More questions on Toprol XL and BP & P

[dancingheart]

Hello all again, Caught in a middle of a doctor's argument and want out!  Getting a new PCP and cardiologist and starting over. One says I have heart rhythm problems, one labels it anxiety, and all fight over which medications will or won't work... and now my providers are not talking to each other because of their disagreements... all to my expense... causing me more anxiety and more heart related issues.

  As many of you know I have a tough resistant tachycardia (99-150's bpm depending on what I am doing) and high BP (150's/100's) that doesn't like to stay down in the morning, but it generally in the normal ranges after 4:00 pm in the afternoon BUT then I am Bradycardic (low 50's sometimes 40's) and have extremely low BP (99/56) in evening and early night (6:00pm- around 7:00 am) with breakthrough episodes of Supraventricular Tachychardia while sleeping.  All these readings are BEFORE I take the 50 mg of Toprol XL in morning at 9:00 am and the same 50 mg at bed time 9:00 pm.  A riddle in of itself!!!

  I have approached my doctor's about this.  One says that it is okay to still take my Toprol XL 50 mg. even though my BP is 99/56 and my pulse is 58.  Another says that if I don't I will have breakthrough SVT's that are even tough for ER to get down sometimes (though it is not deadly so they say!).  Who's right and who's wrong!!!  I wake up at about 2:00 in the morning half dead, dizzy if I raise my head off my pillow (of which I sleep on a wedge due to asthma) and unable to get up to the bathroom... I have resorted to using a bed pan.  I take my BP and P and it is sitting just a little lower than what it is before I took Toprol.  

  Now everyone, considering if you were in my shoes and doctor's won't seem to give me a time of day at the moment... what would all of you do?... break the tablet in half and take 25 mg in the evening and hope no SVT's and you could get up with your high heart rate in the morning? or to continue with the 50 mg and put up with this awful 2:00 am slump?

  I have an appointment  to see a new cardiologist on the 10th (15 days from now!) and a PCP (20 days from now!)  I am afraid I will die if I continue on the path I am on.  Not knowing what to do, or what will happen to me either way.  I called my old cardiologist...who is currently my cardio until the new guy and said he THOUGHT starting 120 mg of Verapamil in place of the 50 mg or Toprol would straighten things out...no explanations of why he thought this way...So do I listen to a guy who put down my PCP doctor so much?, or to my current PCP doctor who hates and doesn't trust this cardio?  I don't trust either now and I am afraid.

  PLEASE, OH PLEASE what would the rest of you do (crying :-( ).  Most ER's here won't do med changes, unless it is life threatening... do I need to let it get life threatening?  Any and all replies welcomed.  Thanks everyone for listening.

[dancingheart]

Thank you, Banglamom for such a quick reply.  No this is my unmedicated BP.  Last Toprol taken was a 9:00 am and this BP is taken BEFORE my bedtime dose of Toprol.  

I am taking Zoloft 100 mg. and Klonopam 2 1/2 mg. daily for my anxiety, from my psych. doctor I DO trust...lol.  He taks frely with everyone and thinks that it is unfair for me to be put through this.

I am trying not to worry.  Thanks again.

[banglamom]

It would be inappropriate for an ER to do med changes.

If your medicated bp is 99/56, it is ok to take the meds.  It is only that low because of the meds.  It likely won't go much lower.  Or.. try half and see where 25 mg takes you.  You body adjusts.  I never even had high blood pressure.  To take care of the rhythm problems, I was taking 300mg of metoprolol.  I was sure having pressure problems then, but not enough to kill me or anything.   At the time though, I was also on 200mg propranolol and diltiazim and lisinopril.  At this point, you are dealing with relatively low doses of fairly innocuous medications.

Be sure and stay SUPER hydrated to help deal with the side effects of the meds.  The closer it looks to water when you urinate, the less likely you are to have dehydration issues to compound the issue.

Rest assurred, it is rare for people to have these issues become life threatening.  Honestly, check into something to help with the anxiety as well.  Take this from a more relaxed perspecitve if you can.  Come here for answers and reassurance frequently.  It really will be ok.