new addition

As if taking walks wasn't challenging enough, my dad has to now drag two poles with him. In addition to his double decker IV pole, he now has a cardio monitor hooked up to him. He has had an arrhythmia called atrial fibrillation for about five years. It has been well controlled with a medication (beta blocker called metoprolol) which also happens to lower blood pressure and heart rate. Normally, it's not been a problem but for whatever reason, my dad's blood pressure has been running decently low so his dose was cut in half.
Well, we now know that dose is not sufficient to control his arrhythmia. It came back with a vengeance last night. On a scale of 1-10 for the severity of crisis (10 being oh shit!), it was about a 4. They gave more metoprolol but it didnt respond. Give more? Can't. His bp was getting uncomfortably low. Crisis number starting to creep up. Digitalis time? Wait, his serum potassium levels were already out of whack. Corrected that and they had to give digoxin to cardiovert his heart back into normal rhythm. He was close to being transferred to the ICU (intensive care unit) but fortunately the digitalis worked. It was a rough night for him, which is an understatement.
Now the challenge moving forward will be finding that sweet spot of a metoprolol dose which controls the arrhythmia but allows him sufficient blood pressure and heart rate that is compatible with remaining upright and coherent. His heart rate was running in the 50s today and that was after his exercise. He's continuing to walk that razor's edge and conquer each crisis.