Inoperable

Help, I have afib.
Had heart attack last year, just had scan and there's a huge clot in a fistula that connects arteries and veins.
Vessels are too dialated and twisted to operate.
Causes?
Probably methadone and cannabis use,but I stopped smoking tobacco and cannabis but methadone must be reduced so I have withdrawal to cope with and that causes heart attack.
I need an opioid I just don't function without one.
I don't ever use illegal opioids when I have enough prescribed and I fear myself, heart and drug wise..... although I am bed bound more or less.
Ideally I need a morphine script and my MP may get me one but I am only prescribe apixoban and not a clot busting drug like clopitegrol.
Nor do iget beta blockers yet my heart pounds when it afibs.
Every dose could kill me methadone wise..... withdrawal will kill me for sure.
Don't do drugs kids!
Nearly 30 years of methadone and cannabis. I'm only unhappy when not on opioids my receptors are not normal an anaesthetist said. I don't have the same endorphin system.
So please I understand abstinence logic, been there and I am old now and don't want to have my final days on earth in bleak misery.
This is misery you might say but I would like to know if anyone else has seen similar reaction and what meds should I take for the afib?
I need beta blockers at least.
I could have got diamorphine but the NHS has a shortage due to manufacturing problems, the monopoly manufacturers went bankrupt in Switzerland.......as a side note they take 75% of the world supply.

I think we all have that "if I'd known I was going to live this long, I would have taken better care of myself" feeling at one time or another. I say embrace your fate, you did what you had to do to get to this point. There are a million of parallel lives in parallel universes where you would have done worse.

I just did a looong post and it got cancelled as it said I posted it twice?!!
Had heart attack
Scan said massive clot in atrium and fistula connecting veins and arteries.
I only got apixoban no beta blockers or clot dissolvers.

I was in hospital for 3 days.
They were going to do bypass surgery but vessels are too dialated and twisted round each other.

Feels like I'm sent home to die.

Methadone is the initial cause.
I must reduce and stop.....that's a heart attack!

Methadone stops me doing illegal drugs and without it I'm sub human I have less receptors I'm told.

I need morphine, beta blockers and clopitegrol I think.

My MP is trying for morphine prescription.

I'm carer for my skizophrenic partner so can't die!
Every dose could kill me.

I am most sorry and sad to learn of your predicament. I don't know what to offer you as the medical practitioners you have consulted either don't know what to do themselves, or they simply cannot treat you perhaps without doing you even more harm. Without breaching your privacy, what were you told, if you can share that?

The apixaban is an anticoagulant, which means it will prevent that clot from enlarging and new clots from forming. Your body will then dissolve the clot over the next couple of weeks. So it is a sort of clot dissolver. If you're thinking of the drug tPA, there are lots of reasons why they might not have wanted to use that. It's a pretty dangerous drug with a bunch of contraindications. Also, there's a limited window of opportunity to use it, and possibly you missed that window?

As for beta blockers, what's your normal resting heart rate and BP? If either one is low, that might be the reason they didn't prescribe a beta blocker. (Methadone lowers both HR and BP.)

Both of your posts DID post, so you had two duplicate threads. I merged them into a single thread.

Nattokinase + Serrapetase.
Don't be shy about the dosages considering your current situation.
I cannot suggest the possible cause because that subject (at least in a neg. way) is not allowed on this forum.

GL



Edited 1 time(s). Last edit at 01/17/2023 07:12PM by vanlith.

Quote
vanlith
I cannot suggest the possible cause because that subject (at least in a neg. way) is not allowed on this forum.
GL

Huh? Discussion of anticoagulation isn't prohibited here in any way. The only prohibition is on contrarian medical advice without sound evidence to support it.

Anticoagulant drugs like apixoban prevent new clots, but clotripogrel help thrombolise existing clots.
My pulse goes to 150 at rest it's 70.
Beta blockers don't lower resting rate they block higher rates by blocking signals to speed up as I understand it.

I have to wear a monitor for a day.

Withdrawal could also kill me and I don't think it's fair.
My opioid requirements are mental diabetes sort of.
It's the doses that scare them.
In an accident you would get 5-10 mg iv.
I need from 60-3600mg morphine as I'm on what is called blockade dose.
So the conversation ratio is from
1-600:1! And few doctors understand.

I have MRI on 31-1-23 then get monitor 4 days later.

I just want comfort, warmth and love.

Quote
Tpvalley
Anticoagulant drugs like apixoban prevent new clots, but clotripogrel help thrombolise existing clots.
My pulse goes to 150 at rest it's 70.
Beta blockers don't lower resting rate they block higher rates by blocking signals to speed up as I understand it.

I have to wear a monitor for a day.

Withdrawal could also kill me and I don't think it's fair.
My opioid requirements are mental diabetes sort of.
It's the doses that scare them.
In an accident you would get 5-10 mg iv.
I need from 60-3600mg morphine as I'm on what is called blockade dose.
So the conversation ratio is from
1-600:1! And few doctors understand.

I have MRI on 31-1-23 then get monitor 4 days later.

I just want comfort, warmth and love.

Clopidogrel doesn't dissolve clots. It's an anti-platelet drug like aspirin. And like apixaban, it helps prevent clots from enlarging and helps prevent new ones.

Beta blockers most certainly do lower normal heart rates. They also lower BP. But your resting heart rate is fine so that's not why they didn't prescribe them for you. However, the 150 heart rate would make me suspect atrial flutter (AFL), and AFL often doesn't respond to beta blockers.

I've never heard of a dosage range like 60-3600 for morphine. 3600 would be a lethal dose for most people, so I can see why that would scare them. Where do you get those numbers?

I'm sorry this is so difficult for you. It sounds like you might benefit from some counseling.

We all suffer heart arrhythmias in our own degrees. It's relative, just as your dose of morphine is to you. I have been electrically cardioverted from flutter three times in the past two weeks, with none of them lasting more than 11 hours in the correct rhythm. The third time it lasted a whopping 20 minutes before reverting to AF again. Not only that, but the horribly toxic, if effective, anti-arrhythmic drug that worked well for me just three months ago won't even touch the AF now. All that's left for me is metoprolol, and that is working at a B- rate so far. Except now it takes 150mg per day, and not the 100 mg it took until July.

We all understand what you say when you say that all you want is '...comfort, warmth, and love.' Many of us would be happy just to be free of heart arrhythmias and you can keep the comfort, warmth, and love. I hope that doesn't come across as patronizing...I mean it to put all of our sufferings in perspective, each to his own degree, but most salient under all our skins.

Hang in there. You may need to have an advocate in the addictions/recovery fields, maybe a prominent psychologist or psychiatrist. If that person can be an intermediary on your behalf, it may take a lot of the angst and burden off of you.