Dr. Fett and/or nurses and/or survivors who may be able to answer this question...

[Nails]

Okay this is absolutely terrible of me, I will put my explanation at the bottom but first my question:

I have been off my meds for about a month due to financial stuff (see below) and now I can finally afford to start buying them again but I know it is not a good idea to just take everything full force after a month so I want to ease back in. I was taking :
-Coreg 25mg twice a day
-Digitek .25mg once a day
-Furosemide 60mg once a day
-Altace 10mg twice a day

I don’t know if this matters but when this whole thing started I had about a month’s worth of medication and I gradually backed off of it so I did not stop cold turkey, and I was hoping we would be able to afford more before I had even depleted that supply but it just didn’t work out that way. At the time my echo and mugga both had me at an EF in the low 60’s.

Any suggestions on what I should start with and if I should take only half of something at first, I don’t know I am worried about not being on my meds (even though I feel great) but I am also worried I will mess something up by just diving back in. I have an echo and a mugga on the 24th but I would prefer not to wait that long unless you think it is a good idea just to wait and see what my Dr. wants me to do. I am not looking forward to telling my Dr. I feel terrible about this.

Explanation/not excuse:
Okay we got into some very severe financial trouble due to a poor mistake we made in our checking account and the fact that we had no idea that our bank charged almost $90 per ‘bounced’ item, we have never ever messed up the checking account before and were not covered by overdraft protection or anything like that so this ended up being a several, several hundred dollar mistake that cost us 99% of Christmas, my meds, our cable, our phone, and lot’s of other things just so we could get by. I am happy to announce that as of the 12th we will be out of the red and the first thing to come back are my meds.

Thanks for your help!

[JAMESFETT]

Not to punish yourself too much for this situation--these things happen. What is most wonderful to me is that your previous echo/MUGA showed EF 60 percent. That's fantastic! You feel fine, so why not wait and see what your EF will be on the 24th?

If it is still that good--and it may be--you don't need that much medicine and maybe you don't need any at all. I' m not sure when you were diagnosed with PPCM, but in those who return to normal I always err on the side of longer taking of medication and go for at least one year. But I gradually wean away and am left with just one medication at the end of that year, and it is usually the beta-blocker, in your case that would be the carvedilol (coreg).

From a practical standpoint digoxin can (and I believe, should) be discontinued earliest, followed by diuretic (furosemide), which can be taken according to weight (fluid load), fluid retention. Next the ACE-inhibitor (Altace) can be first reduced, then discontinued, and last of all the carvedilol.

One of the reasons I have learned how well this works is from my experience in Haiti, where for economic reasons, patients stopped their medications abruptly--and often had worsening. Now that we pay for all their medicatins that no longer happens, but we know from experience that gradual weaning of medication and then discontinuing altogether is both safe and effective.

I'm truly grateful you are doing so well. Work out the course you will follow with your doctor, but don't blame yourself too much for the situation you are in.

James

[mom2gageandkeely]

I would suggest if your doctor feels you need to be back on medicines asking him for samples so you do ot have the burden of the high cost of medication. My grandmother is on a very fixed income and her doctors office supplies her medication through samples out of kindess so she can continue taking them. I'm with Doctor Fett though ofcourse- If your EF is high and your new echo shows improvement why would you have to continue taking so much? It's something to discuss at your next appointment. I have been off all medication since 1998, some people stay on medicine biut I'm glad my doctor took me off when I showed improvement and so far so good!

[momoftwoboys]

That's an awesome EF...glad to hear it is so nice and high. As for the other stuff...sorry to hear you had to go through all of that (darn checking accounts hey ;) ). My hubby keeps telling me to do everything on the computer (like in Microsoft Money) but for some reason I just haven't started yet. As for the meds...I would hold off on starting back on anything until you have seen or talked to your cardiologist. After all, the 24th is not a very long time to wait. You should see if your EF has stayed up there being off of the meds and maybe you won't even need to take them anymore. Let us know what the numbers are when you get the results alright? Good luck!

[Nails]

Thank you all very much, I feel much better about the whole situation. I was diagnosed about 18 months ago and have been on meds ever since with an EF of 55% or over since about a year ago.
I will just wait and see what my echo and muga have to say on the 24th and go from there unless Dr. Fett you think it would be a good idea to start back on the coreg just to be safe? I guess it is only a couple weeks away and hopefully my meds will be a thing of the past, if not I will be sure to ask about samples that is a wonderful suggestion!

[JAMESFETT]

There is really no urgency to re-start the coreg right now, since you are feeling well, with a normal clinical heart function, what we refer to as NYHA I (New York Heart Association Functional Class I). If your EF on the repeat echo is still in the range of 55 or 60 or above, you don't need to ever restart heart failure medication. Thanks for the clarification on time since diagnosis. Sounds good!

James

[Nails]

Yay!

Of course I am paranoid, especially since me, my husband and my son have been passing a light cold back and forth, but I weigh myself every morning because I have a tendency to not 'listen to my body' and I have been holding steady. I am pretty sure that is the first sign of a relapse, increased weight due to fluid retention. I am off to play ring-around-the-rosy with my son to prematurely celebrate maybe being med free!

Thanks!