COPD and my PM

Although I have a long list of health issues, other than my heart, the most pressing is the COPD. I just learned a lesson that may be useful to others. I use a Trelegy inhaler once a day and it works quite well. Then Monday when I used it I noticed that I did not seem to taste the powder as before, but just figured I was getting used to it. Yesterday it was like I simply inhaled air. I wear a smartwatch and frequently check my HR. I noticed early in the day that my HR was elevated between the high 80's to 100. As the day progressed I noted that my HR was not going below 90 and it took almost no movement to raise it. At one point just walking a few steps shot it up to 112!. Time to freak out. A little research on the net revealed that there is a relationship between untreated COPD and HR. I went t my pharmacy and explained the situation to the pharmacist. She called the maker of Trelegy. After a few questions, they agreed to replace the inhaler. Fortunately, I had just refilled the med so I had another on hand to use until I got the replacement. After getting back home I used the inhaler and within a few hours, my HR was back at normal and staying there. Today all is well.
Just a little FYI for those with COPD and heart issues.


Going to have to think about this one...

by crustyg - 2020-09-23 11:51:39

I don't doubt for a moment your recollection of symptoms and the events that you described.

But - and this is a big but - I don't see how this works, so I may be misunderstanding something important.

Your description *sounds* as though your Trelegy inhaler had run out ("like I simply inhaled air") and your HR went up.

This doesn't make sense to me: Trelegy contains an inhaled glucocorticoid (no effect on HR), an anti-muscarinic (like Atropine) so this would tend to increase HR (blocks effect of the Vagus nerve), and a beta2-agonist (tends to drive up HR).  So how does a *lack* of these drugs become the causal factor of your undoubted increase in HR when it should, in theory, result in your HR going down?

Anyone explain what I'm missing here?

Going to have to think about this one

by AgentX86 - 2020-09-23 12:20:48

Untreated COPD driving pO2 down (pCO2 up) causing increased heart rate to compensate?


by bill328 - 2020-09-23 12:27:51

All I can tell you is what I experienced. When my inhaler stopped working, after two days my HR was hitting over 100 with hardly any activity. Once I replaced the defective inhaler, my HR has returned to normal. IDK, maybe smoke and mirrors...

Well, my deliberate opinion is - it's a jolly strange world. Arnold Bennett

It's good that you were able to get it sorted out so quickly

by crustyg - 2020-09-23 18:41:54

I'm pleased that it was so easily resolved for you - and good advice to always have a spare.  We have two family members with exercise-induced asthma, and there never seems to be an in-date inhaler around when it's needed.

AgentX86: you may be right - pCO2 can rise quite quickly if airways obstruction is significant.

Anyway, a useful mental puzzle.

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