Prescription Question

[Delores]

Hi guys, me again. I have been have been feeling very still lately. My face especially. I was wondering if this has to do with water retention or the Cozaar. Also, is Cozaar a good drug to be on for PPCM? It makes me terribly tired, and light-headed. I'm so impatient to get back to my old self... Is there a medicine that I can take that won't interfere with who I am? Thanks. Delores :)

[JAMESFETT]

let's see--cozar is an angiotensin II-receptor antagonist (ARB) and it is a good medicine for PPCM, for those who can't tolerate an ACE-Inhibitor. Only your doctor knows all the factors that go into making a medicine uniquely suited for you, so I leave that decision between you and him/her. I will say, however, that these days I have a strong feeling that PPCM treatment should include a titrated dosage of carvedilol for at least a year following diagnosis (either alone or in combination with an ACE-I or ARB) unless there is a specific reason why it cannot be tolerated.

James

[Delores]

Okay, I will mention that to my doctor. Sorry to say that I meant stiff, rather than still, lol. My mind has turned to mush lately. I called the pharmacy to check on the symptoms that I've been having while taking Cozaar. They seem to think that I may be on too high of of a dosage. 100 mg is evidently a pretty strong dose. Hopefully, I will feel better soon. Thanks for getting back with me. Delores :)

[melissamph]

Delores are you on diuretics? In the beginning I was and I would get a feeling of numbness across my face and my upper thigh and my doc discontinued it (I wasn't retaining fluids anymore) and it went away completely. Just a thought.

[Delores]

Hi M. Yes I am on diuretics. Lasix (sp?) I've been on them since the ER visit. I did go back to the doctor today, but could only see the nurse, who did blood work, and lowered my dosage of Cozaar from 100 mg to 50 mg. I was so depressed to have to go back in today. I just want all of this to disappear. However, I do feel better. Very little numbness now. Just a bladder infection to deal with now. I did mention the ace inhibitor to the nurse, but she wants me to check with the doctor next week when I come in for a check. Is there any literature that I can bring to my doctor to help him learn about current thoughts and treatments regarding PPCM?

Do most people stay on water pills long? Will I always have a problem with swelling? Also, do PPCM patients actually see their hearts shrink back to normal? If not, can you live a full life with damage?

[melissamph]

Delores,

I only took Lasix for about 3 mos. Then I would take it only during my period if I needed them for water gain. As soon as the swelling had gone down and the fluid was off after diagnosis I started complaining of tingling in my face and my thighs. My doctor said that I no longer needed the Lasix. I stopped taking it and the tingling went away within days of getting it out of my system. My cardiologist told me when I was diagnosed that a person can live a long long life with an EF of 30% ,,,, He himself was 68 at that point with a 38% EF. He had had that EF from CHF for 20yrs. He said that it depends on your symptoms. He told me that if I could get above 40% he would be thrilled and above 45% he would be ecstatic! Well, I am 65% nearly 3 yrs out and he said I am giving him a heart attack! We have a strange Doc/Nurse relationship though! We medical people have strange senses of humor! So I would say to you......make sure you are on an Ace or ARB and definitely a BB (Beta Blocker) and a diuretic (lasix) only if you need it. In saying all of this I always make sure I have some lasix on hand in case I go into pulmonary edema so I can take about 3 on my way to the hospital. That really happened by the way and my Cardiologist was thrilled that I took them on the way to the hospital. I was not in Pulmonary Edema or HF but had a bad case of EIA (excercised induced asthma) but we ran a BnP and a D Dimer to make sure that was all it was and took a CXR. Just a bad first case of EIA! Sorry for such a long response! Wishing and praying for you health!

[Delores]

[QUOTE=melissamph]Delores,

"BnP and a D Dimer to make sure that was all it was and took a CXR."

What is a BNP and a D Dimer? I'm not even sure if they checked that at the ER. My cardiologist didn't check that either, I don't think.

Thank you M. for your insight. I had no perspective before I found this site.

[JAMESFETT]

BNP or B-type Natriuretic Peptide is a hormone that comes from the failing heart. It is very useful to sort out the cause of shortness of breath and dyspnea on exertion. It may show an elevation well before clinical symptoms have developed, so it has become a useful tool in the diagnosis and following the progress of heart failure. It has also been developed into an intravenous medication that is used in severe heart failure because it is helpful theraputically. We have shown the usefulness of BNP as a biomarker of heart disease in PPCM. I don't know anything abouit D-dimer.

James

[melissamph]

D-Dimer was to rule out PE (Pulmonary Embolus). Delores you are so welcome anything I can help you with feel free to ask.