Friday, March 23, 2018

A new direction

Today was my first doctor visit of the year, and it was with a new doctors’ practice. The change was necessary because of distance alone, but I also felt it was time for new eyes, new perspectives, and new ideas. I think I may have satisfied all those goals.

The doctors I’ve been going to for many, many years are located on Auckland’s North Shore, which is an hour’s drive from here on a good day, and much longer on a bad one. The last time I went, it was an hour and a half drive. I said at the time:
However, the doctor is—under ideal circumstances—about an hour’s drive from home. That’s not too bad for a quarterly check-up, but what if I get sick? Driving an hour (or much more…) when I’m sick doesn’t seem like a great idea. That’ll be a project for the new year, as will a round of the more comprehensive blood tests, something I usually get done once or twice a year.
So, my due diligence was first to look at realistic travelling distances, and the closest practice is 20 minutes in good traffic (which means almost any time other than morning commute). They were also spoken of highly on the Facebook group for our community, which is a thing—a grain of salt kind of thing, but a thing worth at least considering, nonetheless.

As it happens, I got my annual comprehensive blood tests this past Tuesday, so I had current data. The tests were actually pretty outstanding: Everything was normal, apart from my “good cholesterol” which is too low and has been declining for months. That, in turn, drives down my cholesterol ratio, which is bad. One of the main reasons that remains low is that I just haven’t felt up to getting any exercise, and the reason I've been less physically active than usual, is all due to the beta blocker I’ve been on. And that was where I most wanted a change.

At the new practice, they took measurements and my history, and then I met with the doctor. I’d already told the nurse why I was changing practices, and she asked if I had any health concerns, and I replied, “beta blockers”.

The doctor talked to me about it, and before I had a chance to say how they made me feel, she ticked off all the symptoms I’ve complained about: Tiredness and memory/focus problems, chief among them. But then she did one thing more: She explained to me why I’m on beta blockers in the first place. No one has ever done that.

I knew that people who’ve had a heart attack are put on the drug to help their heart heal. I didn't have a heart attack. I also knew that they’re used for irregular heartbeat (and migraines, even). But it turns out that when someone has a heart attack, part of their heart is damaged, as we all probably know, and when someone has a blockage like I did, part of their heart is weakened. As a result, one half of the heart isn’t strong enough and has trouble keeping up with the healthy part.

Beta blockers slow down the heart, ideally to no more than 70bpm or so, so that that weakened part can keep up with the strong part. This is almost certainly a permanent requirement (or until new treatments become available). So, she said, the trick is finding a beta blocker that balances the life-saving properties with having a life.

She put me on a different beta blocker drug, Bisoprolol. I’ll take half a tablet for a week, then switch to one tablet per day. If I tolerate all that, I can renew the prescription twice (she gave me one month at a time). If not, I’ll contact her and try a different drug.

This is the first gradual introduction I’ve been offered, which is a nice change. The bad thing about this is that if I can’t tolerate it, or it’s not better, it will cost me another doctor visit to try a new one, plus another prescription dispensing fee ($5). Or, it’ll cost me that $5 twice more if I do tolerate it.

Here’s the thing. I’m not expecting any miracles from this drug (though I hope to be wrong about that), but I do like that she both gets what I’m feeling, and is willing to change drugs to try and find one that doesn’t make life miserable. Maybe I’ll be lucky with this drug, maybe I won’t, but she at least understands what I want, why it’s important, and what can be done. I honestly feel that’s more than I had been getting.

I now understand so much that I didn’t until recently. My lack of focus, my memory problems, my lack of “oomph” to blog, podcast, make videos, etc., I now know were all directly caused by beta blockers. That also means I have a standard by which to judge these new drugs: If I don’t feel up to blogging or other creative things, if I don’t feel up to going for a walk, if I don’t feel able to focus on tasks at hand, then I’ll know the drug is a failure.

I hope that this new drug will be it. I want so badly to feel like myself again, and to be able to engage fully with life and all the wonders it has to offer. But I also worry, of course, that this new drug won’t do any of that. Or the drug after that. Or that I may be left with being required to stick with the least awful of all the drugs and forced to learn to exist rather than live. What then? Well, that’s a problem for another day, because it may never happen. First things first, and all that.

As I was leaving, the doctor remarked to me that many people on beta blockers think they’re experiencing dementia, and that’s it exactly. I was scared that I had early-onset Alzheimer’s or something. “No,” she said, “it’s the drug”. Like I said, she gets it.

The main thing for me right now is that I feel listened to and understood, and that the doctors are willing to work with me to achieve the best result. I think it just may work out.

Important note: This post is about my own personal health journey. My experiences are my own, and shouldn’t be taken as indicative for anyone else. Similarly, other people may have completely different reactions to the same medications I take—better or worse. I share my experiences because others may have the same or similar experiences, and I want them to know that they’re not alone. But, as always, discuss your situation and how you’re feeling openly, honestly, and clearly with your own doctor, and always feel free to seek a second opinion from another doctor.

1 comment:

rogerogreen said...

GREAT POST! You know I've missed your regular posts. I did understand why you weren't blogging, et al, but I still missed your wisdom. Coincidentally, one of the two MDs in the practice I've going to for years is retiring at the end of June. He's not my primary, but I am still sad, because I saw him maybe a half dozen times in the past 4 years, when my primary was unavailable.