Stopping Carvedilol (Coreg): When will the effects wear off?

@cabgx6maze517 Hi Gnite: Thanks for the update after your appointment. It does sound like things are in the process of getting back to normal. I am very pleased for you! Keep in touch with us at Mayo Connect as you need encouragement and support in your continued recovery from the procedure as well as the medication problems. (Stay cool as the temperatures rise!) Teresa

I have seen my Primary care provider and made some adjustments to my meds. We have increased my Metoprolol to pre surgical norm of 25 mg twice daily and my blood pressure has stabilized, hovering about 120 / 75 +_ 5. Damn near perfect, but still fluctuating. And we have reintroduced Multaq ~ Dronedarone 200 mg which has lowered my heart rate from 90s to 80 and below. We took another look at Lasix for a day and removed 2 more Liters from accumulated fluids. But ended up back in the ER for opioid induced constipation, so I have to lay off the Oxy 5mg acetomenaphen 325. And set aside the anxiety drugs as well.

I still have a little blurred vision. And a low level whole body burning has replaced the tingling and numbness in my fingers and toes.
I no longer get dizzy and light headed every time I eat. The knots in my stomach have untied a little, and I can breathe a little deeper each day that pass, my resting 02 has risen to 94 generally, where my active o2 has remained higher, while not sitting.
But here in Vegas the daytime temps as indicated on my truck dash board have risen up to 109 degrees.

All in all I know the day the nurse called out that my BP was 200/100 and rising, the Cravedilol saved my life, but the following three weeks have been living hell. Here it is 4am and I did get a couple hours (3) sleep so far. I need to get off here and try to get some more. So I guess at 26 days post surgical CABGx6 w Maze I am doing fairly well and I should stop complaining and get some more sleep...

Gnite

I am not a newbie when it comes to surgery, For I had my first double bilateral carpal tunnel releases in early 1985 the left hand radial and ulnar, with a repeat of the left hand before the year was over. By a surgeon whom I occasionally had lunch with at a DC area hospital where I worked as a Bio~med Tech in the clinical engineering department for a couple years, with a 2yr tech degree from Penn State University. I did an internship, paid off my student loans working is a couple diff facilities and left the field.

With the guidance of my PCP and cardiologist, I went cold turkey off the Carvedilol and have returned to pre surgery Metoprolol lowest level and increased to regular dosage, which has helped my body regain control of my BP swings. We have on two occasions used Lasix to reduce edema in lower legs and feet ( especially the left), with positive results , including wearing compression sox to reduce swelling.

I am keeping daily record of BP HR and Po2, and the only issue to address is a minor inconsistent Sinus rhythm, which I am watching trend toward higher numbers from low, and waiting to hear from arrhythmia specialist to guide toward specific technique for control.

things have settled down quite a bit for my body, mind and soul. Peace of mind has begun to set in. Time is again on my side.

I am looking for the happy medium between Haste and Hesitation, It would be a waste if I missed it.

@cabgx6maze517 Hi Tom: I'm glad to hear that you received some confirmation about your thoughts regarding the Carvedilol and that you have a "plan of action" to help with your symptoms. I wish you well and do hope that the swelling begins to be reduced and you begin to recover from this experience. Best wishes and please keep in touch with Mayo Connect. We value your sharing of your experiences and look forward to hearing from you again. Teresa

How did your appointment go today, Tom? Any clarity?
I wish you a sleepful night tonight.

My primary care physician also is not in doubt that Carvedilol is the culprit, as well as the prescribing physician being in denial of the adverse effects. Our current path toward remedy is simply: determine the status quo> reduce the swelling of the extremities, using a reduced quantity of Lasix continue with but increase the Metoprolol and observe, repeat and observe with blood work to monitor kidney and liver function. Continued as outpatient while within the VA system.

@cabgx6maze517 Thank you for the update. I hope that your appointment will provide you with some assistance to this very perplexing set of problems. Teresa

Well, I have had another nearly sleepless night, of possibly 3 hours in one hour increments. But I am not really sure cause I was asleep. But I was aware of being awake more than unaware of being asleep. And I took 1 Lorazepam at 6:45pm, 2nd at 11pm and felt sleepy.
I cannot lay flat on the bed because my breathing becomes laboring immediate and anxiety sets in to near panic, so I sit up to sleep. Also I am unable to elevate my legs because I would need to lay down to do that. I am in Las Vegas Nv and it is so hot I go to super Walmart and walk in the coolness for exercise, the music is OK and I take Oxycod/Acatamin 5~325 a @ 4 hrs as needed to control some pain in my left / graft harvest leg and ankle. My legs are a large blood pump but I am not maximizing the effect, as my left leg is not getting smaller, even though I wear the compression tube from the HealthSouth rehab Hospital. in essence; walking for 2 hours and more does make me feel better, my edema did not decrease or improve in the two days since release. Today will be my first opportunity to visit my VA primary care provider and I will do that early, like 9;30 am for referral to other clinics in the Vegas VA system. I do already have in my patients copy of lab reports fro the rehab center to carry into this appointment. I have a scheduled telephone appointment with TRIwest insurance at shortly after 8am for some type of conversation. And then I will be off to get a patients copy of the disc and reports to forward to VA Arrhythmia Center Palo Alto as well as transfer files to the Vegas VA for my team to access the files.
I was prepared to go to the VA ER if necessary last night but did not feel any aspect of my current condition required that. I have already scheduled a follow~up apt with the CVsurg teams physicians assistant for Monday, but that is still a long time from now, too long...

Thanks Martin and others, TLC Tom

@cabgx6maze517, from Las Vegas you might prefer an appointment in Phoenix, but Rochester, Minn. is accessible if you can travel there. If you would like to seek help from Mayo Clinic, please call one of their appointment offices. The contact information for Minnesota, Arizona and Florida can be found here http://mayocl.in/1mtmR63. If you call them you'll have the opportunity for a helpful phone conversation with a medical professional, or you may wish to start off with an online application (the form is available in the right column of that page on the Mayo Clinic web site). Either way, ask the Mayo staff for help with travel plans from your house to your preferred Mayo Clinic.

I'm surprised that you have linked Carvedilol to symptoms of severe edema. I haven't seen that listed as a side effect of the medication. Sometimes it causes problems from an initial dose that is too high (more than 6.25mg twice a day to start) or when it is not taken with a meal. Over time, the dose sometimes is raised (mine is now 25mg twice a day). DIscussion of its side effects is available on this web site: http://www.rxlist.com/coreg-side-effects-drug-center.htm.

Before I went on Carvedilol, I was on Lasix for a few weeks to deal with swollen ankles and calves, but it forced me to slough off so much potassium that I needed emergency room treatment for severe hypokalemia. Have your lab tests included your potassium level?
Martin

@predictable Thanks for your suggestions to @cabgx6maze517. A second opinion from another medical institution sounds like a great idea. This is a complex situation. Teresa