So, my plan was to go to
the cardiologist, as I'm supposed to go yearly anyway, and to ask him to take
me off the carvedilol...as I didn't believe I needed to be on it anyway.
Now, to give a you an idea of that appointment...and the events that
followed...leading up to tomorrow's T.E.E. (which I will get to), let me
explain a small chain of events that led to this point. Or maybe.. not so
small chain of events.
The day I saw the
cardiologist I'd forgotten to take my carvedilol, and by the time I'd made my
appt that afternoon... my bp was pretty elevated. But still, I planned on
asking him to remove me off the medication and to explain why, that the
fatigue/exhaustion, unbelievable breathlessness/gasping for air, etc. was made
worse by the drug. He wasn't convinced and wanted me to continue taking
it and wanted to put me on an event monitor to see what was going on with my
heart.
I believe it was less than
two weeks with the monitor, or right about two weeks, I received a call from my
cardio's nurse asking me to come in that Thursday (last Thursday) because the
monitoring company had picked up something on the monitor and the dr wanted to
discuss it with me and talk about medications. Now, I'd pushed the button
a few times, though not every time I felt something (as I should have), but I
didn't realize that the folks monitoring me via satellite were actually
monitoring me every minute, wether I pushed the button or not. I had an
echo scheduled with my cardio's technician, whom he trusted more than my former
GP's tech (which I agreed with totally), so that thursday I went in for the
echo and to talk to the cardio doc about what they'd found.
Thursday. Diagnosis:
A Fib (Atrial Fibrillation). One of the most dangerous arrhythmias anyone
can have. All this time I thought those simple 'palpitations' were just
that... palpitations. They weren't. They were my heart going into a
dangerous pattern of A Fib.
Now we know why I had the
mini stroke (TIA) last April. Mystery solved!
The carvedilol was
actually keeping my A Fib from going into long episodes as they had in the past
(up to an hour at times), keeping them in short bursts lasting from less than a
minute to up to about 15 minutes. That's a good thing. But I have
to remain on carvedilol.
I not only have to remain
on carvedilol, but I now have to have an ACE inhibitor added, as well as a
"big guns" blood thinner.... for the rest of my life.
Cardio doc says that this
is a dangerous situation because my BP is unstable and goes up and down.
High one minute, too low the next. My HR also varies between
extremely low, to normal. Carvedilol is also a high bp medicine, but it
has to be taken twice a day and in a TIMELY fashion, and I found out a couple
of times just short the half-life of this stuff is...the first time being the
day I forgot to take it before going to the cardio appt. The second
time.....
This past saturday... I
dared to sleep in. By the time I got up and had my ShakeOlogy
breakfast... I was somewhere in the area of about 5 hours late taking the
carvedilol. I have to keep a BP log now, at least 2 readings a day, more
if I have symptoms that I feel I need to check my BP in relation to. I
took my pre-medication reading...
Hypertensive Crisis
163/132
(61 bpm) This is a stage 4 hypertensive crisis that would normally send people
to the ER or calling an ambulance to avoid a stroke. Being new to this, I
simply took my carvedilol and waited. 11 minutes later my BP was 105/71
(45 bpm). That second reading was actually low, and my HR was extremely
slow. These wide swings are what my cardiologist was talking about, and
it has only somewhat to do with the carvedilol, of which I'm on a very low
dose. But these swings occur throughout the day no matter what. Though
with proper timing of the heart/bp meds there's less of these swings.
Problem is... when my HR drops very low, the regurgitation becomes even
worse.
Moderate to Severe Mitral
Valve Regurgitation and Increased Pulmonary Hypertension?
Last year when I was in
the hospital the MV Regurgitation was at the "Moderate" level, which
is considered a 'careful watch and wait' mode to see if symptoms increase, stay
the same, etc. When my new cardiologist received the records from Mobile
Infirmary, however, he found that the written records stated "moderate to
severe," which he said 'puzzled' him. He explained that severe
regurgitation usually presented with right side heart enlargement. My
dimensions are normal (thank God). But, if it's bordering on severe, that
could be an issue in which action may be required to stop it from reaching the
severe stage.
He stated that because of
my symptoms they needed to take a closer look to make a more accurate
assessment of the regurgitation and to try and find the cause, such as mitral
valve problem (prolapse, etc), and the only way to get a closer and more
accurate look is to do a T. E. E. (Transesophogeal Echocardiogram). In
other words, to do an echocardiogram from inside the esophagus, because you can
get closer to the heart that way..and get a better view. I will be under
for this procedure, of course. :)
Pulmonary Hypertension... kind
of spooky.
One year ago during an
echo, I was told there was elevated pressure in my heart, meaning I had mild
pulmonary hypertension. In some people, mild cases often stay mild
(depending on the cause). When I spoke about this to my cardiologist on
the first visit, he said... "You probably do have PH! With the heart
arrhythmia, high BP swings, mitral valve regurge..." Well geez! lol
He's pretty blunt, but.. he's an awesome cardiologist, so I didn't mind
that. He's aggressive and leaves no stone unturned. So anyway.....
Normally the pressure
should be less than 25 but is now at 41. Laying down makes me gasp for
air. Taking a shower or bath makes me gasp for air. I just picked
up one of my ferrets...and am gasping for air as if I'd run a marathon.
No fun.
I had a colonoscopy
yesterday (because I'm 52), and the best part of that was.... the nurse putting
the oxygen hose under my nose. I wasn't expecting to feel so good when
she did that. It was so telling.
Today.... (Tuesday 4/22/2014)
Kind of a
tough day. I feel a lot of pressure in my chest, faint fluttery
sensations, super dizzy, can't breathe well, head hurts, and I'm so tired.
Did one load of laundry... and I've had it.
I've been avoiding talking
about any of this, even as I've dealt with it over the months...as it's gotten
worse. I'd been convincing myself it was this or that, blamed it on
needing vitamins, needing my hormones balanced (which is being taken care of
anyway), needing better nutrition (which I'm getting GREAT nutrition), then I
blamed it on carvedilol... as it just got worse and worse. I thought, if
I just didn't talk about it.... ever.
Well, not talking about it
sure didn't help. Thinking it was nothing didn't help. And thinking
it was just my imagination didn't help. In fact, my cardiologist showed
me the EKG strips on the computer from the monitor and showed me what the A Fib
looked like. It's real. And it's dangerous. In fact he said
"This is extremely dangerous."
I look back at all the
stuff I ignored, shrugged off, because I didn't have insurance and no other
doctor would take that next step and look into it....
I recall one episode last
year when I was at Winn Dixie in Mobile. I was in the check-out lane and
my heart started with the 'palpitations.' Normally I can count the beats,
which range from 160-180 BPM. This time...they were SO fast I couldn't
count them. I missed so many trying to count and counted to 200 and gave
up. It lasted some 25 minutes or so and stopped on its own.
Everything hurt by the time I got to my car. I feel like I'd
climbed a mountain, running, with someone beating me with a baseball bat the
entire way. I was so tired by the time it was done.
I knew I needed a
cardiologist, that I didn't want to just allow my GP (at the time) to prescribe
carvedilol and have his in-house tech do echoes on me without my seeing a
cardiologist. That inner voice EVER SINGLE DAY keep SCREAMING at me to
INSIST on a referral NOW. It wouldn't let up. That voice would keep
me awake at night, and it would be the first thing I'd think about when I'd
wake up. I thought maybe it was because I believed I needed off the
carvedilol. I'd told T about this and he said I should just tell Dr. E
that I needed a referral. Period. So I did.
I had multiple episodes
one week, about 4-5 about 1 1/2 days. During the day, sitting down doing
nothing, laying down trying to sleep, and even once.. that woke me up during
sleep. I thought maybe it was the prednisone I was on. Maybe it was
just a bad week for my heart. Don't know. Either way, I knew I had
to do something. Glad I did.
Tomorrow's procedure.... (tomorrow being 4/23/2014)
I go in
at 9:30am for the T. E. E. and the procedure is to take place at approximately
11:30a. I'm not scared. But I'm a little grossed out that they're
putting something down my throat. lol They're going to give me propofol,
and I don't have any adverse reactions to that (as I found out yesterday), so
I'll be out of it. I'm also a little bummed that I can't watch. I
love to watch the echoes I have, so this is one little bummer about this
particular procedure.
What do I expect?....
I guess I
suspect they'll find my regurge is moderate. I trust that the doctor is
correct in that if my regurge is severe that I would have issues with
enlargement of the right side of my heart, and... I don't. So I think
it's going to be okay in that respect. I also doubt that the mitral valve
is having any serious issues, because they don't seem to SEE it on the previous
echoes. But then, maybe there's another issue other than prolapse that
can cause this? In previous echoes they've found moderate regurgitation
WITHOUT seeing the valve prolapsing? Weird, if you ask me. Oh well,
I'm not the cardiologist.
So.... I guess, I've had
my workout on this laptop for the moment. Seriously, you've no idea what
it takes out of me to do this, especially on days like this. Ugh. lol
Laterz, taterz! :)
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