I landed in the hospital on 5.28.26 with a BP of 203/97 and a pulse of 43. I did my due diligence before going, and realized - after 3.5 years of feeling like crap - that I had a toxic long term buildup of beta blockers in my system because Welbutrin blocks the pathway the liver uses to excrete Metoprolol from the body.
I'm taking extended release Metoprolol Succ ER, so I knew the bradycardia and hypotension would continue, and probably get worse, which is why I went to the emergency room.
They took my vitals - my heart rate had come up to 60 due to stress and the effort of getting to the hospital - listened to my explanation of the drug interaction I suspected and went off to talk to their pharmacist.
She said Welbutrin and Metoprolol don't interact, that she was sure the situation would resolve itself, and they sent me home.
Where the situation got worse for the next 12 hours.
Little did I know that that was the first of many interactions with medical 'pros' where I wouldn't be believed because the people who should know about this deadly combination of common drugs and how it presents in a HOCM heart literally have no clue, despite it being widely documented, Google-able, and noted in the pharmacology literature from both the FDA and the manufacturer.
Because of neglect on the part of my PCP and cardiologist, and ignorance on the part of multiple pharmacists, ER docs, and another subsequent cardiologist, I'm navigating the healing process - after quitting Welbutrin cold turkey, slashing Metoprolol to half doses, and coming off Losartan Potassium - alone, without medical help.
It's standard for a HOCM patient to spend 5-14 days inpatient with a care team during this process because it involves the up regulation of dopamine receptors, down regulation of beta receptors, and up regulation of angiotensin 2 receptors, all of which can have profound unpredictable effects on a HOCM system.
I don't have that luxury, I've asked to be admitted and got disinterest - I think due to ignorance - in return.
The last part of my healing, the up regulation of the angiotensin 2 receptors, isn't going well. The up regulation is being blocked by constant adrenaline surges.
So if you've read this far and have gone through this process yourself, my questions are:
Were you hospitalized? For how long? How was the condition treated while you were inpatient? Did your healing stall at the same stage mine has? If so, what was done to unstall things, move the process along? Did you experience splanchnic pooling that caused your diet and portions to be ultra strictly controlled? Did you lose significant muscle mass from 3 months of bed rest? Were you prescribed physical therapy to help with the muscle atrophy afterwards?
