Finally Put the Nitro Patch On

So a few weeks back I posted about my increased angina episodes and the decision for me to start using a low dosage Nitro (glyceryl trinitrate) patch.

Ten days ago I bought the patches but because I was feeling good, had not had an angina episode for a few days, me being me, put off starting to use these patches.

Nitro-Dur 5 patches

And I won't mention my inherent fear of starting a new medication when it comes to my heart!

Well that all changed over the weekend when early Sunday morning around 3.00am I woke up with pressure on the chest, SOB and a bit of a racing/pounding heart - I have a history of heart arrhythmia and get it from time to time. Got up out of bed and used my GTN spray and things improved pretty quickly. Checked my blood sugar level and it was 3.8 (68 mg/dl) which for me is on the low side and being so early in the morning I knew they would be going further down over the coming hours. I had some juice and nuts and cheese to get the sugar level up and then went back to bed.

Blood sugar level converter

For most people a reading of 3.8 would be considered good but I know for me, most times when I go below 4 and definitely below 3.5 I tend to get typical HYPO symptoms and over the years have noticed that at the same time I can also get SOB, racing/pounding heart, pressure on the chest issues and using my GTN usually brings these under control - the racing heart and SOB are not common to HYPOs.

Maybe I did it to myself, overdoing things on Saturday - going to a Jazz festival event during the day and meeting up with friends we hadn't seen for years and then that night going to a music tribute show with me busy taking photos at both events. In a way, I probably brought the latest episode upon myself given I have very low stamina levels and heart muscle damage following my heart attack in 2007.

And having other health issues including a thyroid condition, means I am on a multitude of medications. In 1996 I was diagnosed with Graves disease and two years later had my thyroid burnt out and have been on on thyroid replacement medication ever since.

In May 2014, I had an episode of angina which landed me in hospital. Having just had a sandwich for lunch I started to feel unwell, thought it was angina, took my GTN spray and it didn't help. When the paramedics arrived they found my blood sugar level was 3.8. In hospital a discussion between endocrinology and cardiology decided my angina episode which included chest pain, sweating and pressure down both sides of my neck was related to my diabetes. In the following weeks I did a Holter monitor test (for the heart) and wore a blood sugar monitor for seven days.

Here I am after being brought into hospital in May, 2014

Whilst I have not had such a bad experience since, I am always conscious of my sugar levels and the effect a "low" can have on me when it comes to my heart.

Holter Monitor test in 2014

After the angina/HYPO episode early Sunday morning and then needing to use my GTN spray twice more during the day, once later in the morning and again in the afternoon when I had pressure in the chest and SOB issues I made the decision that today, Monday, I would start using the Nitro patch. The brand my chemist has given me is called Nitro-Dur 5.

In accordance with the instructions I have put one on my upper right arm and leave it on for twelve hours and then take it off tonight and put another one on tomorrow morning after a twelve hour break.

Nitro-Dur 5 patch applied per instructions to upper arm

Need to be aware that as I am getting used to these patches I can get similar side effects like headache, dizziness, light headedness etc. that can come with using the GTN spray.

We shall now see in the coming days, weeks if this will help with my angina issues.

This may be of interest regarding Diabetes Heart Disease: http://www.nhlbi.nih.gov/health/health-topics/topics/dhd/

Another article which may be of interest regarding diabetes and heart disease: http://www.abc.net.au/radionational/programs/healthreport/high-blood-sugar-levels-as-risk-factors-for-heart/3381068#transcript

Glyceryl Trinitrate Patch for Angina

Thought it would only be a matter of time, what with increasing angina episodes, needing to use my GTN spray almost daily and sometimes twice a day compared to once every week or two last year. And of course not totally unrelated to a new 99% blockage being found during an angiogram in May which could not be stented.

Now getting episodes out of the blue while sitting at the computer or watching TV and even, on occasion, when getting out of bed in the morning after a relatively, for me, good night's sleep. And have even started getting angina when exercising which rarely happened in the past.

Anyway, saw my GP, told him what has been happening and he suggested I contact my cardiologist about going on to a low dose, 24 hour Glyceryl Trinitrate patch which can be used in conjunction with my Isosorbide Mononitrate 60mg tablet which I take each morning - will double check this when I speak to my chemist as I using my GTN spray should angina issues continue although been told the same rules apply with the GTN spray - use up to twice and if it does not relieve an attack then call an ambulance. 

Lucky I can communicate with my cardiologist via email and he replied pretty quickly and agreed. So Monday, it is off to the chemist to get my first box of 5mg/24 hour patches. Just need to find out if I can wear these in the shower and when swimming. I do know you need to vary where you place them on your body to avoid skin irritation.

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Minitran patches (glyceryl trinitrate).

Minitran patches contain the active ingredient glyceryl trinitrate, which is a type of medicine called a nitrate. It is used to help the heart work more easily.

What is it used for?

• Preventing angina attacks.
• Minitran 5 patches can also be used to improve the blood supply to the site of an intravenous cannula. In people receiving medicines via an injection or drip (infusion) into a vein of the arm or leg, the patch is applied close to the cannula site to help keep the vein open.

How does it work?

Minitran patches contain the active ingredient glyceryl trinitrate, which is a type of medicine called a nitrate. It is used to help the heart work more easily.

Glyceryl trinitrate works by being converted in the body to a chemical called nitric oxide. This chemical is made naturally by the body and has the effect of making the veins and arteries relax and widen (dilate). When the blood vessels dilate in this way there is more space inside them and hence less resistance. This makes it easier for the heart to pump blood around the body.

Widening the veins also decreases the volume of blood that returns to the heart with each heartbeat. This makes it easier for the heart to pump that blood out again.

As a result of both these actions, the heart does not need as much energy to pump the blood around the body and therefore needs less oxygen.

Glyceryl trinitrate also widens the arteries within the heart itself, which increases the blood and oxygen supply to the heart muscle.

The pain of angina is caused by too little oxygen reaching the heart when its workload increases, such as during exercise. Glyceryl trinitrate improves the oxygen supply to the heart, as well as decreasing the amount of oxygen that the heart needs by making it easier for the heart to pump blood around the body. It can therefore be used to treat angina.

Minitran patches are used on a regular basis to help prevent angina attacks. The medicine is absorbed continuously from the patch through the skin and into the bloodstream.

For more information: http://www.netdoctor.co.uk/medicines/heart-and-blood/a7124/minitran-patches-glyceryl-trinitrate/