He did not tell me the actual number. Just said the gradient was lower and according to the algorithm my dosage should be reduced from 5 to 2.5. The 5 mg is not making me feel any better even though the gradient is lower. I did have to do the “bearing down” maneuver. My issue is that my obstruction is only significant upon exertion/exercise. My records show this. But my cardiologist is going by the algorithm which provides that if the gradient is a certain level, then the dosage has to be lowered. Yet, he acknowledged that he does not have to follow that protocol. The written responses I got looked like it was straight out of a text book, with no regard for the actual facts. I am very frustrated; I am not an algorithm. So I am going to 2.5mg. What choice do I currently have? I meet with my cardiologist on the 26th. The journey continues; I wish the road was smoother.