non-cardiogenic pulmonary edema

[denisegg]

Thank you for all your help. I have already been through quite a lot of extensive pulmonary and cardiac tests including invasive ones, like my femoral artery being punctured for a heart cath even though ekgs and an echo showed no findings. It was very painful mentally to go through all of this and be told nothing.

Forgive me if my heart is not ""racing"" to be invaded again (both physically and mentally):

Per Kat,

"There were things about the study that concerned me - mainly the catheter that they would feed through my
heart in order to obtain pulmonary artery pressure at the ‘exit’ point"​

 

[Duke Dive Medicine]

Thank you for all your help. I have already been through quite a lot of extensive pulmonary and cardiac tests including invasive ones, like my femoral artery being punctured for a heart cath even though ekgs and an echo showed no findings. It was very painful mentally to go through all of this and be told nothing.

Forgive me if my heart is not ""racing"" to be invaded again (both physically and mentally):

Per Kat,

"There were things about the study that concerned me - mainly the catheter that they would feed through my
heart in order to obtain pulmonary artery pressure at the ‘exit’ point"​

Totally understandable. If you change your mind at any point, the study will be going on for a while and we'd be glad to have you if you qualify. Also, I'm sure Kat would be happy to correspond with you about her testing if you email her.

 

[Bubbletrubble]

On another side note, taking the bp medicine makes me feel like crap.I have fatigue, dizzy upon standing and weakness. My bp now runs what it did when I was in my teens 110/70 (sometimes less) and my heart rate averages 70. My primary physician also added coreg cr 10 mg when I went to him for a check up about a month ago because he said it was just good for your heart, that he took it himself.

The reason I agreed to continue on the coreg even though it is making me feel tired, etc, is this:

"Two placebo-controlled studies compared the acute hemodynamic effects of COREG to baseline measurements in 59 and 49 patients with NYHA class II-IV heart failure receiving diuretics, ACE inhibitors, and digitalis. There were significant reductions in systemic blood pressure, pulmonary artery pressure, pulmonary capillary wedge pressure, and heart rate. Initial effects on cardiac output, stroke volume index, and systemic vascular resistance were small and variable."

In my layman's mind, it sounded like it would help with IPE because of the reduction in pulmonary artery pressure and PCWP? I did my AN/DECO and first dives of my Adv Rec Trimix a few weeks ago a week after beginning coreg cr. We had 3 intense days of diving and I felt awesome. The dive to 160ffw felt no different than 20ffw on my breathing rate. (And yes, I received a doctor's release to do the class.)

@denisegg: What was your "baseline" BP after you were off of the armour thyroid (being prescribed by the quack doc)? If it was slightly below 120/80 (which is normal BP, by the way), I think it's curious that your physician would still prescribe carvedilol (Coreg). Among other effects, carvedilol is known to block beta-1, beta-2, and alpha-1 adrenergic receptors. Not sure that it would be wise to take a patient with normal BP and have him/her take Coreg which would then risk decreasing BP too much (hence, the symptoms of fatigue, lightheadedness, dizziness, orthostatic hypotension, etc.). The Coreg studies you cited in your post were conducted on a population of heart failure patients. I don't think they should/can be extrapolated to patients without heart failure. The physiological processes which regulate BP are complex. I wouldn't monkey around too much with them.

FWIW, in most cases, there are lifestyle modifications that one can make in order to lower BP, rather than taking prescription medication. According to JNC7 (Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure), reducing weight to the recommended BMI range 18.5-24.9 could lower systolic BP (SBP) 5-20mmHg/10kg. Sticking to the DASH eating plan can help reduce SBP 8-14mmHg. Dietary sodium reduction can reduce SBP 2-8mmHg. Doing aerobic physical activity 30 min/day on most days is good for a reduction of 4-9mmHg. Dropping alcohol consumption to less than 1 drink/day can reduce SBP 2-4mmHg.
Did your physician suggest doing the daily aerobic physical activity combined with the other activities above to help you achieve your BP goals? If I were you, I would prefer doing that rather than taking Coreg.

 

[denisegg]

I take my b/p once a week. The range before going to the physician on 02/10/2011 on the 5mg lisinopril ranged from as low as 92/62 with heart rate of 78 to the highest being 116/83 with heart rate of 75. (I keep a journal. I even made him a copy.) When I went to the doctor, I thought I had the flu and was taking a lot of cold medicine. I honestly didn't think about the fact that it would cause my b/p to show higher. In fact I had taken something a few hours before the appt. It was very high that day like 146/96. I tried to tell him I had been checking it at home and it was fine but that is when he gave me the coreg. I actually had a respiratory infection and got on antibiotics and it cleared it up in one week. I went back to him a week later and it was back to 110/80. He lowered the dose but didn't take me off of it(from 20mg to 10mg)
My b/p was normal before the thyroid medicine. It went up during that time (around 6 months 10/2009 til the IPE in 07/2010) and the cardiologist put me on the lisinopril and I just stayed on it after my IPE last July. I do the diet and exercise thing. I may be over medicated now and that is why I don't feel good but kind of afraid now to get off of meds and it contribute to another IPE. My PCP did say we would reevaluate it in a month.

 

[denisegg]

I just looked back at my journal. I am a fanatic when it comes to heart disease and diabetes because it runs in my family. I quit eating sweets years ago to keep from becoming diabetic. In 07/2009 my b/p was 111/72. I started the thyroid medicine end of 07/2009. By 01/2010 my b/p was in the 140's/90's. That is when PCP started prescribing different b/p meds but they all made me feel bad. I would take them for a while and quit. When I had the IPE, it was 140'/90's. I got off the thyroid meds and it went back down 110/70 but I thought it was the lisinopril 5mg. In hindsight it tells you alot. I have had an annual physical twice since last July.
Anyway, it is time to move on. I will just have to keep a check on my b/p and keep lowering my meds with my PCP until he feels it is safe to get off of it.
It may not be in every case but mild hypertension sure seems to play a part in IPE.

 

[Bubbletrubble]

@denisegg: Thanks for the reply.
Your baseline BP in 07/2009 (prior to armour thyroid) was 111/72. That's a normal, healthy BP. Was that with or without BP meds?
You mentioned something about lisinopril, so I'm not sure when you were placed on that. FWIW, calcium channel blockers are pretty well tolerated by most patients.

Has your physician considered putting you back on whatever BP regimen you were on prior to the armour thyroid med? That would seem to be the most reasonable thing to do.

I'm not sure why any physician would make decision on long-term BP management when the patient (you) were obviously sick. Yes, OTC cold meds (depending on what the particular cocktail of ingredients was) can affect BP. Moreover, just being sick can elevate a patient's BP.

 

[denisegg]

I wasn't on any b/p medicine before being placed on the thyroid medicine. My blood pressure was always about 110/70. The lisinopril 5mg was given to me by the cardiologist when released from the hospital after the IPE July 2010, along with the instructions from the endocrinologist to get off the thyroid medicine. When I was rechecked, my blood pressure wasn't overly low so I was not taken off of it.

And YES!! I agree! A doctor should not go by the one reading you have when you walk in sick that day!!

 

[Bubbletrubble]

I wasn't on any b/p medicine before being placed on the thyroid medicine. My blood pressure was always about 110/70. The lisinopril 5mg was given to me by the cardiologist when released from the hospital after the IPE July 2010, along with the instructions from the endocrinologist to get off the thyroid medicine. When I was rechecked, my blood pressure wasn't overly low so I was not taken off of it.

And YES!! I agree! A doctor should not go by the one reading you have when you walk in sick that day!!

@denisegg: I believe that you have too many chefs in the kitchen. Being hyperthyroid made you hypertensive and probably contributed to pulmonary hypertension, which may have played a role in your IPE incident.

So long as you have the patience to remain compliant, I'd bug your physician to take you off the lisinopril at your next appointment and see what happens.

 

[denisegg]

I intend to bug him.

And thanks again everyone for all of the great information!

 

[denisegg]

Ok so the b/p medicine has got to go. I took myself off the lisinopril Thursday because my b/p was getting too low. I didn't take either one Thursday. My b/p was 90's/60's. I took one coreg cr 10 Friday night and slept most of the day yesterday. I took one last night and I slept all night and I am still so sleepy, achy and exhausted I can't stand it. I checked my b/p this morning and it is 90/60 with heart rate 60. I can't wait until I see the doctor in 3 weeks to get off it. I am just going to have to quit taking both of them and keep a check on my b/p and only take one if it gets too high until I can see him again.