Beta Blocker/Healing

[chopstickgirl]

Dr.Fett, my question for you is in regards to beta blockers or other meds and the healing process.

I am only on turosimide and metoprolol. The reason being, it was very important to me to be able to breastfeed my baby (the only thing that kept me going somedays, esp if we don't have more children of our own)

My cardiologist said that I would have a longer healing process, but he felt the end result would be the same-I am young (25) and no other health problems, and he anticipates I will recover fully. The difference being I guess that I would get better more quickly if on beta blockers or other stronger meds.

I just wanted to see what your thoughts were on this. If my cardio had told me that I might never get better unless I took stronger meds, I might have reconsidered taking them. He said I could start them when I am done bf'ing, but currently I have no plans to be done anytime soon as I would like my daughter to self wean, which could be over another year or more away.

My EJ was 25% @ dx in December. My latest echo in July was at 30-35%. I feel great, I am losing weight (60lbs since Dec) and so on. But I was discouraged in hearing so many women recover fully in 6mths and here I am almost where I started! Wondering if this is b/c of the beta blockers.

Wondering if I want to have another child, if I need to go on beta blockers sooner, so my heart can get better?

Sorry to ramble, and thank you very very much for your time.

JEN

[JAMESFETT]

You are already on a beta-blocker: metoprolol. Metoprolol (proprionate) is very good, there appears to be a difference with more effectiveness with the long-actiing form (proprionate). Carvedilol, as a beta-blocker may be better than metoprolol, particularly because it has an effect that metoprolol appears not to have--which is blocking the undesirable remodeling of the left ventricle that occurs with ppcm, dcm. The reason this form of remodeling is undesirable is that the new shape is less efficient than the normal shape as a pump, so we want to block that change if we can, and now it appears that carvedilol helps. My experience with threating many women with ppcm, and my understanding of research studies, tell me that right now the best treatment of ppcm is:

1)diuretics for fluid overload
2)ACE-inhibitors for improved cardiac output and down-regulating an overactive immune system (or ARB-blockers for those who can't tolerate ACE-I).
3)Carvedilol for same reasons as in 2) as well as for blocking the undesirable remodeling of left ventricle. I believe the beta-blockers add an additional help to reduce risks early of dangerous rhythm problems.

The diuretics are eased off as the fluid overload problems are overcome, and the other two are maintained at tolerable dosages for at least one year, since too-early discontinuation may be detrimental so far as ultimate left ventricle recovery.

Every cardiologist has his/her favorite regimens, and that is fine. I'm not advising treatment here on the net, only sharing info. The 1-2-3 above has been arrived at over a period of years with intense investigation of ppcm and a continuing search for early diagnosis, effective treatment, and new therapies (coming, believe me).

James

[mikeyandBellesmommy]

I am going to be brutally honest here, if you want another child and you want an easier quicker recovery process, I would follow a regimen that may not include being able to breastfeed, I understnad how important it is to you, but on the ace ihibitor the beta blocker and the diuretic, you may be able to recover quicker and have another baby...

Not on the proper meds may prolong recovery or even ihhibit a full recovery and while you will still lead a normal happy life you may not fully recover, The ace and the beta such as enalapril and coreg help the heart remodel which aids in recovery, it takes some of the workload off the heart again which helps in recovery..

Now that being said there is NO guarantee that the meds will work like I said above BUT there is a good chance..

This disease takes a lot away from us, believe me I know, I didn't get to bf either of my children, I didn't get normal pregnancies and i CAN NEVER have another baby.. IT STINKS, so I do understnad why you are holding onto the BFing believe me..

I just don't in my personal opinion think it is in your best interest..

Also my doc did say I could BF on my ace and she even said their are great beta blockers you can still BF on, maybe you should inquire about that!

Goodluck and I pray for a quick recovery for you!!

XOXO