Bounding pulse issue going on for years

[MikeO]

On 1/8/2023 at 5:17 AM, RecipeForDisaster said:

He knows I didn’t try it sheerly due to cost.

Not sure how cheap you can get  ivabradine for yet. I did talk to my diabetes trainer about buying medical supplies thru Canada she did mention that when Plavix first came out it was so expensive that the would send prescriptions to be filled in Canada for folks that could not afford the drug. Fortunately i can find diabetes testing supplies at a reasonable cost in the US. 17 cents a testing stick vs  $1.50 a stick and allows me to test more frequently.

It is possible to find "Cost Plus" pharmacies in the US that pretty much take out the middleman cost of prescription drugs (fraction of the cost).   

   

[RecipeForDisaster]

4 hours ago, MikeO said:

Not sure how cheap you can get  ivabradine for yet. I did talk to my diabetes trainer about buying medical supplies thru Canada she did mention that when Plavix first came out it was so expensive that the would send prescriptions to be filled in Canada for folks that could not afford the drug. Fortunately i can find diabetes testing supplies at a reasonable cost in the US. 17 cents a testing stick vs  $1.50 a stick and allows me to test more frequently.

It is possible to find "Cost Plus" pharmacies in the US that pretty much take out the middleman cost of prescription drugs (fraction of the cost).   

   

Yeah, I always look at Cost Plus, but they don’t have all meds yet. Ivabradine is $85 a month copay. I can ask my cardiologist about Canada, but we went back and forth for months about how I could or could not swing it, so I am betting he doesn’t want to do it this way.
 

I have to be really careful with my asthma and am on low doses of both my beta blockers - I also have to try not to lower my BP at all. It’s tough to rock the boat. I also really like the anti arrhythmic property of the acebutolol, which I take in the morning, because I don’t feel PVCs during the day anymore.

[MikeO]

15 minutes ago, RecipeForDisaster said:

I have to be really careful with my asthma and am on low doses of both my beta blockers

I have asthma as well. And like you i am on a low dose of a beta-blocker. 50 mg of metoprolol ER was ok but last year i switched to the equivalent of Carvedilol. So far has not agitated the asthma. My heart rates have been a bit higher but i do not feel the palpitations as much until i hit the 110 mark or so or my butt starts hurting (Lol).

Sounds like you are in the know.

  

[RecipeForDisaster]

2 hours ago, MikeO said:

I have asthma as well. And like you i am on a low dose of a beta-blocker. 50 mg of metoprolol ER was ok but last year i switched to the equivalent of Carvedilol. So far has not agitated the asthma. My heart rates have been a bit higher but i do not feel the palpitations as much until i hit the 110 mark or so or my butt starts hurting (Lol).

Sounds like you are in the know.

  

Good to know. My friend loves her carvedilol. I can feel palpitations at a HR of 70, but they are worse and different over 90. I happen to do pharmacy for a living  I hate being on this side of the bench… 

[Jason_X]

FYI:  I get the Ivabradine from Canada for ~$40 per month at 7.5 mg twice/day.  The generic Bystolic is about $13 month at one 2.5mg tablet once/day.  I actually break the Bystolic in half and take in divided doses (1/2 in morning, 1/2 at night).

[MattyT]

Hey Rupey - I’ve had similar symptoms for a long time. As your were posting this, I was also experiencing a heart pulse which was pounding in my head, fingertips, chest, everywhere. I’ve had the problem for years. I noticed it mostly at night when trying to sleep. Recently, in Dec 2022, it got worse because of a medication which probably should not have been used. My primary provider prescribed the medication hoping that it would address a blood pressure problem; the drug actually made a bad situation worse. Once I stopped the drug and switched to a medication which was recommended by a specialist, the problem resolved.

The good news - I think I finally have an answer and the right medication. The bad news - these problems can be difficult to diagnose and treat. In my case it took years.

You have had a lot of important screening completed; it seems like your care provider is thoughtfully and methodically looking at the most important concerns first. You should take comfort in that. Be reassured by that. Also, importantly, you seem to be young, fit, aware, and keen to get to the bottom of this concern. You are motivated and using that to find answers to a legitimate concern. You will eventually find answer.

[rupeydoo]

On 1/21/2023 at 1:30 PM, MattyT said:

Hey Rupey - I’ve had similar symptoms for a long time. As your were posting this, I was also experiencing a heart pulse which was pounding in my head, fingertips, chest, everywhere. I’ve had the problem for years. I noticed it mostly at night when trying to sleep. Recently, in Dec 2022, it got worse because of a medication which probably should not have been used. My primary provider prescribed the medication hoping that it would address a blood pressure problem; the drug actually made a bad situation worse. Once I stopped the drug and switched to a medication which was recommended by a specialist, the problem resolved.

The good news - I think I finally have an answer and the right medication. The bad news - these problems can be difficult to diagnose and treat. In my case it took years.

You have had a lot of important screening completed; it seems like your care provider is thoughtfully and methodically looking at the most important concerns first. You should take comfort in that. Be reassured by that. Also, importantly, you seem to be young, fit, aware, and keen to get to the bottom of this concern. You are motivated and using that to find answers to a legitimate concern. You will eventually find answer.

Hey, thanks for your reply. What medication did you find to help it? I tried beta blockers they made it worse if anything.

[MattyT]

1 hour ago, rupeydoo said:

Hey, thanks for your reply. What medication did you find to help it? I tried beta blockers they made it worse if anything.

Hi Rupey, The medication that seems to work well is clonidine (an alpha blocker). Also, I've used carvedilol with pretty good success (a beta blocker with some alpha blocking). I'm still trying to find the right dose/balance of the two. I have laboratory evidence of very high norepinephrine levels, so it makes sense that these meds should work in my case.

You mentioned that beta blockers made it worse. Yes, indeed I have experienced that with other alpha blockers. They sometimes have a sort of "rebound" effect and effectively make a bad situation worse. In my experience, doxazosin (an alpha blocker) solved the blood pressure problem but made the tachycardia worse. Your description of your symptoms reminded me of what I experienced while trying to fall to sleep while my heart is racing and pounding. I tend to be pretty chilled out but a heartbeat pounding in my chest is really annoying when I'm trying to sleep.

Also, you mentioned SSRIs. My experience was similar with both SSRIs and SNRIs. In retrospect, this is a known issue in the literature for some people with high norepinephrine levels. Additionally, I've found that any amount of alcohol is problematic especially for sleep. That means, none, not even one small glass of wine for me.