2.040 RA meet, walk, dosage rant

Monday 01/11/2021

During the morning news I picked up that today was a “king tide” day, extra high. It was on the news because it (coincidentally?) combined with unusually high onshore waves, and quite a few beachcombers had been caught by these.

Anyway, I recalled going to the Baylands on high tides before and decided I would again. Fortunately on a whim I called Patty to ask if she wanted to go, and she said, “after the 10:30 meeting, right?”. Oh holy fuck, the 10:30 Residents’ Association meeting. At which as RA Treasurer I would be expected to report. And I was ready to bop off for a walk exactly then. This is the kind of mistake I’m supposed to prevent by checking my Google Calendar. Anyway, I said, uh, sure, right after that, and went off to compile my Treasurer’s report. That took all of 5 minutes to do.

Nothing dramatic at the meeting, except that, during the Administration section — the staff, usually CEO Rhonda, is always given the final agenda spot for any announcements they want to make — Yadira (the hero of the vaccine story I told a few days back, remember?) announced that of the three Lee Center residents who were being treated in our Covid isolation wing, one had passed away of the virus or its complications. She went “peacefully, surrounded by relatives and friends, on Zoom,” Yadira said. So that’s now I think 5 deaths we’ve had over the two instances where staff brought the virus into our AL/SNF wing. And another 4 recovered, two in progress.

Now I’m trying to imagine “sitting” at a relative’s bedside via Zoom. I guess the nurse arranges the laptop to show the dying person’s face? Kind of… well, attending a death is never pleasant but this seems kind of weird.

So I left that meeting and we went for a pleasant stroll looking at high water. Not dramatic high water, not overflowing the banks or anything; just that channels through the reeds which are normally little muddy creeks with a trickle of water at the bottom, were today full, no mud showing.

In the afternoon I went over to CVS because they had texted that I had a prescription ready. And here begins a complicated story.

After Dr. Watkins braced my aorta with stents, she gave 3 post-op directions. One, I’m to not lift anything over 20 pounds. Two, use whatever it takes to keep your stool soft and avoid straining on the toilet. And three, get your (systolic) blood pressure under 120. All of these are really aimed at not breaking an aneurysm. I don’t have any aneurysms (swellings off the aortic wall) but if one should form in between annual CT scans, these measures lower the chances of it breaking.

At the hospital I was given a prescription for Metoprolol, 25mg, take 2/day. Soon after my cardiologist Dr. Dibiase (dee bee ah-say) changed it to Metoprolol succinate 50mg, and I thought, also 2/day. Which is what I was taking, one tab morning and night, until I picked up a refill at CVS around Christmas, and noticed that the label clearly read, one per day by mouth.

Well fuckety-doo, I had been doubling the dosage, silly me. So I changed to 1/day in the morning. Over the next couple of weeks I was not pleased with my BP. I was taking it 4 times a day (8am, 1pm after lunch, 6pm after supper, 10pm going to bed) and it was running from an occasional 121 to an occasional 151, average around 135 roughly. (That’s an eyeball average, I haven’t done the arithmetic.)

So I sent a message to the doctor using the Sutter Health website, in it giving a table of about 5 days readings. I received no direct reply. However yesterday I got a text from CVS saying my prescription for “MET” (they only show the first three letters of the drug) was ready, come pick it up. Huh? I have enough Metoprolol for a couple of weeks yet, so this can’t be an automatic refill.

When I picked up the drug at CVS this afternoon I noticed that the bottle was bigger than before, and that the prescription printed on it says, “Take two per day by mouth”. So is this the reply to my message, doubling the dose because of the numbers I reported? Or was the prior prescription in error, and I was right to be taking two per day? Should I inquire about this when I see Dr. Dibiase in a couple of weeks? Or should I just let it go?

To further confuse things, looking back at my spreadsheet, the BP numbers when I was taking 2/day are not a whole lot lower than while I’ve been taking one. Definitely not consistently under 120.

On the bright side, I am not having any side-effects from this beta-blocker. I’ve had a problem with a beta-blocker in the past, made me feel listless and low-energy. Not this one, that I notice. Whether I take 50mg or 100mg.

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