Medications Side Effects

It's one thing having had a heart attack, but it's quite another that you have to contend with the side effects of the medications that you are prescribed. When I originally went into hospital, having had my heart attack, I was put on a range of medication, mostly to relieve pain. I had Warfarin to thin my blood and thus to prevent further blood clots. I recall that when a nurse was taking out the canula which was in my wrist, at around the time I was discharged, there was a quite a spectacular flow of blood as she had not noted that I was on Warfarin (which prevents not only blood clots, put prevents wounds from healing quickly.) I was put on statins, and the first type had the effect of giving me flu-like symptoms, which were rather unpleasant, to say the least. It wasn't until I discussed my state of health with one of the nurses on the C.C.U. ward that I learnt that this flu-like symptom was a side effect of taking this particular statin drug (which is used to control cholestrol levels in the blood.) I don't exactly remember what the name of this drug was, but I was soon put on another statin which didn't at first appear to have such violent side effects. I was also put on Bisoprolol (which I am still on, but at a much lower dosage, 5 mg.) I was also on Clopodogrel and soluble asprin (another drug to keep the blood thin and thus prevent clots.) 

Some of the side effects of the drugs, particularly statins, are that they give you muscle cramps. Without beating around the bush, another is rather unpleasant, bloating, flatulance and diarrhoea. Sometimes this can be very violent and you can spend quite a lot of time running to the toilet, and it can be quite uncomfortable. On the other hand, it can also have the opposite effect, constipation. Sorry if this is rather  too graphic for some people, but I'm writing this on this blog to try and help anyone else who is going through a similar experience. If my experiences can be shared with others then I hope it comes as some sort of comfort to know that there are others who have had a similar experience.

According to the leaflet which comes with a packet of Pravastatin it gives a list of possible side-effects. It reads as follows:
Dizziness
Headache
Sleeping problems
Sleeping disturbances
Vision disturbance such as blurred or double vision
Stomach upsets (such as feeling or being sick, constipation, diarrhoea, flatulance, indigestion and stomach pains.)
Hair loss
Rash
Itchiness
Tiredness
Feeling of weakness
Changes in the way your liver works
Heartburn
Bladder problems (painful or frequent urination

Very rare side effects:
Numbness or loss of sensation in the arms and legs
Tingling or pins and needles (paresthesia)
Inflammation of the liver or pancreas
Severe allergic reactions including localised swelling of the face/lips and/or throat
Yellowing of the skin and whites of the eyes (jaundice)
Muscle and joint pain

When I was first put on statins (although it might have been caused by other drugs I was on.) I used to get tingling in my feet and sometimes my fingers, and a sort of numb sensation in the soles of my feet, but that gradually went off after a couple of weeks. 

Immediately after I had the heart attack (which was back in May 2006.) I felt really depressed. I was told that this was a normal reaction to what had happened to me. I discussed this with a nurse on the C.C.U. Most men don't like to talk about their health, and particularly not depression. I have had a few periods of clinical depression, a couple of years before my heart attack, but I haven't experienced anything that severe since my heart attack. 

I was put on isosorbide mononitrate fairly recently, as an alternative to using glycerol trinitrate spray, which I used whenever I got an attack of angina. It was prescribed the last time I was in hospital back in October. It does seem to work, and I haven't had any severe angina attacks since then. But I get quite severe headaches and I'm sure it's that medication which causes insomnia. I go to bed as normal, but after a few hours I wake up, generally to go to the toilet, but then I cannot get back to sleep. I was told by my consultant at Milton Keynes Hospital that this drug would cause headaches for the first month or two, but that it would gradually ease off, which it did, but the headaches seem to have come back, but not quite as severely as when I first took this drug. The drug makes the blood vessels widen so as to increase blood flow, and this is very prominent in the brain, hence headaches (if you use the red spray,glyceryl trinitrate, you do find that you get headaches, as well as feeling light-headed, which is another effect of the iosborbide mononitrate, although I admit that it's not unpleasant, rather similar to the feeling you get when you've had one too many alcoholic drinks, but without the other unpleasant side-effects you get with alcohol.)

I can feel extremely tired. This particularly was a side effect of not only taking some of the drugs, but the effect of actually having a heart attack. A heart attack is a very traumatic experience in itself, and tiredness is the body's way of repairing itself. If I over-exert myself, like going on long walks, I find that my leg muscles can get quite painful, but if I rest for a short while, stop and sit down, this soon eases off. 

Overnight Snowfall

We've had quite a bit of snow falling on Milton Keynes overnight. The car had a blanket of the white stuff on it as I walked Carol over to the Academy. She's still not completely over the throaty bug she's had for the last day, but if she stays off work much longer she will need to go to the doctor's for a sick note. Another case of burocracy. When I got back to the house I scraped the snow off the car windows as I need to go out later to do some shopping. We're down to 68p on the electric meter. The gas ran out yesterday and we had to use emergency, so that will need topping up too. According to the B.B.C. weather forecast we can expect more snow, but it can't be as bad as Scotland, which has had something like two feet of snow over the past week or so.

During my last doctor's appointment the other week I mentioned some of the side effects of the drugs I am taking for my heart. I have changed the times I take the Isosorbide Mononitrate, from 4 and 9 p.m. to the original 8 a.m. and 2 p.m. I have some slight headaches (these were really bad when I was originally prescribed this medication, but it wore off after about a month.) I have found that I wake in the night and cannot get back to sleep. I was informed by my doctor that it wouldn't be the Isosorbide Mononitrate that cause the sleeplessness, but the Bisoprolol which I have been taking since I had the original heart attack in May 2006. I have done some research on the internet and one site has mentioned 'sleeplessness' as one side-effect. Certainly, I can say that at times I have the opposite, I get very tired, usually during the afternoon, but at the moment I am finding that I do wake in the night and cannot get back to sleep. I am currently trying other things to help me sleep, such as having a bath before I go to bed and sometimes having a warm, milky drink, such as hot chocolate to help me sleep. My dosage of the Bisoprolol have been halved, from 10mg to 5mg, but I cannot say I have noticed any difference as regards my sleeping pattern. The other side effect has been muscle cramps, which was the chief reason for halving the dosage, and the muscle cramps seem to have subsided, although at times they can be fairly mild. 

Cardiology Appointment

It's really mild at the moment. There's quite a strong wind blowing, but it's unseasonably warm. We have had the central heating on last night, but we decided to turn it off as the lounge was far to warm. 

I had an appointment at the Cardiology Department at Milton Keynes Hospital at 10.50 this morning. It's no more than a 15-minute walk from here, along the Redway that runs behind this house and into the hospital campus, and a short walk around the ringroad within the hospital grounds. The waiting area was really packed, and I was called into a room to be weighed and have my blood pressure checked before going in to see the consultant. The queue seemed to go down fairly rapidly as people were called in one by one and then I was sitting all on my own. It must have been a good 45 minutes after I arrived that I was called into the consultant's office. It seems odd that I have to keep on repeating what happened the last time I was taken in to hospital through Accident and Emergency, as I would have imagined that it would have been in my clinical notes. I had to describe the sort of pain I get when I have an angina attack. A sort of persistant pain in the middle of my chest, usually brought on by something strenuous or stressful. Sometimes it can be bought on by stretching up, (ie putting something on a shelf where I have to lift it above my head) carrying something, pushing (ie a shopping trolley) or generally just doing light exercise, like walking. I have felt very dizzy when I have bent down to pick something up quickly, but all this usually goes away if I sit or lie down for a short time. The last time I was in hospital and had to call an ambulance I wasn't doing much of anything, just about to read a book, quietly sitting in an armchair, so I can't pin any one thing on what caused that attack.

The consultant suggested having another stress-echo test. I then told him I thought that was what I'd had a few weeks ago. He wasn't sure and had to look on the computer to find documentation. He told me they had a new computer system and it was taking a while for people to get to grips with it and it was difficult to find anything. It seemed a somewhat random system. Anyway, he then decided that it wasn't really necessary to have another similar test. Which pleased me, as I'm not too keen to go throught all that again in a hurry! Anyway, it would appear that there is nothing wrong with my heart and that the 'prognosis was good.' I still don't need any sort of surgery and I should keep on with my medication.

He went through my medication. I said that I had started taking the Pravastatin again, and that there was no muscle pain as a result. I said that the Isosorbide Mononitrate was giving me headaches, and that I had changed the times which I took it from 8 a.m. and 2 p.m. to around 4 p.m. and 9 p.m. I told him that I was having trouble sleeping, and then he said that he would recommend changing this medication to something which worked in a similar way but which would not cause headaches. Also, I have been having really bad heartburn, so he will prescribe something to ease that and also I am to be prescribed something which should help my heart function better and help reduce blood pressure, although I don't have excessively hight blood pressure. I wanted to know about my cholestrol levels and that we had seen that this had been checked when my blood was tested when I was last in hospital. He told me that it seemed alright.

He is going to write to my G.P. and tell him the recommendations for my medication-changes and that the doctor will give me the required prescription so I can get it made up by a pharmacy.

Anyway, it's good to find that things are going O.K. I left the cardiology department and walked the short distance home.

Sunny, But Cold

The weather is deceptive. If I look out of the window it is bright and sunny, but as soon as I get outside it's strikes really chilly, so a coat is required. I did some washing on Tuesday, when it was sunny and warm. It was hung out on the line in the garden, but there was a short sharp rainstorm so we bought it back in, but next day I put it all out once more and it was soon dried.

We took both dogs for a walk along the Redway as far as Woughton Green (actually pronounced 'Wow-ton' and not 'Wuff-ton' as I had expected. It doesn't make a lot of sense when there is a village near here called Loughton which is pronounced 'Low-ton.') We let the dogs off their leads. Poppy just pootles around, sniffing and exploring, whilst Alfie runs off and enjoys his freedom. Every time someone comes along, either walking or on a bicycle, Alfie has to run up to them and ingratiate himself, going 'hello, talk to me, stroke me!' and so on. He doesn't run off far, and just a call from us brings him back. As long as we're within ear/eye shot he's happy. We have to put their leads on when we approach the road, as there is no telling whether there will be traffic, although the road is devoid of any cars or other vehicles. We go under the main road, Marlborough Street and walk over the canal bridge at Peartree Bridge. I'm not so sure that either dog won't decide to jump in the canal, so we are glad that the dogs are on their leads again. There is a dog being walked along the opposite side of the canal and ducks that Poppy looks likely to decide to chase. Several months ago we walked in the opposite direction with both dogs, let them off their leads and Alfie ran off, jumped a low wall and landed up in the canal, much to his great surprise! I don't think he'll be trying that trick again in a hurry. We managed to fish him out, and he had to run around for quite a while, looking for all the world like a drowned rat, until he dried out completely. Anyway, there are a couple of young swans drifting along on the canal, and as soon as the dogs approach they hiss. I think it's more a sort of 'keep your distance' sort of sound rather than any sort of aggressive intention, but I'm not too keen to discover what they're likely to do. We walked on along the canal until we came to the next bridge back over the canal and walked back the opposite way through Woughton village, following a path which goes through this really nice orchard and then back across the village green and back, in a loop, towards the canal and then eventually along the Redway towards home.

We took the dogs out again this morning, when we walked through the park in Eaglestone, and as we were about to leave the house the workman came to the door, ready to install two smoke alarms and put some hardboard along the landing where he'd repaired the floor. We let the dogs off to run in the park, Alfie going crazy and barking madly, and he jumped up to grab the lead and nipped Carol on the arm in the process. I don't think he meant to hurt her, he was just being over-zealous. Just the thought of going out and being free to run for a while had gone to his head. We went as far as the shop and bought some rolls for our lunch and some chocolate. One can never do without chocolate, as I'm sure you'll agree.

I must have told you that I'd stopped taking Pravastatin. This was a result, if you remember, of my last time being in hospital, when I mentioned to the consultant the muscular pain I have experienced since having my heart attack. Mostly due to taking statins. I was prescribed this medication as it controls my cholestrol levels. I was prescribed various types of statins, which do more or less the same thing in that they keep my cholestrol levels within safe boundaries in order to prevent a further blood clot and another heart attack. The first sort I took, when I was originally in hospital, gave me side-effects similar to flu. I only knew this when I discussed it with one of the nurses who cared for me on the C.C.U. I eventually ended up taking Pravastatin, which seems the statin that my body is most tolerant of, apart from the muscle pains, particularly in my legs and stomach. Well, I have started taking Pravastatin again, as the one month's rest from it has come to an end, and what happens? The muscle pain has started up again.  My medication at present is at follows: Bisoprolol 10 mg tablets and Dispersible Asprin 75mg, one tablet dissolved in water. Taken around 6 a.m. each day. Isorbide Mononitrate Tablets 20mg. currently taken at 4 p.m. and 9 p.m. Originally taken at 8 a.m. and 2 p.m. but times changed due to side effects. The headaches have now worn off, but I still feel somewhat light headed as a result of taking this medication. Pravastatin taken in the evening, round about bedtime.