Blood Pressure

For most of my adult life my blood pressure had been on the high side. I don't know how high, exactly, but high, on the order of 160 over 100, that sort of thing. But since quitting smoking and going on metoprolol, my blood pressure is now about 120 over 70, as measured by the automatic blood pressure measurement stations in Safeway, Walgreens and Target. My cardiologist was initially a little worried that my blood pressure might slip a little too low, especially since she prescribed an additional pill for my consuming pleasure, an ace inhibitor that reduces blood pressure and helps damaged heart tissue heal. The threat of having blood pressure that is too low is new to me - it's about as alien to me as the prospect of being pregnant.

So at this point, I haven't smoked in a month, I haven't had a cup of regular coffee in a month, and my blood pressure is just about right. How do I feel?

1. I haven't had a headache since the heart attack. Not a single one, and I was renowned for having headaches virtually every day. This is a major boon, believe me, and the savings in Excedrin alone are not to be ridiculed.

2. Normally I suffered from Restless Legs Syndrome at least every other night, and often every night, and usually bad enough that I either couldn't get to sleep, or was awakened after sleeping for half an hour. My RLS hasn't entirely gone away, but I can report that I've had only one episode in the last month. It was a doozy, sure, but it was still just one episode, and I think it was triggered by Tylenol PM.

3. I used to keep an over-the-counter asthma inhaler handy because taking a shower usually caused my lungs to tighten up to the point that breathing became difficult and uncomfortable. So I'd take my shower, take a honk on my "air thing", as I called it, and then have an Alka-Seltzer to wash the residual "air thing juice" down, which if not washed down with a bunch of sodium bicarb caused me fairly serious heartburn. But I haven't had to use my "air thing" since the surgery. Not even once.

4. I used to feel my pulse pounding in my head. Now I don't.

5. I used to feel my heart misfire several times a day. I think these are called PVCs, little breaks in the normal sinus rhythm of the heart, that in my case anyway are perfectly perceptible without instruments, because I can feel the lurch in my chest when it happens (and when it happens three or four times in a row, the sensation is uncannily like having a mouse trapped inside your chest). I've been paying attention to these PVCs or minor arrythmias because I read that they can hint at deeper pathology, and thus far I have to say I haven't had PVC one since the second day after surgery. I remember feeling the PVC in the ICU and looking up at the monitor and actually seeing it, which was kind of eerie, but I haven't had one since. And remember, in the old days, I had them three or four times a day.

So, no headaches, a sharp reduction in the severity of RLS, apparently no PVCs, no pulse pounding in my head, and no need for the old inhaler. Is this the result of properly managed blood pressure? Smoking cessation? Elimination of caffeine? Cool drugs like Plavix and metoprolol and ACE inhibitors? Restoration of coronary blood flow?

I don't know, but I feel so much better I almost wish I had had my heart attack ten years ago.