Had some problems this morning when I woke up – prematurely, due to my daughter’s alarm. I felt sick & immediately knew what was wrong. This has happened before, but not for a long, long time because I’m pretty careful about this, but just as I was falling asleep last night I remember thinking that I hadn’t drank enough water with the final pills that I was taking, namely a time-released calcium channel blocker. This may not seem like a big deal, but when the other pill that I took was a diuretic, this could mean problems.

So here’s the thing: the calcium channel blocker lowers the blood pressure while it makes the heart beat evenly & more slowly. The diuretic removes excess water from my system, so I become rather “dried out.” This makes the effects of the CCB all the stronger & I feel sick. Specifically, I felt nauseous, chills, shaky, & like I was going to faint. Every heartbeat was like pulsating tiny little explosions in my blood. OK, it’s hard to describe, but it feels just awful, plus it’s scary. I didn’t dare take my BP at the time. I did, later in the morning after I had drank a lot of water & ate some crackers & it was 112/57 then. Then about 5 hours later it was at 127/67 (P72) & I was feeling much better. But my ability to sleep had been shot. I catnapped throughout the morning & was left feeling weak & washed out.

I have been taking 2 doses of my diuretic each day – 20mg during the day at some point (usually late afternoon) & then 40mg at night before bedtime to really help my kidneys rid my body of the excess water. But now I realize that I was setting myself up for this to happen if I didn’t take care to have enough fluids in me. It was probably be a lot smarter for me to take my big dose during the day, but that’s not always practical. For one, it helps your body a lot if you can put your feet up for a half hour or so when you take it so the blood isn’t fighting gravity to get up from your legs & feet to your heart & kidneys. Also, it’s not always handy for me to have to find a bathroom & pee my little heart out during the late afternoon/evening hours. These pills have a 6-hour window in which they work. So I was putting it off until night when I was naturally reclining & asleep. Sure, you’re probably thinking, but then you have to get up in the middle of the night & go pee. Well, yeah. But I haven’t had a continuous night’s sleep anyway since before my kids were born & my baby’s now 21! So I’m going to get up to pee anyway.

Another issue occurred to me as I was lying in my bed this morning. I have Thalassemia Minor – Mediterranean anemia - & therefore my blood has a decreased capacity to carry O2 in my blood because my iron level is so low & the red blood cells are misshaped. Add to this problem the problem with my lungs – they’re restricted & obstructed by my body make-up & asthma – so I don’t take in enough O2 to begin with. (I still believe this is part of the reason that I needed supplemental O2.) It all seemed so clear to me, in the early morning hours. It all seemed to come together in my mind. The meds I take both help & hurt me at the same time. What I mean by that is that they do what they’re supposed to, but they also carry some nasty side effects that can make me miserable. The CCB & the diuretic are necessary to help lighten the load on my heart in which my left ventricle is struggling to relax & allow more blood to pump. But if the meds dehydrate me too much & the CCB’s effects are amplified because of my low fluid levels & slow my heartbeat down too much, this could be disastrous. So I must walk a narrow path, once again, health-wise & be vigilant with my meds. Just like every heart patient. Just another thing to worry about. The ticking time bomb in our chests. Hell, yeah, it scares me.

BTW, I have asked my cardiologist to consider lowering my CCB dosage several times, but she doesn’t seem to want to budge on this issue. To begin with, I was taking 300mg a day, now I’m at 180mg. I’d like to go down to 120mg, but I do notice my BPs creeping up in the afternoons & evenings. But in the morning, they’re all at 110/60 or lower even. She says that’s just fine & not too low. So be it. I trust this woman a lot & put myself in her hands when it comes to cardiology. She’s also been very supportive of my use of vitamins & supplements, something most other doctors just sneer at still. But they’re coming around, as I’ve written about here previously.

So I think I’ll change my meds schedule so that I take the large dose during the day & the smaller one at night. As for the CCB: more water, of course. I don’t want a repeat of this morning. As I sit here I feel weak & washed-out. I need sleep & rest badly. I’m going to take it easy today & see if I can’t get some.