On the other hand. If you’re worried about something like parkinsons… may I suggest cigarettes?
I’ve been better, looking at more surgery now. I knew this would be a consequence of training the way I did given my constraints. Was hoping it would be at an older age
Have at least two big ones coming up.
I regret none of it. If I could do it all over again I wouldn’t change a thing.
Sorry to hear that.
That is what cardiologist told me…too healthy. Said I needed to take up smoking!
Getting back up to 18% BF would probably fix me right up.
Hang in there. I got no answers at the moment.
You and Ronnie both. Studly!
Being a lifelong adrenaline junky and having to take this 2x/d is like a cruel ironic twist.
When I was only taking 12.5 2x/d sometimes I’d skip it or hold off for a while then do speed reps just to get that adrenaline/dopamine burst.
Some people take up to four HUNDRED milligrams of metoprolol per day. At those dosages I you’d feel like a zombie though.
If you like the “rush” from exercise… can you run? Distance running is a good one for an endorphin rush
However it’s a high impact activity that if taken to the degree distance runners practice at tends to destroy peoples hips and knees.
I know a few old former competitive ultra marathon runners. They’re seriously worse off than the guys I know who did weights for decades.
No, not really. My LVEF is down to about 40% at last measurement through stress/echo.
And yeah, 400 mg. would turn me into a potato.
There’s a medication used off label for ADHD called guanfacine… another one called clonidine. They work on alpha adrenergic receptors instead of beta adrenergic receptors
Unlike stimulants used for adhd these meds actually work by blunting the sympathic nervous system. Similar to beta blockers, but not as cardioprotective
They were developed as anti hypertensives, but don’t work as well as beta blockers for that purpose. Anyhow what people noticed is that is REALLY calmed people down, aside from a few other properties like the regions in the brain they bind to and antagonise alpha 2 adrenergic receptors
Some very savy people thought of the idea to trial and patent these meds for ADHD (i’m sure they got very rich)
I take them for my terrible ADHD as I prefer them to stimulants that I very seldom use… every time the dose was increased by ONE MILLIGRAM I’d wind up sleeping 12+ straight hours a day for a good week.
It works great if you can get past the first month or two of initiation and dose titration. Many can’t due to work/life, but in high school outside of homework and whatnot you can get away with needing to sleep a lot. Kids going through growth spurts do it all the time
I’m sorry to hear about the LVEF, is that the measurement you’ve had ever since the heart attack?
Is it symptomatically low? I’m not a cardiologist but I know 40% is right on the cutoff between mildly and moderately reduced cardiac function. Mildly reduced is 41-50%
I don’t have heart failure but I have IST. So my heart feels like it’s going to explode if I don’t take beta blockers or ivabradine. Ivabradine us crazy expensive though.
What’s interesting for IST is, beta blockers for a majority of this cohort actually increases energy and exercise tolerance (myself included).
POTS (don’t have this) is even worse because these people faint whenever they stand up without medication and they have can at times have IST in conjunction with that (dysautonomia is a spectrum).
I’d feel better and have more energy on 50-100mg metoprolol per day as opposed to not being on it. Isn’t that interesting?
Many people with IST are found to have antibodies attacking cardiac beta adrenergic receptors so the condition may be autoimmune. Whether a condition increases morality rates long term is unknown. Untreated I think it would as tachycardia induced cardiomyopathy is a real condition.
As to you using steroids in your 20’s, I wouldn’t worry about it. Not a doctor, but from what i’ve noted the body can tolerate a lot of abuse (for most), esp when young.
You are well spoken and highly intelligent. If it had any impact on your IQ I’d think said impact would be very minimal.
But dementia is awful if you have it, my grandma who lives with us is now moderate stage alzheimers. I hate her as a person and always have (view harboured by a lot of my family as she is likely on the spectrum and harbours many narcissistic atrributes).
The denial is the worst. She’s still driving, but only very short trips even though she can’t remember what happened one hour ago and will never give that up even though her executive functioning/processing skills are pretty much gone at this point.
I imagine she will get in a crash relatively soon if her geriatrician doesn’t revoke her right to drive. She wouldn’t listen anyway, a stubborn narcissist will never listen.
It’s like that south park episode
Because her driving skills are shocking. I think even she’s realised now as I don’t see her drive more than 2-3x per week now.
I imagine the way I react to any titration of guanfacine is how most people on beta blockers feel… that… must… suck…
No, it was initially at about 65% after the STEMI, reduced but within normal range. But after another more protracted eschemic event and a couple rounds of covid it is significantly reduced. The last measurement (40%) was taken was in April.
Eh, I dunno. Ive always been very very high strung and agressive. It has definitely taken me down about a dozen notches, which is actually a great benefit.
I only mention it out of technicality. I consider it pretty insignificant.
It didn’t I’ve had it measured a couple times and it has consistently been within the same range.
40.5 lol
I’d ask if it was a steroid haha. Now, I know that drugs that end in olol are beta blockers.
Is there a different type of drug that could achieve the same results without the beta blocker side effects (sluggishness)? Maybe an ace inhibitor or ARB drug? Maybe those aren’t strong enough? I’ve heard ARB + Beta blocker can have a 1+1=3 effect. You may be able to use a lot less total if combining.
I don’t know enough to give advice, and I know you are smart enough to not take this as advise. I’d like to know if there is a reason you are on the beta blocker specifically if there is one? I do suppose if you are prone to anxiety and it has noticeable effects on the heart, that a beta blocker would be advantageous there.
Autonomic dysfunction / inappropriate heart rate elevation at different times of day including at gym. Gets your attention quick. Beta blocker helps control HR and minimize ectopic beats/afib. Minor help with anxiety/panic. But metoprolol mainly works on heart.
Not fun. Thanks. It is mild dose. I don’t recommend getting this condition. Basically heart electrical sysyem got messed up somehow. Even minor stressful dream gets me awake at 3AM with 120-140 bpm HR.
Prior nutty workouts not really possible right now. Like being imprisoned in your own body if that makes any sense.
Those alpha 2 adrenergic receptor agonists can help too.
Substantially decreases my required beta blocker dose.
But very sedating initially.
Also cost like a zillion dollars
Look at pharmacokinetics of guanfacine, how it blunts sympathetic outflow.
I can’t relate to that. But i’ve had covid twice.
First time took me a month to recover from and I still feel short of breath after second round (three weeks ago)
It’s equitable to the flu for me, which isn’t great. Delta felt worse than omicron.
Look at the standard deviations. Some had a T/E ratio of 0.01
Can likely pass a simple doping test using TNE and ceasing use like a day or two out from the event.
Large scale social situations will also do it. I always need to take more if i’m going to be around crowds.
I’ve had the fast heart rate (according to medical documentation) from around the age of 13 onwards. It gets better with age for many, I can’t say this has been the case for me
400mgs of metoprolol per day!!!
In combination with some desoxyn (google) and you’ll be ready to take on the world!
/s
I’ve found for IST it honestly is “the more the better” before a very distinct cutoff point when my RHR will dip too low and I’ll be quite tired. But if beta blockers make you tired that’s a no go.
What about ivabradine (for fast HR, won’t alter how forcefully your heart contracts and isn’t used for afib)
Some calcium channel blockers like
Diltiazem can slow HR while acting as an anti arrhythmiac.
I’m not a doctor, I don’t even know what particular subtype of dysautonomia you have. Is it POTS (regular vs hyperadrenergic. The latter = pots + ist), IST, familial dysautonomia…
But these are things to discuss with your doc. I used to take a pain medication that gave me auditory and visual hallucinations when dosages were titrated to any dose above minimum dose that can be prescribed for SR tablets of this nature.
Eventually after having dealt with this for quite a while I asked my doc “is there any alternative. I have university and these particular side effects are very annoying”.
So I was kept on the lowest possible dose and given IR oXyCoDoNe to take as needed.
I don’t like oxycodone because it makes me tired and it makes my brain feel fuzzy. But when I’m waking up at like 3am (if sleeping at all) that actually works out.
It is that particuar medication. Every time post OP when the dose goes above around 150mg/day it happens. The medication in question here is tapentadol
Like anabolic steroids, corticosteroids, benzodiazepines and potent anticholinergic I’d be willing to argue opiates/opiods aren’t great for cognitive function.
Beta blockers seem to be fine though 
Discount for the fatigue
Going to knock off a few IQ points over the next few months lol. Next two surgeries are bad enough to warrant PCA, and I’m in painkillers daily at this point…
I’ve made my voice known that I don’t want that nasty PCA machine ever again unless they put something that isn’t fentanyl in it… I don’t think I have a choice in the matter
It’s the most nauseating experience. Morphine is supposed to be worse according to literature, but nothing has ever made me feel so sick so quickly aside from that fentanyl PCA.
Surgery wound up going from arthroscopic to open incision when it was decided to perform biceps tenotomy… I have popeye biceps on that arm now… but I regret nothing aside from having never presented to an ER after one of my many shoulder dislocations.
If I can get it back in it’s fine… or at least I thought so (not really but didn’t want prolonged rest)… until I woke up and wasn’t able to use that arm anymore… oops…
The next two are probably going to be worse as I imagine shaving off bone is unpleasant
I hear tren is great for postoperative recovery (joking). Though I wouldn’t be suprised if TRT or sometbing like oxandrolone expedites healing
I’ve seen animal models that seem to suggest this notion. With TRT think about it… you’re in bed for days/weeks/months depending on how bad the surgery is. You might be using painkillers that cause secondary hypogonadism (all opiate painkillers aside from tapentadol). On TRT no compensated hypogonadism!!! More muscle preservation!!!
I imagine AAS to a degree would shorten rehabilitation time as you’d have less muscle mass/strength that’d you’d need to gain back postoperatively
At the expense of giving yourself dementia… one shot of test is all it takes 
to wind up with alzheimers
Thank you for sharing that information and I wish you the best on your recovery!