a couple a things

Yesterday, I visited with my local internist.  I have been seeing him for over 30 years so we are pretty familiar with each other. He said that my recovery had made his day and that were I not in good physical condition and healthy before the recent events, the outcomes might have been quite different. He has been able to follow along because the Budge Clinic is a part of the Intermountain Health Care system. So SLC and Logan records are transparent.

In pretty clear terms he thought that the advent of my heart failure was due to my chemotherapy. In my mind, the more proximate cause was the discontinuation (necessary!) of my beta blocker (attenolol) after 27 years and it was then that my heart manifested arhythmias. That would not discount the compound weakening effects of the chemo as a precursor or setting event and as causal in the bradi-cardi syndrome I was in (ie fast upper chambers, slow lower chambers) prior to all of this.

He asked whether we were going to go to AZ for the winter. I said we would like to. He said there is nothing to stop us. Onward!

As part of our foray into causes I noted that I was surprised to see in the literature provided to me as a patient, that sleep apnea was a correlate, if not a cause, of heart failure. I mentioned that as a part of the pneumonias I was pretty much defeating the nose pillows in my former C-PAP machine (to get rid of apneas), but that the new one with a mask covering nose and mouth seemed to have restored the quality of sleep that I was getting earlier. (I now have a BI-PAP machine which means that they can set one pressure for inhaling and another pressure for exhaling. I believe mine is set for 20 psi on the inhale and 15 or 17 psi on the exhale.) In any case the new machine and mask seem to work well, much to my long-suffering wife's pleasure--I am quiet now during sleep--and that I was getting much better sleep. That is all good.

 I also mentioned my continued use of O2 to keep my O2 saturation levels above 90% while I sleep. One of my sleep problems during the pneumonias was the O2 levels dropping into the 80s and below during sleep. Somewhere in this he mentioned the increased likelihood of dementia. I am assuming that was in relation to sleeping with O2 levels less than 90%. I will keep using the O2 during sleep. I hope the reference was not broader than that! At this point I don't know what is happening to my O2 during sleep, however, I assume the SLC guys were tracking that--while I was on O2 there--and did not report anything untoward.

I see him again in 3 mos before heading out of state.

Workouts continue and I feel better on each occasion.