My Father is Not the Same Since the Hospital (Advice Needed).

Miscellaneous and Personal Stuff I Must Share
1

Last week, my father felt a little weak. So he went to the doctor at my insistence Aug. 15th. (My father is already being treated for “Afib”.) The doctor said his heart rate was too fast and told me to take him straight to the hospital, which I did. They gave him drugs to slow his heart rate, then released him a couple of days later on the 18th. When they released him, they gave him a glowing bill of health. His heart rate and blood pressure were perfect, they assured me. Never better.

The only thing is my father is definitely not the same! He feels even weaker. His once strong loud voice is weak and quiet. He drove himself to the doctor’s office on the 15th. Now he is unable to drive a car at all. He no longer has an interest in the things he once did. He no longer laughs and jokes around like he once did. And he told me today he has problems concentrating he didn’t have (too much) before. The doctors claim this is all because he was laying around alot in the hospital. But there is clearly more to it than that. What on earth did they do to him in that hospital??!!

FWIW, the new medicine my father is taking is Lopressor a/k/a Metoprolol, a beta blocker. I looked it up in a book, and I guess confusion is one possible side effect.

I am not asking for a diagnosis here (although any medical experiences will be welcomed). I just want general advice on what to do. He is seeing the doctor tomorrow. What should I tell and ask the doctor?

BTW, my father is signed up for 2 months of home health rehabilitation services which are supposed to help him with this. Also, my father is scheduled to see a neurologist next month, which is also coincidentally what the regular doctor suggested if we don’t like her prognosis.

My father is now an elderly man (he had me a little later in life). But I love him very much and hope he is still going to be with me for a long time to come.

Thank you all in advance for your help and advice :slight_smile:

2

Question: what is he taking for the A-fib?
Metoprolol side effects:

Ask your dad if he’s had any of these other symptoms, too. “Tough guys”, for fear of seeming wusses, are often reluctant to volunteer the information that their nose seems awful runny, or that they’ve got this weird itching, or that their hands and feet are cold all the time now.

I also found this other version, which notes:

He’s over 60, right?

The short version also says:

Fatigue and weakness could lead to him not feeling able to drive a car. I see “depression”. I see “sleeping badly, having strange bad dreams”. And of course, “confusion” and “memory loss”.

All in all, it sounds like it’s probably his meds.

What should you say to the doctor?

Say, “My father isn’t doing well,” and enumerate his symptoms. Make a specific list beforehand so you won’t feel buffaloed once you’re actually in the August Presence itself.

Then I’d nail down exactly what the rationale was for putting him on beta blockers, I’d point out the side effects, I’d persist until I got some actual answers, bearing in mind that my dad didn’t have anybody else but me to go to bat for him, I’d refuse to be intimidated, and and…Jim, if during the proceedings the doctor said anything along the lines of sneering at my “Internet research”–then I’d thank him politely for his time and get my dad the hell out of there, and get him another doctor. A good doctor won’t have any problem at all with “Internet research”, but an insecure, bad doctor is very threatened by it.

I dislike the implication that the doctor has said, “Well, if you don’t like my diagnosis, feel free to go waste your time with this neurologist over here.” It’s up to this doctor, here, to figure out what’s wrong with your dad, not to fob you off on some other doctor, who will have to go in starting from scratch at Square One.

I have a bad feeling about this. Maybe it’s just that I have a nasty suspicious mind. Or maybe because this…

…is just flat-out eyerolling stupid.

Let us know how it goes.

I once escorted my mother to her doctor a few years ago in order to get some words-of-one-syllable answers out of her, my mother being totally intimidated, and it was quite instructive. The doctor was not prepared for an alert middle-aged daughter armed with a Merck manual and a sheaf of Googled printouts, and was surprised into giving out some actual information. :smiley:

3

I don’t know what specifically he is taking for the A-fib, but he does take alot of heart medicines: Digoxin, Verapamil, and Warfarin (to avoid blood clots).

I will post any new developments as they happen.

4

You may be looking at drug interactions then.

I know one way to find out whether all these medications are interacting: go down to Walgreens, to the pharmacy, to the “Patient Consultation” window, and ask the pharmacist to put these all into the computer–the software will give a popup warning of potentially dangerous interactions.

5

The doctor needs to look at medication changes. It may be a physical change that has occurred, but it sounds like a medication problem. He may need a dosage adjustment or a different medicine. Rarely does medicine have no bad effects.

6

Verapamil is for atrial fibrillation.
Digoxin makes the heart beat stronger.

7

Definitely go to your Dad’s MD and state the symptoms clearly without any vague words.
The docs will often try and chalk up the symptoms to the recent hospitalization but make it known that these symptoms are new and not normal.

If it’s not medication related it could really be a host of other things and it sounds like your Dad may need some further outpt. tests done. Good luck.

8

Jim B. - My mother’s been in atrial fib for quite some time now. Four times they’ve “reboot” her heart (cardiovart?) in an attempt to get the rhythm corrected, but she keeps bouncing back into afib.They’ve installed a pacemaker and had her on meds, and now they want to go in and do an ablation, where they will cauterize the nerve that signals the lower chamber of the heart to beat. That effectively kills the nerve and the pacemaker will be responsible for tell her heart what to do. The meds (and I don’t know what they are - sorry) have made my mother very weak. She sleeps a lot and can barely walk.

If your father’s doctor isn’t a good fit, find another one. It took a team of surgeons and cardiologist to decide what they thought was best for my mother, and they presented the options to her.

Good luck to your father and the rest of the family. It’s very hard to see a parent’s health failing.

StG

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What Duck Duck Goose said. Go back and read her posts a couple more times.

I’ve had more than my share of dealing with doctors as an advocate for family members. Don’t let them intimidate you, push until you get answers, and if you just get snotty obnoxiousness then find a new doc.

It does sound like probably either a side-effect of the new meds, a dosage issue, or a drug interaction. Pharmacists are founts of information about drug side effects and interactions. Befriend your pharmacist.

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I’ve had two family members on beta blockers complain that they couldn’t work because they were too slowed down. They couldn’t think well or move quickly. One could barely get to the mailbox. So yes, make a list of symptoms and talk with him and his doctor about fixes.

11

I’ve had some severe A-fib bouts in the last year (some lasting more than 19 hours) and was on a bunch of different meds, most of which had really bad side effects. I had a pacemaker put in about a year ago, and they had me on a mild dose (25mg of Toprol, a beta-blocker). A while back they decided I needed to take more, so doubled the dose.

Within a few days I began to have the same symptoms you describe, tired, weak, listless, etc. I looked it up and found the side effects, as others have noted.

Also, I found that it slows the heart rate (which I don’t need as with all the exercise I do, have a very low resting heart rate), and also lowers the blood pressure. As my BP has always been low, the last thing I needed was to get it lower. One reading was 92/55. So, I stopped the stuff all together for a few days, then went back to my regular dose, and now feel fine.

Doctors has a propensity to just prescribe more and more meds without ever paying attention to what you are already taking.

I’d follow the advice given above and get your dad to a good family physician quickly. Take all the meds he has now with you, and have him checked out.

I hope he gets better soon!

12

The other thing to consider is mild depression. Heart problems make people scared, face their own mortality, etc.

My dad (a healthy and active 66 year old) just had quadruple by-pass surgery a month ago. He’s healing physically its the other stuff thats taking a while. Especially the helplessness stuff, having mom drive him around, etc.

So although drug interactions, and other things are certainly worth noting, consider he might be really down from all the things going on.

13

Digoxin is a cardiac glycoside and it is used as an anti-arrythmic as it can slow the heart rate in AF.
It has side effects including (but not exclusive to): fatigue, drowsiness, delirium, hallucinations, depression.

Verapamil is a calcium channel blocker and has side effects that include, but are not limited to: fatigue, dizziness, myalgia, arthralgia, hypotension.

Beta-blockers have been discussed.

The three classes of drugs potentiate each other’s effects, and co-administration of Verapamil and beta blockers is very, very rarely advised ( so it is likely that your father’s physicians have an extremely good reason for giving him all of these meds).

Not to upset you unduly, but A. fib is a risk factor for strokes and mini-strokes, and while your father has few physical signs of a stroke, he could have some cognitive impairment secondary to one (the memory/concentration/motivation problems).

Depression is common in people who have strokes or mini strokes and it is also common in people who have serious illness or inpatient hospital treatment.

14

You can get a little home blood-pressure cuff that operates on batteries at the push of a button, if you suspect it’s low BP.

15

Jim B.

Your Dad is his own best judge of how he feels. He shouldn’t ignore those feelings and if he doesn’t feel comfortable in pushing **HARD **for answers then see if he will accept your help. The drugs he’s taking are absolute lifesavers. But they are also enormously powerful and the perfect dose for him may be more or less than the average dose contains. Most Dr’s will work with you. If by any chance his Dr acts like a little tin god - as a few do - move on to another. And also be prepared for the eventuality that the change is permanent if his heart is to be kept beating.

Good luck

16

Thank you all who replied. You replies have been very helpful to me. I really appreciate it :slight_smile: . And now, as you requested…

UPDATE. Well, we went to the doctor today. And she seemed very nice and sympathetic, if that means anything. She did bring up the issue of a possible mini-stroke, also brought up on these boards, which I hadn’t considered, seriously at least. She also agreed the Metoprolol might be responsible and said we will careful explore all the possibilities too. She also ordered a Cat Scan for my father to see if there is any problem in his brain. As I left, I asked her if she still stood by her assertion in the hospital that my father would be back to normal in a couple of weeks. She said don’t take that too literally. She also said as some of you have said, the change might be permanent. But “remain hopeful”, she told me. Also, I carefully typed out all of my father’s symptoms to-date, and gave the list to her, which I think was helpful.

Well, that is where I stand now, still worried sick, but still hanging on as best as I can :slight_smile: .

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Well, you’ve done all you can, so go you. :slight_smile:

At least the doctor didn’t openly scoff at all your input, which is promising.

18

And check his blood pressure. I have seen people feel really unwell when they have had heart medications. Occasionally they have felt more energetic after wearing pressure socks (TED hose and the like. They encourage the blood to not pool in the feet) Does he wear pressure socks? Does his physcian think they would be safe and appropriate for him?

19

Jim B., hang in there. Keep after them until you get a resolution (or at least a solid answer).

My mom probably had a small stroke a couple years ago. (Without getting too involved, the situation was complicated by other factors and by the time we started checking for stroke, it was too late to know for sure.)

It took quite a while for her to get back to feeling well, but she’s now at about 99% of where she was originally. (She still has a few problems swallowing some things.)

Don’t lose heart even if they think it was a stroke, just start checking into therapy and rehab options. Therapy/rehab treatment can make huge differences in the final outcome.

20

I suppose another possibility could be related to the A-fib and tachycardia itself. I spent a couple of weeks in A-fib several years ago, and remember feeling tired, tachy, light headed, and a little spacy. For me, it was temporary; I was already on Warfarin, Dig and a beta blocker, so they loaded me up on a fairly high dose of a drug that was intended to impede the A-V node. The effect was similar to an ablation like StGermain mentioned, only temporary. I was scheduled for a cardioversion in a week, but the day of the appointment, I spontaneously converted back to normal sinus. Apparently threats do work.

I had similar experiences of being light headed, mentally exhausted, and a little spacy after each of the open heart surgeries I’ve had, and in each case it was attributed to the bypass. I’ve heard it called “pump head;” since they used hypothermia as well on me, I called it freezer burn, which tended to get a rise out of the neurologist and anesthesiologist.

My point is, this sort of thing could just be the after-effect of temporary changes in blood flow to the brain, and could go away. Doesn’t mean you should stop looking for other causes, but also hope that it’s something that could resolve itself. Even when you’re continuing to look for something really serious, that hope can make a huge impact on the patient’s outlook. Sometimes just believing that “this, too, shall pass” can help make it happen.