Posting for nineboy - angina and starting PT

[ofonorow]

Encouraging report, and along the lines we seen for almost two decades. (Isn't the placebo effect wonderful! Just kidding.. )

So perhaps my body is saying 10 grams for now? I have not been having any chest pain and for now really feel quite well. No I will not go off my pauling therapy and have just bought another container of Ascorbic Acid powder..

That is good news if your bowel tolerance says you require less C! Ultimately this means you are starting to meet your metabolic requirements (just as the Riordin story you mention points out.) Your blood can be completely out of vitamin C as your hungry cells consume all they can. When your cells are nourished, more C stays in the blood, leading to less absorption, leading to more flowing into the rectum - leading to lower bowel tolerance.

[nineboy]

Well I am starting to feel a bit better. I went around the park nearby first time without my nitro patch. no chest pain and I am still taking 10 grams of Vit C, 6 grams of Lysene and 2 grams of proline. Going to gym tomorrow so will see how I do there. My heartrate seems to kick up a bit at night maybe around 80 and I do wake up occasionally with my heart pounding at a fast pace around 3 or 4 am, wondered if it is something I'm taking. I do still take my pravastatin plus a fish oil tablet before going to bed. Any problem? Also 2 grams of Vit c occasionally as well. This morning I took my 40 mg propranolol and that quitened my heartbeat down. On the whole I feel fine. Regards.

[ofonorow]

As I have learned, the hard way, lots of issues can affect the heart rate. It can be the heart trying to obtain more oxygen, but drugs can have an effect too. As usual, I look forward to johnwen's response.

[Johnwen]

This morning I took my 40 mg propranolol and that quitened my heartbeat down

This is a what this med is suppose to do. Since your getiing woke up about 3-4am this leads me to wonder if your propranolol is ER which stands for Extended Release if not it probably is getting out of your system to a low enough level to be ineffective. Beta blockers block Epinephrine which start elevating at around this time during the sleep cycle and if the blocking action has diminished to a low point they will take over and result in a rapid heart rate and a ready to go body (wake up). Epi like any or substance the body uses. If it is blocked for any lenght of time will look for any oppurtunity to do their job with a vengence.
So something else to ask you Cardio if there ER or Not? If not find out about taking a divided dosage AM-PM that way you'll hold a steady level thru out the whole day. If they are ER see if he'll do the twice a day route with 1/2 dose AM and 1/2 PM.
Hope this helps.

[nineboy]

This is very interesting and I don't think my propranolol tablets are Er. Just checked with Pharmacy and no they are not. They recommended halfing tablets and taking 1/2 around 6pm and the other 1/2 at 6 am. My Doctor seemed to agree with this when I saw him recently. Crazy thing to say but I have had crazy dreams for quite some time and wondered if it was medications. I have stopped pravastatin on drs advice to see if it made a difference and for last three nights, it seems to have helped. Some nights I awoke around 3 or4 am in a real sweat feeling as if I had been working hard labour. Blood pressure up and heart pounding. Also I take small amount baking soda with Vitamin C is this affecting my blood pressure? Less than 1/4 teaspoon with my 1/2 teaspoon of vit c, five times a day at the moment. Most times I feel really good. I did a dance class this week for 2 hours no pain. Next morning I went for a walk around park nearby and had chest pain while wearing my nitro patch. Took an hour for it to settle down again. This morning same thing but this time I took a shot of nitro and after few minutes pain was gone and I finish off my walk and have felt pretty good since. I know my Dr. has some ideas and is getting in touch with Cardiologist, not sure where this is going. I really appreciate all advice and am keeping up with Pauling Therapy. Thank you.

[Johnwen]

Sorry Nineboy!
I thought you doc would have given you better instructions OK here it goes.
Say a fairly healthy person is taking a Beta Blockers at a fairly high dose for Hypertension and runs out of Meds and it's friday. He thinks I'll just get them filled monday! Sunday afternoon he's laying in the ER with crushing chest pains. What happened? Well a persons body get used to beta blockers and a sudden level drop and the epi comes back with a vengence as I said before. This in turn sends this person into cardiac arrest. Well you didn't stop them all together but your body got use to the dosage at that time of day and a 50% drop is noticeable in anything in life.
It voiced it's protest as you described. Now your body is getting use to the level change and things are settling down.
The right way should have been for the first 7-10 days cut the pill in half then one of the halfs you cut that in half (1/4). AM 1/2+1/4=3/4, PM 1/4 then after 7-10 days 1/2 & 1/2. With betablockers you always titrate down never stop. I think you know why now!
Any doseage change needs to be done in steps up or down.

[nineboy]

Well I answered this but couldn't have did it properly as it isn't showing up. It answers a lot of questions of what has been happening to me. Thanks for taking the time to expain it. I'm not sure my body has quite got used to 1/2 and 1/2 tablet and wondered if I could still go to 3/4 am and 1/4 pm? I never thought or really had it explained how serious it is to miss a tablet or symptoms if medication is not quite lasting as it used to. I am lucky to have this site to run how I feel and what might be troubling me. I love to keep exercising and hate not being well but when your heart is wonky, it is scary. So thank you for info.

[Johnwen]

I would say go for the 3/4am 1/4pm and see if it helps. I suspect it will. maybe even stay on it for a month and see if that gives you some stability. Hope you got a pill cutter it's a pain any other way, most pharmacy's carry them their dirt cheap, don't get carried away there's some fancy ones but they ain't much better then the basic ones.

[nineboy]

Thanks for quick reply. Yes I have a small pill cutter and will go on 3/4,1/4 tablet tomorrow. Regards.

[nineboy]

Oh I have just read vitamin c may effect my propranolol use. Could this be causing me problems at night.? Perhaps making my propranolol not last as long. Still had heart rate pretty fast last night 101 before 1 am. Kept me up for awhile but managed to get through it. Whew!

[nineboy]

I had a phone call to up my Propranolol to 80mg from cardiologist. One in morning As usual and one after supper. So hopefully this will end my nights of pounding heart and high blood pressure. One morning I woke up with my heart rate at 120 but it was time for my tablet and things settled down fairly quick. I am still on Pauling theraphy and except for night pretty normal. Fingers crossed. Regards.

[nineboy]

Well I'm back. I have been taking 8omg. of propranolol. 40 mg in morning and 1/2 tablet about 6 pm and another 1/2 at about 10 pm. No problems at night now and my system seems to have settled down. I am still reading of propranolol being diminished by use of Vitamin c and wondered if there are any thoughts on this. I am still on Pauling therapy and on the whole feeling pretty good. I am seeing cardiologist soon and heading for another Stress test and will be going over medications as well. So I will keep in touch. Regards.

[Johnwen]

1/2 tablet about 6 pm and another 1/2 at about 10 pm.

If your concerned about V-C and prop. with this schdule above take a dose of C at 8pm. That way your keeping at least 2 hours seperation which gives the prop. plenty of time to get into the system.
I still believe the ER form would be the best route to go but your Doc's may see something that is tending them away from it. That's why they get paid the big$$.
As far as the 80mg dose it's in line with most people who have tachy problems average tends to be +-100mg depending on weight and severity of problem.
I looked into the longitivity of propranolol and at 12hours it's down to less then 10% the ER form holds at around 40% for hours 14 thru 16 and diminishs greatly after, down to 5% at 24 hours. Thats why I believe the er form at 12hour intervals would give you the most steady levels thru out the 24 hour cycle which in turn would blunt your problems. This is just some info I figured I'd pass on to you.

[nineboy]

Thanks for this info. I do appreciate it. I do already space my vitamin c out on a 2 hr. from Propranolol use and its nice to know I'm on track. Sleepwise, no pounding heart etc. and I sleep right through. I will ask about my medication and see what they do for me. Again thanks.

[nineboy]

I had my stress test and was taken off after 2 levels. No change from last test though I felt I could go longer. I am now on 80 mg long acting propranolol, also told to take another 20 mg if required. No sign of angina or chest pain and I am now managing through the night. Naturally I am continuing Pauling Therapy, this I feel is the way to go and hopefully will clear my blockage.I feel pretty good and am back at my normal activities, dance classes plus Cardiac gym and walking. I've been told to take it easy but not to get heart rate up too high. I do have to thank this site for advice on meds and will continue to drop in. Regards for sure.