I’m new to Forum and struggling with my condition….

Hi,

I’m new to this forum and struggling with my diagnosed Paroxysmal Afib. I’m mid fifties female in the UK. You all seem so lovely on here that any words of encouragement would be very helpful at this tough time. I went undiagnosed for probably about 10 years with on and off palpitation episodes that self resolved within a few hours. It started once a year or so and then progressed to once every few months. Never managed to catch anything on a 24 hr ECG. During the summer: this year, I had a bit of a breakdown, of which I’m still suffering with and experienced huge anxiety. It started with severe health anxiety, but seems to have morphed into major anxiety It started with a few things, but covid certainly hasn’t helped. The palpitations came every month, until in September, I went to A&E during an episode and they diagnosed paroxysmal Afib. They reverted me back to SR after 6 hours as my BP was so low, with Bisoprolol and then packed me off with a prescription for 2.5mg daily.

My episodes used to always be in the evening, usually after food between 8-9 or sometimes a bit later. At one time, they always happened on a Saturday night, usually after a big meal and some prosecco. I read somewhere that this is probably my vagal nerve being stimulated. I could go many times, with a heavy meal prosecco on a Saturday night with no attacks.

Since the summer I’ve had no alcohol and no caffeine as I’m scared now, but it’s probably the best for this condition.

I have struggled with Bisoprolol, in that it makes me feel tired during the day, yet my sleep is awful and I wake every 2 hours or so, every night. I also experience bad tinnitus, muscle twitches and hair thinning My heart rate regularly goes to 55 bpm. I’ve been seen by a Cardiologist and had a weekly ECG, echocardiogram etc and they said my heart is structurally ‘fine’, no disease. My CHADS score thingy is 0. As I was struggling with Bisoprolol in October, I said I wanted to try and stop taking it. They said I could take the ‘pill in the pocket’ approach, using Flecainide and was given a prescription. The cardiologist told me what to do etc,

I weaned off bisop for 2 weeks. As soon as it was completely out of my system, my anxiety went through the roof and my usually normal BP and HR went much higher than usual. I was a wreck for the whole time. That first evening off it, unsurprisingly I went into Afib. It happened not after my meal, but at the point I went to bed and lay down for the first time. I took propanolol (which the cardiologist said acted quickly) then 150 mg flec, waited half hour and took another 150 mg flec. The Afib subsided in 2 hours, but I was a wreck, it was 1.30 am by this time. The propanolol made my feet like ice, so my GP told me never to take it again. After that episode, I tried atenolol the day after my attack, but it made my tinnitus much worse straight away. I resorted back to Bisoprolol daily on 2.5 mg for fear of another attack and have ‘suffered’ since. I hated taking the Flecainide too and at such a high dose.

I’ve tried 4 different SSRI anti depressants and seem to get all the rare side effects, including severe bleeding from gums and reduced heart rate. So I’ve had to stop each one.

I’ve told my cardiac unit that I don’t want to try any other medication, as I already take carbamazepine which I’ve taken for 25 years and it interacts with so many of them, plus I’m scared of the side effects. They seem to despair of me and said I need to get my anxiety controlled first. So this month, I’ve decided I want to stop the bisop again. I’m going to try and do it much more gradually over 5 or 6 weeks. I’m not in a good place mentally, I cry every day about this and I am scared of the future and often feel my life is already over. I have asked the cardiac unit if I can have an ablation as I see this is the only way out for me. The cardiac specialist nurse, who I talk to said there is a six month waiting list and told me they don’t always work first time, which I know, but I’ll take my chance. I have no idea when or if I will be referred, but they said they will talk to my cardiologist. I’m disappointed with the support I have got from my hospital as everything I try and contact them, I hear nothing. My GP never has a clue….they try and help but are not experts in this. All they seem to try and say is ‘pull myself together’ but it’s hard and not as easy as that of course.

I’m the meantime, I know that when I get my next episode I have to deal with it, if I’m not on Bisoprolol- and tgat means taking the Flecainide again.

Has anyone else felt like I do? How did you go forward, if you have?

I’ve upset my husband and son so much with all this….it’s been an awful 6 months. I’m planning on taking magnesium taurate, which I’ve read on many, many sites and forums can help….and will start that this week as I feel I must be deficient. I have this dream that I may even stop imy episodes with the magnesium and I’ll live happily ever after…..My potassium levels are fine, but my folate is low, but not deficient but I’m going to raise that too. I take daily vitamins B12 and Vit C since the summer and my levels of B12 have raised sufficiently since then. My bloods are all fairly stable. I’m still thinking there must be an unbalance somewhere and hoping it’s the magnesium. I’m also going to take a rhodiola rose supplement for the next couple of months for my high anxiety to try and help with weaning off the Bisoprolol.

I’m also starting therapy with a CBT therapist tomorrow, but I don’t think she appreciates the problems with Afib.

I just feel so, so low and so frightened. I feel there is no future for me that looks bright, in any way. I feel I’m on my own having to deal with this. I am so sad.

Any words of encouragement or advice greatly appreciated.

Thankyou for reading this far!

Tweez.

Quote
Tweez
I took propranolol (which the cardiologist said acted quickly) then 150 mg flec, waited half hour and took another 150 mg flec. The Afib subsided in 2 hours, but I was a wreck, it was 1.30 am by this time.

HI Tweez,

I don't have a lot of thoughts, but did want to point out that the max dose of flecainide is 300g/day for those weighing over 70kg/154#'s and 200g/day for those weighing less. I presume the docs prescribed the 2x150 for you, but wanted to point this out in case you weigh less than 70kg. One of our members was prescribed 300 and she only weighed in the mid 120's. She got a severe case of flecainide toxicity which has negatively impacted her afib situation going forward.

On magnesium, stress does deplete magnesium, so magnesium may be beneficial for you. Taking some B6 (suggest the Pyridoxal-5-Phosphate or P5P form) along with the magnesium will help your body use the magnesium.

Breathing can help with anxiety. A Type 1 diabetic found that slow breathing helped his blood sugar control. He's a scientist so has spent a lot of time studying research on breathing in general and slow breathing specifically. Here is search of his site on anxiety.

A starting point is here.

Best,

George

Hi George,

Thankyou so much for coming back to me so quickly. I weigh approx 71kg right now ( I’m 5 ft 8) but I have lost weight over past few months too. To be honest, I did wonder about taking such a high dose in a 1 hr period. It was definitely what he prescribed for me and I also have it in writing.

He did also say that 400 mg was the total I could take in a day, but I haven’t read that anywhere and I’ve read it’s 300mg.

I didn’t feel that great after taking it. If I had another attack, I will take 100 mg and then another 100 mg. The tabs I had were all 100 mags and I had to cut them. The cardiologist said it was fine to do that, but I read on line it wasn’t. I won’t take it again at such a large dose so quickly on one occasion. Thankyou so much for letting me know.

Thankyou for the links Too George, I really appreciate it and will look into my breathing.

Thankyou,

Tweez

George, how much B6 do you recommend?

Thanks

Sam

Quote
Tweez
Thank you so much for coming back to me so quickly. I weigh approx 71kg right now ( I’m 5 ft 8) but I have lost weight over past few months too. To be honest, I did wonder about taking such a high dose in a 1 hr period. It was definitely what he prescribed for me and I also have it in writing.

He did also say that 400 mg was the total I could take in a day, but I haven’t read that anywhere and I’ve read it’s 300mg.

Yes, cutting is fine, as long as they aren't timed release. Yes, 400 mg is listed as the max in a day for other rhythm issues, and usually is listed as 300 mg for afib. However taking it all at once versus say 150 or 200 twice a day is different. Though we don't know what the half life of flec is in you, it is considered to be between 12 and 27 hours. If you assumed 12 hours, then if you took 150 and then 12 hours later, there would be the equivalent of 75 in your blood & you took another 150, then you have 225 equivalent in your blood, not 300. Of course if your half life were longer, this would lead to higher doses. In the original 2004 study used to justify giving a large or loading dose of flec to convert an afib episode, this is what they said, "The dose of flecainide was 300 mg if the patient weighed 70 kg or more and was 200 mg otherwise;" Many docs will prescribe a beta blocker on demand (like the Bisoprolol ) in advance of the flec. This can help reduce the probability of adverse events, like high rate atrial flutter. If you know when you are in afib, and you don't have high blood pressure, then you likely don't need to be on the Bisoprolol all the time. Warning, I am not a doctor, just throwing out ideas to discuss with your medical team. Also, many docs will have someone take say 100 mg of flec and then wait a few hours to see if they convert on that dosage. If they don't then take another 100.

Quote
Sam
George, how much B6 do you recommend?

Sam, a consultant recommended I take 150 mg/day or alternate 100mg one day and 200 the next as my capsules are 100 mg.

Tweez- I converted your 71kg to pounds and it’s 156…pretty close to the 154 limit of a maximum of 200mg flecainide in a 24 hour period. It’s probably ok but it could depend on your kidneys and liver are functioning well to process out the dose. But you said you lost weight—so 200mg is your limit in a 24 hour period. However if you gain weigh more than 69.85 kg then 300mg of flecainide in a 24 hour period is the limit—never 400kg.

Read this tread on toxicity. I’m the member George referenced. I weighed 121 pounds and was told to take 300mg a day. I ended up with a flecainide overdose and spent 3 days in the intensive care unit fighting for my life.

[www.afibbers.org]

Thanks George,

I’ve lots to think about. I won’t take 300 mg again, I wasn’t happy taking that amount and I panicked a lot the next day, wondering if I’d go into Afib again and what I’d do if I did.

Thankyou for all your help and consideration again,

Tweez.

Hi Susan,

Thankyou - and I’m sorry to hear about the issues you had with Flec and I hope you are fully recovered now, it sounds like you had an awful time.
I have read your link, Thankyou for that and it provided an insight into flec and dosages and I can see that it’s never been clear. When I sat with my cardiologist for the first time, he was quite vague about the pill in the pocket approach and I asked him to write it down as I thought I’d never remember what to do and when. He seemed to advise it all ‘off the cuff’ to me and not based on anything tried and tested. It’s how I felt anyway. He knew I wasn’t happy on the bisop and at that time, I was weaning off, so he prescribed the propanolol to try instead at a lower dose, but as I say, that caused my feet to literally turn to ice and that was a very low dose.

I’m just so scared, I Google too much too ( need to try and stop that). I know that coming off bisop isn’t going to be easy for me, as I’m so anxious.
I just want my life back.

I notice you had an ablation….I hope it was successful?

Thankyou,
Tweez

Hi George,
I meant to say too, yes about the Bisoprolol…I really wish I’d never started taking it every day, when I was prescribed it by A&E that first time. I told them I never got many episodes. I asked the Dr at A&E if I needed to take it every day. He shrugged and said ‘see how you feel” yet on the prescription it said to take every day and do not stop unless you talk to your Doctor. I asked my GP who was equally as confused and said I needed to take it every day, which is why I’m in the position I am now.

I am going to wean off my 2.5 mg of bisop very slowly and aiming to do it over a 5/6 week period if I can, to minimise the rebound effects I had before.
I know I’ll panic if I go into Afib again though sadly.

Regards,

Tweez

I meant to add too…I do take anti convulsant med - carbamazepine, which they all know about at the hospital. I know there’s an interaction there but they didn’t seem to think there was a problem, though I am wary of the flec because of it.
I will try 100 mg next time and wait an hour to see if I convert. I have a Apple Watch with heart rate monitor which helps….though it can be a bad thing at times as I can look at it too much.,,,

Thankyou,

Tweez

Hi, Tweez. I've no advice for you, but I wish you soon find some peace of mind, you seem to suffer a lot from stress, which is always a bad situation.
Unless they're afibbers themselves, doctors can't often imagine how bad we may feel. They say we have a healthy heart, and assure us that afib isn't life threatening by itself. They're right but they don't know how our afib, their meds or both are able to rot our life. Some would even say "live with it".
Afib is like a pinball in our chest. It's bouncing like crazy. We don't want the machine displaying "game over". We don't want to take those drugs any more.
I hope you'll find here the help you need. There are marvellous people in this community.

Quote
Tweez
I meant to add too…I do take anti convulsant med - carbamazepine, which they all know about at the hospital. I know there’s an interaction there but they didn’t seem to think there was a problem, though I am wary of the flec because of it.
I will try 100 mg next time and wait an hour to see if I convert. I have a Apple Watch with heart rate monitor which helps….though it can be a bad thing at times as I can look at it too much.,,,

Thankyou,

Tweez

Can you space carbamazepine with your other drugs to give time for your liver enzymes to process? Otherwise it could act as an inhibitor and remain longer in your system (act stronger). I used to faint almost weekly after talking Prilosec and flecainide together. I had tests done-tilt table- and it turned out if I spaced 3 hours, my fainting would stop.

Hi there, I’m from South Wales, diagnosed at 40 and had ablation 5 years ago, I too struggled with anxiety over it and had a spell on citalopram, you’ll get great advice here off people who know more than most dr’s…… but I’d start with getting an appt with a good EP, I went to Prof Sabine Ernst in Royal Brompton London, she was amazing, in meantime any questions just message👍🏻👍🏻👍🏻



Edited 1 time(s). Last edit at 01/03/2022 06:12PM by Juggsy75.

My 2 cents: off the top i was encouraged that you looked at ablation. 6 months is fairly far out. Were i you as its not that far id look into going to Bordeaux FR. Elite reputation. My guess is you could be a one and done. The earlier its ablated the better. Most of us get the anxiety! Some here have stories that will raise the hair on your neck. Ive got a few too. The great thing about afib is that its not a death sentence by any means not close. I use 20/20 propananol myself. Has helped calm me and slow HR a tad. So best to you making a plan. True the horrible virus wrecks things but you ll be ok.
Tom

Quote
Tweez
During the summer: this year, I had a bit of a breakdown, of which I’m still suffering with and experienced huge anxiety. It started with severe health anxiety, but seems to have morphed into major anxiety .

More on anxiety and breathing.

This PDF book by Irish breathing instructor, Patrick McKeown, addresses it somewhat. This is an mp3 download breathing exercise by Patrick. This book (Kindle version available) by Patrick addresses it specifically.

This is Patrick's encyclopedia of breathing and health.- "The Breathing Cure" (Kindle version available).



Edited 1 time(s). Last edit at 01/04/2022 08:25AM by GeorgeN.

Thankyou Ponpom,

I do appreciate you replying and yes, stress is the worst thing for me since this Summer especially. Everything you describe is so true. My GP even said to me last week, I could be a lot worse off and basically pull myself together. My cardiac consultant did say to me ‘ it won’t kill you’ when he saw how worried I am. Sounds like they all do that

Thankyou,

Tweez

Hi Susan,

Thankyou for coming back. I space my carbamazepine about an hour to 1.5 hrs before I take my Bisoprolol, but as I take both in the morning, one before and I after breakfast, I’m not sure how I could leave 3 hrs….,y pharmacist said I could take the Bisoprolol first, then the carbamazepine, but I’m too scared to mess around with the timings, as it would mean I start taking my Bisoprolol much earlier than I do now. I could try and do it in stages, but 3 hours is quite a major change in the mornings. I take tegratol ( carbamazepine) twice a day and it’s a slow release tablet…. But I will think about it definitely. I already have to space vitamins out with it as it affects the tegratol and how I feel.

I also will struggle with blood thinners with carbamazepine, which worries me greatly. Another reason I want to have an ablation and hopefully only be on them a short time. The only blood thinner I can take is warfari, from what I have discovered and what the hospital gave told me. I am too young now to take them at the moment as I am also low risk, but I won’t be in the future but I do worry about the future. I’ve been told they may have come up with a blood thinner I can take safely by then, but who knows. They may even have found a cure by then, you never know.
Thankyou,
Tweez



Edited 2 time(s). Last edit at 01/04/2022 01:02PM by Tweez.

Hi Jugsy,
Thankyou.
Citalopram is the only anti depressant I haven’t tried….it’s good to hear you were ok on it.
Please can I ask what an EP is? I’d see this a lot and just don’t know what it means I’m under our local hospital and although I’m not impressed by the time things take or the lack of support, I’m not sure how I can switch from the help I’ve been given so far under the NHS? I did look at private but we would not be able to afford it, especially if it needed to be redone. There doesn’t seem to be any private hospitals that do heart surgery near me.

Did you go to the Royal Brompton under the NHS? Were you sent their by your own hospital?
I just feel I have to go with what I’m told under the NHS and have no choices. Though I have been chasing my ablation referral and the latest I’m told is that my cardiac consultant will call me, but I don’t know when. I feel that time is ticking by, especially if I need to wait 6 months for one, once I’m put forward.
I did intend to ask him, if I ever speak to him, how I can get one quicker.

As I’m paroxysmal and the episodes were becoming more frequent before the bisop, I know time is of the essence.

Thankyou,

Tweez



Edited 2 time(s). Last edit at 01/04/2022 01:21PM by Tweez.

Hi Poppino,

Thankyou for coming back. Yes, 6 months seems a long wait and being a pessimist in all this, I bet it’s longer. I’d have one next week if I could.
I’m not sure how I’d even be able to go to France and as I said to Jugsy, under the NHS I feel I have no choices and the cost of going to France, or even trying to sort out how and when would be beyond me I’m afraid, but it is a lovely idea. Also, if I had issues afterwards, I’m not sure what support I’d get from the NHS?

Thankyou and yes, the anxiety is the worst thing at the moment. I really wish I could have taken the propanolol as apart from the icy feet, it made me feel quite calm

Thankyou,

Tweez.

Thankyou George,

I really do appreciate your help and the breathing exercises will certainly help me, especially when I go through the tough times of getting off the bisop, which I am dreading.
I have a kindle, so I’ll definitely be checking that.

Thankyou so much,

Tweez

Quote
Poppino
I really wish I could have taken the propanolol as apart from the icy feet, it made me feel quite calm

Tom, you haven’t experienced icy feet until you try my high dose of sotalol. Wool socks, fleece leggings tights and Uggs in a heated room are not enough. Idk, I prefer being too cold than too hot.

Hi Susan ( I know you were writing to Tom though),

My Gp took me off the propanolol when I told him it made my feet go like ice….did he do the right thing? They were literally like blocks of ice, I’ve never experienced anything like it I took a really low dose too…I think it was either 10mg or 20mg I can’t remember. I was only told to take it as I was off the BIsop and I needed it as a PIP to go with the flec at the time.

I did wear two pairs of bed socks tgat night, but it didn’t work to relieve the feet.

Like Tom though, it did make me feel calm

Tweez

The best way to describe an EP is that if you think of the heart as a house, cardiologists are the plumbers sorting out the plumbing, an Electrophisiologist or EP is the electrician sorting the wayward electrics out, as afib is an electrical issue with the heart these are the people who know the most,

Hi Jugsy,

Thankyou for explaining it to me. I understand now. Unfortunately in the UK under the NHS, I don’t think I will get to choose the EP who does the ablation. We have to go with whoever is assigned. I am under a good local hospital. My cardiologist said I would get to speak to a specialist at the hospital where I’d have the ablation ( if they say I can have one, I don’t even know that yet) and I assume that will be an EP.

Thankyou,

Tweez.

You can request in England I’m sure if it, if not you could contact prof Ernst secretary to ask about prices for a private consultation

Hi Jugsy,
Thankyou and I see you were the one from South Wales ( apologies, I didn’t connect). So did you go privately to The Royal Brompton? Or was it under the NHS?
We’re you paroxysmal?
We can’t afford privately unfortunately, especially if it has to be repeated.
Is Professor Ernst from the Royal Brompton? Does he work under the NHS too?
Sorry so many questions.
Thankyou,
Tweez

Hi Jugsy,

I did a bit of research I found Professor Ernst is a female and had a look at their website.
I would be under Basildon Hospital for this procedure and they are a cardiac specialist unit in Essex, so I’m probably under a good area ( haven’t met anyone there yet as I am under another nearby hospital that would refer me to Basildon).

When I next speak to my cardiologist ( if he ever calls me, as it’s all on the phone these days) I will ask if there is a way I can get this done quicker.

I’m not sure what else I can do….

Thankyou,
Tweez



Edited 1 time(s). Last edit at 01/05/2022 09:03AM by Tweez.

Anxiety drains your magnesium stores, and a deficiency of magnesium, which 80% of the population has, causes anxiety. Take as much magnesium per day as you can without getting a loose bowel movement. If that happens take a little less the next day until you are normal. If stool is too loose, you will be spilling your magnesium and be worse off! that happened to me before I found this website. I've been down many rabbit holes...... This website is LOADED with great information besides the forum. You can also take epsom salt baths, at least 2 cups in the water and try to sit for an hour and deep breath like George suggested, or meditate or read..

For Anxiety, you could supplement with Inositol, It is a B vitamin, a form of niacin which does not cause the 'flush". I tend toward anxiety and have been taking 2.5 grams inositol mixed in water 2 X a day and it has really helped my mood. There are psychiatrists who recommend it instead of, or along with antidepressant medication. Of Course, do your homework before taking anything , but I believe inositol is innocuous, especially under 10 grams per day as the body makes it anyway. It is almost tasteless , just a faint sweetness . We A-fibbers just burn through our supply more quickly, just as we do our magnesium.

Try your best to "get out of your head" relax, think positive and know you will get through this. Dr. John D Day's book "The Afib Cure" is full of good info. Like, we must keep our A1C BELOW 5.7, avoid blood sugar spikes as they can scar the heart, so avoid sugar and white flour which converts to sugar in the body. You are smart to avoid alcohol as it is a huge trigger. Daily exercise is paramount, but over doing it is also not good. Endurance athletes are prone to Afib. Good luck! You are on the right path and have MANY caring friends here!

If you are getting afib at night after a big meal you may want to consider breaking up the meal earlier in the day. Everyone is different but salty foods and caffeine triggers my afib. Perhaps too your weekend drink of Prosecco could trigger your episodes. Many here restrain from alcohol. It’s worth an experiment to stop for a while and see any improvement.,

Hi Susan,

Thankyou for coming back.
I stopped drinking any alcohol ( and also caffeine) in July this year after I first had my anxiety issues and I unfortunately still had attacks monthly until September, when I was first put on the bisoprolol.
I am going to slowly withdraw again from the bisoprolol due to the tinnitus, the way it makes me feel like a zombie - and the lack of good sleep, plus muscle twitching, slow heart rate and fatigue. When I came off the bisoprolol for the first time in November ( I weaned too quickly I think) I went straight into Afib, but I was so anxious and it wasn’t really a large meal that night either as my appetite isnt great these days. I think it was the high anxiety. I do think in the past though before my attacks got more frequent, it was a combination of richer food and alcohol on the odd night.. Yet I could go to a party and drink champagne and not have anything for months and months.

I’ve had no Afib attacks in 2.5mg bisoprolol - it seems to completely stop them. I hate the drug though and the way it makes me feel and all the side effects that never go. I just don’t know what’s for the best anymore. I hate waking up feeling bad every day,
It’s in the past that alcohol affected my Afib I think …and of course anxiety. I’ve no intention to ever drink again….

Tweez



Edited 5 time(s). Last edit at 01/06/2022 05:09AM by Tweez.

Hi Lani B,
Thankyou so much for all the good advice. I am currently taking 240mg of magnesium raisers at 50 mg B6 which I intend to up but doses. I’ve only
Been taking it two days so far. I started taking rhodiola rose this morning for my anxiety as I just can’t seem to tolerate anti depressants. Inositol looks interesting, but I’ve just had a quick Google and unfortunately I think it interacts with carbamazepine . Lots of things seem to interact, though the site I looked at was very medical speaking and not very easily understood.
Please can you let me know what an A1C value is? What does it stand for?
I do have my latest blood test results but I don’t know what it is…

I’ve obviously got a lot to learn!

Thankyou for your help,
Tweez

Tweez,
Yes, I remember how down right scary it was when I got my first few episodes. And, yes, in retrospect, my stressed state at the time was probably a factor.
And for me being worried only compounded my psychological situation…but when you are in a symptomatic episode it rules or when you are worried another one is around the bend.
Retiring, getting more sleep, regular exercise has helped, but I do rely on Flec 75 mg twice a day.. I weigh 150. I have been tempted to reduce the dose as the last few years all has been good, but then I don’t want to disrupt the north.
I take and do TaiChi….for me it is very calming and slows things down and trains your breathing.
I hope you find what best helps you. It is a hard time.
Tibbar

Hello, I am also new to this forum. I have noticed that I have episodes of afib almost immediately after eating gluten, add something salty and I am off the charts. Needless to stay I stay away from everything with gluten and high salt. I have been countering the afib with exercise. 30 minutes on the rowing machine seems to get me back to sinus rhythm for about 2 days
I am scheduled for an ablation next week at Deborah Heart and Lung in NJ.

Thanks everyone for sharing.

Good luck Bob…keep us updated

Good luck too Bob
Regards,
Tweez.

Hello All,

The Ablation went well, have occasional PVC’s but am told they will go away in about 30 to 60 days. Feels good to have my energy back ..

I have to stay on Eliquis for 60 days, can’t wait to be off of that so I can get back to cycling outside.

Take care.

Bob