictable to share their thoughts about your question.

Here's some great information from Mayo Clinic which might interest you:
"Getting active after acute coronary syndrome" https://www.mayoclinic.org/diseases-conditions/acute-coronary-syndrome/in-depth/getting-active-after-acute-coronary-syndrome/art-20207799

I'd also like to introduce you to a few members, who've shared their experiences about activity after a heart attack; please meet @hals @thankful @ronbee @HeartPatches @sharlane @lisab62 @joem; you can read their posts in this discussion:
– Staying healthy physically (and mentally) post heart attack https://connect.mayoclinic.org/discussion/hi-there-i-just-now-joined-your-group-and-after-reading-a/

@motiger, have you considered joining a cardiac rehabilitation program which would create a activity routine tailored to your needs?

@motiger76 Sounds good to me. I had multiple infarctions (4-6) and multiple mini-strokes over the course of a few years. I have "history of a myocardial infarction and afib together with type 2 diabetes. I use one of those finger insert gadgets that gives oxygen together with pulse rate. I'm 77" and sounds about the same. I also take 50 metropolol tartrate in the AM and 25 PM. I do have some other stuff, Primary systemic hereditary, light chain, Amyloidosis, including Cardiac, Kidney, Lung and Cerebellum involvement. My story is at https://bit.Ly/1w7j4j8 "Amyloidosis" is a disease of mis-created and mis-folded protein in the system. There over 1,000 varieties such as these cardiac issues, Crohn's, Lupus, Alzheimers, etc. Since the basic protein assays for protein disease are cheap or free, every person on medicare should avail themselves. It must be a top lab, such as Mayo-Quant, ARUP, Stanford, Brigham & Women's, Sloan Kettering, etc. If there is a problem, you must find a lab with such tools as an atom-force microscope, etc.

@dear oldkarl, how can i be added to ptsd or bipolar group? peachbarbara

Hello @motiger and welcome to Mayo Connect. We appreciate your sharing your concerns regarding your exercise routine. While I've not had a heart attack, I do some have heart valve problems that affect my ability to exercise like I would like to. I agree with Kanaaz, @kanaazpereira, that being a part of a cardiac rehabilitation program would be the best way to develop an exercise routine that would suit you best.

You do not mention how long ago you had the myocardial infarction but that is an important factor. Also, did your doctor recommend cardiac rehab for you?
If your doctor is OK with your current status, that sounds good, however, please know that you can always seek a second opinion.

Please keep in touch and let us know how you are doing. Have you sought a second opinion for your concerns?

Teresa

@peach414144 Hi, Peach. Hope you are doing OK. But, gosh, I am not sure. I am neither smart nor a moderator, but I think this should get you into the area. Then you just reply to someone, smile sweetly, and Bravo! I guess I am just pushy enough to try to get myself in somehow. You may have to do it for yourself. I have been a pastor for 60 years or so. When I step to the pulpit, and the room quiets down (usually!) I know that someone will say something; and I am just controlling enough that I want that someone to be me. Now, At the top of this page is a menu, and the second word is "groups".Under Groups when you click it another menu appears. Then there appears, I suppose by magic, a screen with a search under mental health, put in ptsd or bipolar, search for one or the other, and just keep searching until you find the one you want. Then start typing, and trying to think at the same time. Difficult, I know.

Hi, @motiger. Glad you could join us here on Mayo Connect, and I hope you'll enjoy and benefit from conversations with the members that @kanaazpereira has poked for you. I wrote a fairly long comment in response to your opening message, then lost it when my computer window closed without warning. It was too wordy anyway, so I'll reconstruct from memory only the main points that I'd have bothered you with.

Like you, I have A-fib, but neither diabetes nor infarction. My main medication is Carvedilol, a newer version of the drug class that includes Metoprolol. My dosage matches yours -- 25mg AM and PM. But my dosage is that large as much for its effect on my blood pressure as on regulation of my heart rate. Does your diagnosis also involve hypertension?

Because A-fib sometimes results in small blood clots being formed in the heart and sprayed around in the arteries, I'm also on an anti-coagulant -- Coumadin. That has meant regular blood tests to be sure of a safe coagulant index and avoiding a lot of leafy vegetables which contain Vitamin K, a Coumadin antidote. Have you taken an anti-coagulant?

Are you pushing too hard with your exercise regimen? Not that I can see, and if your cardiologist is OK with your daily walk of a mile -- with a heart rate of 150 at the end -- you should keep right on trucking. My heart rate used to be 50bpm (from running, biking, and hiking); A-fib pushed it up above 90, but it's now regularly 75-85 as a result of the Carvedilol.

Incidentally, a number of patients on Carvedilol have troublesome side-effects, often because they (or their doctor) abruptly cut their dosage in half or less. It should always be phased down with the doctor's close oversight.

Let us know how you're doing . . . what you're thinking . . . as a result of these discussions. Oh, forgot to mention that I'm originally from Iowa, so I'm assuming that "motiger" reflects a relationship with the University of Missouri Tigers. Right? Martin

oldkarl, i thank you peach

Motiger
To my last epistle I want to add that I think my stated pulse rate is probably bogus. As a finger insert gadget it creates the stated pulse by measuring the time between heart beats and multiplying. So this morning I was already at 135 by the time I had taken maybe 15 steps. Despite the fast start I never went beyond 152 and it dropped quickly to 14?. Just a random experience. It also tests Oxygen and it is ALWAYS at least 92+. I wonder what others might be using. Mine comes from Walgreens. My Afib requires that I take warfarin 5mgs daily and be tested monthly. I don't have any trouble with this being normal. I'm just getting started with metoprolol and can't discern any slow down in the heart rate. Perhaps Cavedilol would slow me down perhaps not. Wish I knew.
My MI was discovered during a checkup in 2011 and I don't recall anything in the way of symptoms but I have an EKG that Is definetely abnormal. My diabetes was discovered on a check up too. A1C then was 6.6 and has always been less than that since. My ejection fraction is 35% and I have never suffered any angina as best I can discern. So as you can see I am kinda borderline in several ways but I want to keep in decent shape withour pushing too hard. A hundred years ago in high school football I picked up the nickname tiger and I live in Missouri but am not connected with the University except to be a fan. I'm a transplant from a small town in Illinois by origin. We lost our profootball team here(Rams) when a greedy walmart co-owner wanted either more money or notoriety who knows which. He has a gods plenty of both already. Thanks to one and all... I do appreciate the sharing of your experiences and would love to hear more about how you determine your pulse rate.

Hi, Tiger (@motiger). Glad to get your message just now. Glad also that you're taking Coumadin/Warfarin and don't mind the inconvenience. I think it's the best of the anti-coagulants (despite TV ads in dispute). One reason for my choice was the death of a friend who was on Coumadin and fell off a step ladder and struck his head. I was the first to find him, called the EMT, and sent him off to the emergency room. Sadly, the ER had no Warfarin antidote -- CAN YOU BELIEVE THAT? So they called in a helicopter to ferry him to a more competent hospital -- but the half-hour wait was too much, and he died shortly after he arrived at the other hospital. Sounds perverse, doesn't it -- he died from lack of treatment for an anti-coagulant. Not perverse, however. For Warfarin there is the Vitamin K solution that can stop the effects of the anti-coagulant in 15-20 minutes, while the other anti-coagulant drugs still do not have antidotes available, although drug companies are working to develop them.

My other point is whether you might be too concerned about your 150bpm heart rate. After a brisk mile walk, that doesn't seem threatening, but you -- and your cardiologist -- would know better than I. I caution you about hankering to change to Carvedilol, which might work for you, but also might cause some uncomfortable side effects. Like with politics, it looks like the two (or three or four) sides of the issue need to get together and agree on a compromise that meets your personal preferences as the patient (the PPP).

For my heart rate, I rely on my BP meter at home, which reports heart rate along with blood pressure. Like you, I sometimes worry about a rate measured during a brief time, then multiplied to its per-minute equivalent. So I just take my heart rate the old fashioned way, counting the beats per minute and using that as a check on the meter. Bottom line, though, I rarely have any syncope symptoms (feelings of fainting) from accelerated heart rate during or after exercise, although it sometimes shows up when I stand up fast from lying or sitting positions.

Hi Tiger......I'm told to only take the pressure and pulse rate twice a day. Once in the morning before any meds and once at night. I have been on 40 Mg a day of Lisinopril a day for many years and after much stress the family doctor added 10 mg of valium to help bring the pulse rate down. I felt great until I saw a cardiologist that added 25mg a day of metoprolol . My pressure and pulse rate decreased to a very low level. Mostly readings in the 80's over 50's for the pressure but it did help the pulse rate to drop in the 70's. I saw another cardio surgeon that cut the dosage of the metoprolol to 12.5. Vitals were still all too low and he removed me from that completely. Like most meds they work great for some people and for others they are horrible. I am still suffering the many side effects from the metoprolol that included some rare side effects like vision problems, bloating and a constant weird humming in my head. I am told that surgery for me will be a definite in the future to replace the heart valve due to the calcification but I wish that I never had never taken that metoprolol. Please read all the possible side effects and discuss with your doctor if you experience any of them. If you shop on line you can find a cheap and accurate blood pressure monitor that includes the pulse rate on Ebay. If you purchase a monitor bring it to your doc's office and check the accuracy with your doctor's readings. If you plan to take K2 make sure you get your doc's approval on that too. I am waiting for the doctor to respond to my request to use K2. Good luck and enjoy the Holidays.