Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand.
Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information such as:
- Age
- Complaints)
- History
- Medication use, including supplements, etc.
- Smoking, alcohol
- Overweight
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- Possible blood pressure
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Dear Martin,
My apologies for the late reply, but we were on a short break in Cha-am. It must be quite a change, because if I understand correctly, Aspent-m 81 mg and Tamsulosin (my pee is a weak trickle 😌) is enough to use. Or Doxazosin?
I have no chest pain and my pulse is between 55 and 65, my blood pressure is 110-60. Even when I'm working in the garden.
I try to follow your advice as much as possible.
The doctor has forbidden me to even drink a beer (I took a beer once in a while, 2 x a week) do I absolutely have to leave it?
With thanks and best regards,
Awaiting your reply.
W.
******
Dear W.,
If a beer increases your happiness in life, I wouldn't resist. However, don't overdo it.
Tamsulosin will help your prostate just as much as doxazosin.
Your blood pressure and your pulse are on the low side. If your pulse falls below 50 for an extended period of time, a pacemaker is an option.
So for now only tamsulosin and aspent. The nitro spray just in case…
If you still have a lot of doxazosin in stock, you can take half of it.
Monitor your blood pressure and pulse.
Sincerely,
Dr. Maarten
First question
Dear Martin,
After my heart attack (6 months ago) I received the following medicines that I still use. I'm also starting to get forgetful, could this be due to the medication?
I am 83 years old and otherwise healthy, weight 67 kg, 1.75 m.
- Atorvastatin Sandos 40mg. 1x with bedtime
- Vastarel 35mg. 2x daily..morning and evening
- Ticagretor 90 mg 2x daily, morning and evening
- Doxazosin 4 mg 1x daily morning
- Aspent-M (aspirin 81 mg) 1 x daily after breakfast
Seven medications a day isn't that a bit much?
Thank you kindly for your opinion.
Regards,
W.
*****
Dear W,
Vastarel could be the cause of your forgetfulness. It is a remedy that is no longer recommended.
The Atorvastatin has more disadvantages than advantages especially at your age.
You will be given two “blood thinners”, which carries serious risks at your age. Omit the ticagrelor. Aspirin alone is risky enough.
It is often difficult to convince doctors to change ingrained habits, often based on research that is often funded by industry. This becomes even more difficult when dealing with gifts. It is also difficult to convince a baker to use other flours unless it is to his advantage.
Given your medication, you have a stable angina pectoris, which means that you have no discomfort (chest pain) at rest. If so, then nitrates qualify. I would always take a nitrate spray (Nitrolingual) with me everywhere. Spray under the tongue for chest pain.
Doxazosin an alpha blocker is usually used for prostate problems, but also works for high blood pressure.
Depending on your blood pressure, you will need to take more or less medication. As long as that blood pressure is below 150/90 and your resting pulse is not higher than 80 and not lower than 60, there is nothing to worry about.
A good choice for your blood pressure is the vasodilator beta-blocker Carvedilol. Carvedilol also lowers the pulse rate. A calcium blocker such as Amlodipine is also suitable.
My advice:
- Aspen after breakfast.
- Carvedilol or Amlodipine in the evening. (dosage depending on blood pressure).
- Doxasozin in prostate problems. Never take in the morning. Better in this case is Tamsulosin.
- Emergency nitrolingual spray.
Do you have any questions. Then let us know and also send your pulse and blood pressure. Do you ever have chest pain?
Yours faithfully,
Dr. Maarten
Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information (see list at the top of the page).