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Re: Re: Fwd: amiodarone Thanks board!!

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In a message dated 7/3/04 8:44:08 PM Eastern Daylight Time,

mandyofca@... writes:

> I might add, that at the time of being put on the amiodarone, I was a

> two to three times a year fib attack person. So it was an extreme

> measure that He took, by prescribing that med. I had gone in to see

>

Mandy,

Scary. Very Scary. That cardio's treatment or lack of treatment, demonstrates

why I feel many cardio's don't have a clue on how do deal with AF. It tells

me that we, afibber's aren't high on their list of priorities or revenue list.

They're not used to be questioned. So who's going to check? Well guess what,

we will ask the questions. If we don't like your answers? We're out of here!

Good job Mandy!

Rich O

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In a message dated 7/3/04 8:44:08 PM Eastern Daylight Time,

mandyofca@... writes:

> I might add, that at the time of being put on the amiodarone, I was a

> two to three times a year fib attack person. So it was an extreme

> measure that He took, by prescribing that med. I had gone in to see

>

Mandy,

Scary. Very Scary. That cardio's treatment or lack of treatment, demonstrates

why I feel many cardio's don't have a clue on how do deal with AF. It tells

me that we, afibber's aren't high on their list of priorities or revenue list.

They're not used to be questioned. So who's going to check? Well guess what,

we will ask the questions. If we don't like your answers? We're out of here!

Good job Mandy!

Rich O

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In a message dated 7/3/04 8:44:08 PM Eastern Daylight Time,

mandyofca@... writes:

> I might add, that at the time of being put on the amiodarone, I was a

> two to three times a year fib attack person. So it was an extreme

> measure that He took, by prescribing that med. I had gone in to see

>

Mandy,

Scary. Very Scary. That cardio's treatment or lack of treatment, demonstrates

why I feel many cardio's don't have a clue on how do deal with AF. It tells

me that we, afibber's aren't high on their list of priorities or revenue list.

They're not used to be questioned. So who's going to check? Well guess what,

we will ask the questions. If we don't like your answers? We're out of here!

Good job Mandy!

Rich O

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  • 2 weeks later...
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douglas finlay wrote:

Am I between a rock and a hard place here?

Doug

Probably so. I'm another amio user and have been for about three years. I took

a six month sabbatical and kicked back into fib big time. I have a real problem

tolerating rhythm fluctuations (not nearly as big a problem with rate issues --

go figure, it appears to be the rate that raises the risk), so I'm resigned to

amio...but only as a bridge to an ablation. I'm now in line. It looks like

it'll be around 9 months before anything happens. So I'm toughing it our and

keeping my fingers crossed with amio for that time. (Once the procedure is

scheduled, I'll be talking with the EP about stopping the amio to give it a

chance to work out of my system in advance of the procedure.

Bill Manson

" When [] put on a uniform, something happened to him. He turned

into Manson's cousin, Manson. " -- Ken Kaiser

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> That you've been on it three years must be some sort

> of testament, just as Driscoll being on it 1 1/2

> years is.

>

> Doug

>

Hi Doug, it took me 18 months to recover (after stopping amiodarone) I was

on it just over 8 months before developing thyrotoxicosis.

--

D

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> That you've been on it three years must be some sort

> of testament, just as Driscoll being on it 1 1/2

> years is.

>

> Doug

>

Hi Doug, it took me 18 months to recover (after stopping amiodarone) I was

on it just over 8 months before developing thyrotoxicosis.

--

D

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> > it took me 18 months to recover (after stopping amiodarone) I was

> > on it just over 8 months before developing thyrotoxicosis.

> > --

> > D

> .............................................

> , what dose were you on?

>

> P <MI>

Hi , sorry my records weren't that detailed then and it's 5 years ago. I

have a wooly

memory that it was 200mg a day (which I think was pretty low dosage) but take

this info

with a pinch of salt. I do know my cardiologist was quite keen on NOT giving me

the maximum

dosage because of the fear of side effects (I was was only 29 at the time and it

was never

a long term plan but it managed to calm my heart down quite a lot)

IMHO though, dosage is not such a big issue when on amiodarone,

adverse reactions are so common with this med that close

monitoring is simply a must. (I think around 75% of people

experience problems and almost a fifth have to

discontinue the med because of the problems)

http://www.rxlist.com/cgi/generic/amiodarone_ad.htm

--

D

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> ,

>

> You're back on Amiodarone, if I recall your discussion

> with me earlier about having thyrotoxicosis? And

> everything is fine with your heart once again...

No Doug, I've only been on Amiodarone the once.(which gave me

thyrotoxicosis, the thyrotoxicosis took 18 months to fix) I currently

take metoprolol on demand for rate control. Apologies if I gave you

another impression.

[sNIP]

> But you surprise me when you say it's more about the

> bizarre effects than the dose. Wouldnt a high dose

> bring about adverse reactions more quickly than a

> lower dose, or do you suggest it's all according to

> the person's tolerance, which is what I believe as

> well?

I believe it's because of the unusual way amiodarone

builds up in your body (binding to fat cells throughout the body)

and it's long half-life (26 to 107 days) that even low doses can build

up to toxic levels over relatively short periods of time. But yes,

higher doses can add to the problem.

Whilst it's true to say many meds have problems I think it is recognised

that amiodarone is particularly high on the toxic hit list. It's also pretty

high on the list of meds that actually do something useful to prevent

arrhythmias

and there's the dilemma.

It's a tricky problem. It's hard to say in the same breath. " Amiodarone is a

problem

because 1 in 5 people have to come off it because of it's toxicity and 80%

success rate

for PVA is pretty good. " Whilst I know we can't really compare the two without

looking at the many shades of grey in between success and failure (and I'm not

suggesting

that 80% of amiodarone takers are AF free) we equally can't say " PVA, good.

Amiodarone, bad "

What I think it is safe to say is that amiodarone is not a first line med for AF

and, if

the decision is made to take it, close monitoring should be part of the regime.

I for one

am glad it's there as an option - there's definitely a place for it in the AF

arsenal when

it's used correctly.

All the best

--

D

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> ,

>

> You're back on Amiodarone, if I recall your discussion

> with me earlier about having thyrotoxicosis? And

> everything is fine with your heart once again...

No Doug, I've only been on Amiodarone the once.(which gave me

thyrotoxicosis, the thyrotoxicosis took 18 months to fix) I currently

take metoprolol on demand for rate control. Apologies if I gave you

another impression.

[sNIP]

> But you surprise me when you say it's more about the

> bizarre effects than the dose. Wouldnt a high dose

> bring about adverse reactions more quickly than a

> lower dose, or do you suggest it's all according to

> the person's tolerance, which is what I believe as

> well?

I believe it's because of the unusual way amiodarone

builds up in your body (binding to fat cells throughout the body)

and it's long half-life (26 to 107 days) that even low doses can build

up to toxic levels over relatively short periods of time. But yes,

higher doses can add to the problem.

Whilst it's true to say many meds have problems I think it is recognised

that amiodarone is particularly high on the toxic hit list. It's also pretty

high on the list of meds that actually do something useful to prevent

arrhythmias

and there's the dilemma.

It's a tricky problem. It's hard to say in the same breath. " Amiodarone is a

problem

because 1 in 5 people have to come off it because of it's toxicity and 80%

success rate

for PVA is pretty good. " Whilst I know we can't really compare the two without

looking at the many shades of grey in between success and failure (and I'm not

suggesting

that 80% of amiodarone takers are AF free) we equally can't say " PVA, good.

Amiodarone, bad "

What I think it is safe to say is that amiodarone is not a first line med for AF

and, if

the decision is made to take it, close monitoring should be part of the regime.

I for one

am glad it's there as an option - there's definitely a place for it in the AF

arsenal when

it's used correctly.

All the best

--

D

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Guest guest

> ,

>

> You're back on Amiodarone, if I recall your discussion

> with me earlier about having thyrotoxicosis? And

> everything is fine with your heart once again...

No Doug, I've only been on Amiodarone the once.(which gave me

thyrotoxicosis, the thyrotoxicosis took 18 months to fix) I currently

take metoprolol on demand for rate control. Apologies if I gave you

another impression.

[sNIP]

> But you surprise me when you say it's more about the

> bizarre effects than the dose. Wouldnt a high dose

> bring about adverse reactions more quickly than a

> lower dose, or do you suggest it's all according to

> the person's tolerance, which is what I believe as

> well?

I believe it's because of the unusual way amiodarone

builds up in your body (binding to fat cells throughout the body)

and it's long half-life (26 to 107 days) that even low doses can build

up to toxic levels over relatively short periods of time. But yes,

higher doses can add to the problem.

Whilst it's true to say many meds have problems I think it is recognised

that amiodarone is particularly high on the toxic hit list. It's also pretty

high on the list of meds that actually do something useful to prevent

arrhythmias

and there's the dilemma.

It's a tricky problem. It's hard to say in the same breath. " Amiodarone is a

problem

because 1 in 5 people have to come off it because of it's toxicity and 80%

success rate

for PVA is pretty good. " Whilst I know we can't really compare the two without

looking at the many shades of grey in between success and failure (and I'm not

suggesting

that 80% of amiodarone takers are AF free) we equally can't say " PVA, good.

Amiodarone, bad "

What I think it is safe to say is that amiodarone is not a first line med for AF

and, if

the decision is made to take it, close monitoring should be part of the regime.

I for one

am glad it's there as an option - there's definitely a place for it in the AF

arsenal when

it's used correctly.

All the best

--

D

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