Attenolol, wherefore art thou..?

I have been 5 days without attenolol (50 mg), a beta blocker, which I have taken since I was roughly 50, that is, 27+ years. It was prescribed to counter a couple experiences that I had at that age, which resulted in fibrillation. Both experiences involved pushing my body too hard. The first was a work out outcome--I both ran and lifted weights in the same session. A carotid massage by the physician on call at Budge Clinic at the time (Ed Redd), brought the HR down into normal territory.  The second, a year or two later, was an extended trumpet solo in a big band that put me back into fibrillation. This was during a performance of the second tune from the end of the concert (Take the A Train by Duke Ellington). I had a feeling (high) that all was not right, but finished the concert and then Jan and I drove leisurely to the hospital and hung around in the parking lot deciding whether I should go in. 45 min after the onset of the event, we went in and my HR was 245 bpm. The nurse doing the measurement mused that after that long in fibrillation, I should be dead. On that occasion the heart did not come down in the right rhythm. So I was hospitalized until such time as it did and then went to SLC for electrophysiology of the heart. The outcome there was not significant for any ablation, but they found out that attenolol would nicely limit my heart rate. Too late, I found out that I could have maintained my trumpet playing during this period, under the medication, but instead I took almost 2 decades off. Bummer!

Which brings us to today, the fifth attenolol free day. But first, a digression. When we were invited to Mexico by good friends a number of years ago, I decided I would like to try snorkeling. I never really did this in earlier days, but during my 40s, I was swimming 3 miles per week, in 1-mile workouts. (This probably saved my fibrillating heart!). I did this workout faithfully for 12 years from age 39 to age 51. In anticipation of the Mexico event, I got back in the pool. Granted, a large number of years had passed since I was a regular swimmer, but in a lap and a half, I was totally out-of-breath. So out-of-breath in fact that I had to grab onto the lane rope. It was like a huge stop was placed on my heart. This was the most noticeable time when I think the attenolol was at work. It stopped the planned snorkeling in its nascent tracks. (It is also possible, in retrospect, that I was already down to the 44% lung capacity caused by my recently-discovered, lamed-assed left diaphragm muscle.)

Oh yes, the anecdotal effects of being attenolol free.

1. Two cups of tea in the morning with breakfast has been a part of my morning for many years. Real tea. No camomille. This past five days, this amount of tea has made me so high and jittery, it is unbelievable. So I cut back to one cup. More tolerable, but still high. In fact, when I began typing this post, I was quite high. A minute or so ago, I felt myself finally coming down some, and immediately experienced some pre-syncope--almost fainting--light headedness.   I still feel somewhat high.

2. Increased variability in heart functions. My heart rate after just walking from one room to the other now is in the 90s. Prior to this during a workout on the exercycle, it would take me 10 min to get my HR to 100 and to keep it there. In fact the first day without the attenolol it seemed to me that my HR was almost always at >90 bpm whenever I measured it (a lot!). By the second day I was beginning to see some returns to resting rates = for me, low 60s. Perhaps there was an anxiety component, I don't know. 

The hour before rising this morning after nearly 10 hours of sleep, I dozed in bed in that relaxation state of well being in which respiration is slow and deep. I was in it for quite a while, it seemed. When I got to the breakfast table, I immediately took a bp reading. Nasty surprise: it was 155/95! I have never had such a high reading that I can recall. But we all know that bp is amazingly variable, so after breakfast and all the normal activity that goes with it, I repeated the test. BP now at 110/66 = fantastic! So normal variability? I don't know. I am guessing that the attenolol would have prevented the high reading. 

So, in part, what the docs want to see appears to be happening. My heart is beating faster. Still don't know whether this will result in less ventricular pausing as well. 

The sleep cycle difficulties appear to be on the wane. I have a new CPAP machine and perhaps that has something to do with it. But also, I am remarkably free of nasal congestion right now. Not taking any Nasonex. Perhaps it is a low season for allergens. In any case, without a nap yesterday, I was dead in the water by 7:30 last night and turned the light off at 7:45 with the Utah Jazz behind by 9. I awakened at 5:40 for 9:55 hrs of sleep. I think I arose just once during the night. This makes a cumulative third or fourth night of successful sleep. Yet right now I am still tired. Also, no melatonin helper on the front end.

Still to come: I am back on the Holter monitor for 24 hrs commencing Friday am. So in the absence of readouts Saturday won't know more about current heart function until early next week.

Until then..