yes, but you're a young 80....

We are having a fine holiday weekend. The weather is typical--snow showers, rain, clouds--clean air! So, a lot of TV and reading and, of course, eating.

You may assume--correctly--from the foregoing that health things are going well for me at the present. They are. My recovery seems to be as full as it may get from my second ablation. This last couple weeks I have had no trouble doing my usual workout. Upon follow up, my rhythm doc cut back the amio. 75%--from 800 mg to 200 mg. There have been no untoward effects of that, but it has only been a few weeks and that stuff lurks for sometime. I have an appointment with the rhythm guys on the day we leave for AZ in the first week of Dec. I expect they will dc the amio at that time. We'll see.

I had my semi-annual follow up with the Heart Failure Clinic this past week. The PA, a very knowledgeable women whom I have seen before provided this post's title. That made me feel good. She was a little concerned that my current resting HR is in the mid-50s. She would like to see it in the low 60s to prevent a "block". So she cut back on my beta blocker from 50 mg of metoprolol to 25 mg. at night. Apparently amio has some beta blocker-like effects as well so the two together might be lowering my HR. She thought that cutting the metoprolol might raise my overall pulse rate. Then we will monitor that dose with the possible effects of dc'ing the amio.

So, at this juncture, no news from me is good news.

Happy holidays!

free at last...

I'm home at our home-away-from home in SLC. I was released about 12+ hrs after my procedure on Mon p.m. It did take longer than they thought--about 4.5 hr from rolling out of the room to rolling back in. This time I felt more hammered when I got back. But I had a pretty good night's rest and feel pretty skookum this morning. I am not to lift anything heavier than 3 lbs for 3 days and to let Jan drive (OMG!). We are going to overnight here just because we can and because we are only 5 min from the hospital mothership.

My rhythm doc found 4 pulmonary veins that he claims regrew: that is, they were what he had previously ablated. Who knew this could happen? And no wonder I was speeding. He says that he had to hunt for a couple others that seemed to be sources of flutter but is convinced he got those as well. I did come out of the procedure with a high HR (155 bpm) but an amiodarone drip took care of that.

So now we heal. Months are the timelines. And then we'll see if anything more grows!

Part of that process is once again to be on amiodarone with its potential side effects. But it does control my rhythms. We will fade it gradually after a number of months of healing to see what gives.

the rest of this story

Well, I was right. The docs came by shortly after I finishing posting yesterday and sent me home to await scheduling for a second ablation. That will begin with check-in on Monday Oct 1 at noon at the mothership in Murray UT. (The nurses at IHC Murray are fantastic!)

Roughly 50-75% of patients profit from an initial ablation--in terms of controling irregular heart rhythms. I did. That procedure bought me a year or two, I think, before a second circuit established itself. Of those who need a second ablation again the percentages are pretty good: 40-60%, I think, profit from that one. A third is possible, too. But by that time I believe they are thinking about pacemakers. One of the PAs said he thought this one would be easy, apparently fairly well localized.

Pacemakers are primarily for supporting low heart rates but apparently can also be programmed with a lower limit and an upper limit. In that case the heart upper and lower circuits are separated and the pacemaker controls it all. 

This is probably simplistic but it is what I understand right now.

My first ablation was 4 hours! I expect the same this time. By then it will be late enough that I will have to overnight once again at IHC in the Heart Institute. They pierce the groin in a couple places and don't want you oozing when you leave. So earliest home will be Tues but we might stay in SLC another night to be sure we don't need services quickly.

Notably, I have had a pretty good day today. I came home yesterday speeding along and remained speeding until I went to bed. I was free of speeding today until after lunch when I had a burst for a couple hours. Free at this time (HR 72bpm)

I should note that a maternal cuz in Canada reports that he is living in a-fib permanently since none of the foregoing worked for him at all. He is not the only person I know experiencing this.

how I spent my 80th birthday...

How about: in hospital? Yep. I am languishing on the 4th floor of the Intermountain Health Center's Heart and Lung Institute in SLC. I am undergoing a trial of tikosyn, a medication for serious heart arrythmias. While it does its job, it is potentially dangerous in that it can increase the qt interval which is the time it takes for the heart to repolarize for another beat, Too long an interval and one can get venticular flutter and other bad things like stroke and death. 

The tikosyn protocol involves a dose morning and evening for 5 doses, followed by an EKG each time. So, the possibility of an increase in qt interval means one needs to be in hospital if the worst happens. And it means a 2.5 day hospital stay. That stay began Tues afternoon after meeting with the rhythm pros next door to this building. It ends tonight.

Leading up to all of this is that I am speeding. When the high heart rates began they were of a few minutes duration and seemingly controlled by relaxation. And these speeding occurrences were fairly infrequent, like every few weeks. Two things happened: the interval between occurrences decreased and their length increased to where I felt as though I couldn't control them. (Hint on below: I am speeding right now at 153 bpm and have been for some time.) I even ended up a couple times in the ER in Logan.

So, I have had 4 of the five doses of tikosyn and from my perspective it does not seem that tikosyn is working out. I will know in an hour or so.  (Aside: a respiratory guy just came in; he thinks I am getting a procedure since he announced that he will be measuring my CO2 output therein!) What I think is going to happen is that I will get a second ablation. I don't know when--could be as early as tomorrow morning. 

More when I know more....

trying to get to 80...

Did I mention coffee in the last post? I have only drunk decaf for the last 50 yr. But this past episode seemed to follow coffee somewhat and when I tried to restart tea after my heart failure I found it way too stimulative. Is that what is happening with the coffee now? I felt a little jacked after this morning's cup. Unusual.

I have been having issues with a Bose Soundtouch 300 sound bar synching with an LG-OLED TV. The latest issue is the loss of sound while streaming video on Netflix or Amazon Prime. This morning I believe I found the fix for it--note to self: cancel Geek Squad--and when the sound came on we found ourselves back into a new series that just won 8 Emmys--The Wonderful Mrs. Maisel.  To us, this show has been a laugh a minute. Jan was ironing and watching and we binged the series last 3 episodes, that is about 2 hr 20 min of laughs. During the last episode we had a sandwich while we watched. After that I arose and could feel my heart rate go up. These are the exact conditions under which my last palpitation episode occurred. And the conditions mimic those of earlier episodes--digestive system working, feeling relaxed with the natural opiates produced by laughter and by digestion. Then Shazzam.

The episode went on for 15 min before it resolved--it was resistant until that point--at which I thought we had dodged another ER visit--when it shot up again. We left pretty quickly for the ER and I was still ticking at 147 when we arrived. They got the 12-leads on and got a good picture this time. The ER doc said it just looked like supra-ventricular tachycardia. He wouldn't commit to flutter vs fibulation. The rest was the same: blood assay with slightly elevated BNP--not to worry--normal chest X-ray. Lie there watch NFL and read until all the results are returned and go home with a promise to contact my electro-phys doc. Which. I. Will. Do.

He'll have the EKG tomorrow so I will call in the a.m. and get him started and see where this leads....

I am a little less sanguine.

I will complete my 80th year in two days. That means I will turn 80.

he's baaack!

Well that slightly hubristic blog from last month is out the window. Here's what has happened.

My general condition has been good. I had a brief flutter episode Aug 15 during my workout. A brief pause and it resolved and I completed my program. Then nothing until two days ago on Sept 6. That episode was in the evening after dinner. It, too, resolved quickly. But change occurred yesterday morning. I felt an adrenaline surge with my coffee (decaf) post breakfast. I waited for the high HR to come down. It did briefly, then surged again. It did this for about 6 cycles all with highs in the 147 bpm range. This went on for 2 hours. Then it resolved finally However, I had another episode after lunch which resolved on its own. I was worried because my relaxation procedures were only momentarily effective this whole time. 

This continuing resurgence seemed the occasion to contact my rhythm doc. He wanted an EKG of an episode and/or a 30-day monitor. In the past each time I have gone to the ER the episode has been over and the EKG looks pretty normal. 

This morning's onset was a textbook copy of yesterday's. Immediately after finishing breakfast and relaxing with the Washington Post up went the HR after an adrenaline bump. I waited to see whether it would resolve with some relaxation. It did. But it returned again in a few minutes. We headed for the ER, about 1/4 mile away.

They hooked me up quickly to an EKG, 12-lead machine. It was all normal except for a PVC. However, on the 3-lead machine to which one remains hooked a few minutes later they caught an episode. HR bumped up into the 140s. ER doc said it looked like flutter, not fib. An enzyme symbolic of heart failure, BNP: B-Type Natriuretic Peptide, was slightly elevated. ER doc suggested a much greater increase would be necessary to talk about further heart failure. But he did note that today's amount was elevated over my prior baseline.

The ER doc then consulted with my rhythm doc's on-call partner:

I am to increase my use of the beta blocker, metoprolol, from 25 mg per day to 25 mg twice a day. This ought to be fun. I had serious lightheadedness when first taking this med a few months ago but after several weeks, not so much. And, if that proves too much, I can cut the pills in half.

Stay tuned.

blog pressure

Not much to report on. But a number of you always surprise me by asking if I am okay in the absence of information to the contrary.

I am okay, maybe even better than okay.

I haven't had any palpitation episodes in over 3 weeks. That, one hopes, is the start of a promising trend.

But I am gaining weight. Some of it seems to be water as the gains show up in multiple pounds overnight. I managed to go about 6 weeks without a diuretic but have taken a couple in the past 2 weeks with the last today. Typically that lowers my next day's weight by 6-7 pounds.  I don't think the retention is due other than to uncontrolled eating and drinking. We have had company. QED. 

The gains are conflated with seeming increases in strength. It feels to me as though I have developed new muscle mass. In the past when I have experienced this the weight appears to be 50% water. I am making gains in my strength exercises of a few pounds on each exercise. I am increasing the resistance on the recumbent bike for a longer period of my 30-min ride. I can more easily open vacuum-sealed condiment jars.  My waist dimensions don't seem appreciably affected, ie my clothing appears to still fit about the same.  So it is a time to raise consciousness which I am doing by recording this, and to cut back some on portions and snacks and alcohol. Let's see what happens

happy fourth

Drove south to SLC on Monday to do some shopping and an appointment with the rhythm doc yesterday. You may recall that his office scheduled an appointment because the heart failure clinic put me on a new beta blocker.  The latter move was ostensibly to cut down on the number of pre-ventricular contractions (PVCs) that they heard and then saw on my EKG and my 24-hr Holter study. As a sidebar they also did a sonogram and showed that my heart's ejection fraction was 50% which is (barely) in the normal range but way above what it was during my heart failure of 2015. Otherwise I was not to see the rhythm doc for a year. 

Good news: the rhythm doc's EKG showed no PVCs! I don't know if this is the result of the beta blocker (Metoprolol). But the rhythm doc wants me to stay on it. If it is such a result, score one for the heart failure clinic and I take back what I said in my last couple posts about their assertiveness. (I cannot perceive these PVCs.) The doc also said that the Holter turned up no instances of A-Fib.

I also shared with him that my rate of palpitation episodes is every couple of weeks and that they are related to exertion and occasionally other excitement (e.g., I had one after watching a tense movie. Go figure.) Further, I told him of my last episode beause it seemed a little different. To wit:

On the recumbant bicycle at the gym on Monday morning, I increased the resistance during my ride at one point. I had been doing 5 min (of the 30 min) of this increased resistance with no side effects for several sessions. I went for 10 min. Toward the end of this period I felt a bump in my chest as my heart did something. I looked at my oximeter and my heart had spiked at 139 bpm, but instead of staying there for several minutes it came back down to the 90s and then the upper 80s within seconds. This was the quickest resolution that I had seen. During this episode I kept cycling, albeit at the lower resistance and somewhat more slowly, with no further effect. One should also note that this was the 4th workout in 8 days--an attempt to catch up a little given the time away in AZ.

I mentioned this to the rhythm doc and asked whether these episodes might get "better" meaning shorter and less frequent and he said that was possible. This was excellent news as I was laboring under the impression that that wonky circuit would be there forever. Could this also be an ancillary effect of the Metoprolol? One hopes.

So, I am newly energized.

Happy 4th of July!

death and taxes

I helped to bury my surviving bro yesterday. It was a rare, rainy day in AZ. We had travelled south to be with him the prior week when it was clear that his time was drawing to a close. He and I had a good 5 days in which we talked--mostly me, since he was very weak--about the old days, growing up together in Vancouver and early times in AZ.  But he understood: his comments were on target. To fulfill UT obligations we had to leave and were texted about his demise whilst on the highway. We returned after a hiatus of a few days. Did the funeral along with a short eulogy and the interrment, which was in his wife' s family's plot in the cemetery at Pine, AZ. The latter reminded me of Boot Hill in Tucson without the tourist trappings. It was unpaved, ungrassed, and untouched except for some ragged rows of modest headstones and stone outlines of the gravesites--appropriate to the Mormon pioneers that were the family into which he married. It all seemed very natural. We all repaired to a local tavern in the downpour afterward. He leaves us with a passel of nieces and nephews and their kids all of whom seem to be the real deal.

So far the metoprolol doesn't seem to be doing much of anything. I've had a couple palpitation episodes, maybe a bit more disguised in onset. I'm no longer really feeling woozy upon taking the med in the a.m. which would suggest I am tolerating it okay, The episodes have been typical: following a fairly strenuous day; during a workout, etc. And they resolve in minutes. At this point--early days--I don't see any change is frequency of episodes. 

Rhythm doc is back on the schedule for July 3. We'll see what he makes of it all.

Oh yeah, the taxes part of the post's title: Got it wrong again on an estimated state tax payment--thought it was going to happen and it didn't. Penalty and interest. Oh well.






















d

they win...again

Well, the Holter results came back and the PA called me to discuss them. They counted about 6-7% pvcs which they thought was high and not good--but they didn't really say what level would be intolerable. They prescribed a beta blocker called Metoprolol. I began it about 3 days ago, amid the usual warnings--don't operate heavy machinery, may make you dizzy, etc.--and am tolerating it reasonably well. It may make me a little zooey when I first take it with breakfast but each day the effect is a little less noticeable. They said it would make me a bit more comfortable. I am not sure what that means. But, so help me, I do feel a teensy bit comforted.

I was on an old-standby beta blocker--attenolol (Tenormin)-- for 27 years preceding my heart's failure. It did a fine job suppressing most of my A fib and keeping my hr under control. It was only when, for other reasons, they pulled me off the attenlol after that time that my heart went fully into the whole heart failure boogie. Interestingly, one of the warnings with this med is to not stop it abruptly. Fair warning.

The prescription information states that the drug is for: high blood pressure; chest pain or pressure; or heart failure (weak heart). So I'm in there somewhere. I have mild hypertension and the obvious weak heart (really?) but no chest pain or discomfort. This morning's bp was 120/75 which is fabulous. The result however is conflated with a torsemide yesterday which dropped me 5 lbs of water weight overnight and is usually accompanied by a lower bp the next day.

the semi-annual heart clinic thing....

I am posting again to discuss the findings of my semi-annual visit to IHC's Heart Clinic in SLC. These visits have been fairly routine--but this one has not. The two new docs I saw--both women--were worried about the number of pre-ventricular contractions (pvcs) they heard in my examination. I was under the impression that people live with these without problem. An ER doc once told me that his wife had thousands each day. So they asked to do an EKG and a sonogram and a Holter. By that time they had scared me--they in turn thought I was resisting--so I relented and said okay. They were also seemingly worried that I am on no actual "heart med". Doesn't it follow that meds are necessary? Well, no, actually.

I had gone to the extent of calling the heart clinic before my semi-annual physical in Logan because I didn't want to pay for unnecessary re-testing, viz., a blood panel in Logan followed a couple weeks later by an almost identical one in SLC--one of which Medicare would not want to pay for. And, I liken it to churning the system as these guys are paid by the test. I had had an EKG as part of the discontinuance of my heart meds in March and it seemed quick to have another one now. Ergo, my resistance. But I did set the context for this by describing my palpitations to them, though I also explained that my rhythm doc knew all about them and did not want to see me for a year. The latter's feelings appear to be that if I find the frequency and duration of the palpitations tolerable, he is okay with not proceeding to another med at this time.

So, I had the EKG. Result: normal sinus rhythm. Then I had the sonogram. Result: normal. In the latter, the ejection fraction--the amount of blood moved from one side of the heart to the other  on each stroke--needs to be at 50% or higher to not be clinical. Mine was at 50%. (It could be better.) After my heart repairs during the heart failure crisis of 2015 I scored a 55%, but the error range is +/- 3%. They were unconcerned. As am I!

So here we sit in SLC awaiting the completion of 24 hrs of wearing a Holter monitor (7 leads). No shower today--stinky boy. It comes off at 3:30 pm after which we drop it off and wend our way with the rush hour traffic (boo!) north to home. I fully expect no further clinical outcomes from the Holter. But there's always a chance.

In any case, the positive side of this is that we have a new baseline 3 yrs after 2015's heart failure and that, along with its outcomes, is good,

extra choruses on the rhythm thing

I see that I have not posted in over month. Most of you faithful readers know that this is often because--happily--there is nothing to report. And this was true until yesterday. I have been free of rapid heart rates since I last posted. Yea! And, my regimen has obviously been working: I have been working out a couple times per week, again cutting the amount of reps in my lifting and omitting the sprints from my recumbent bike riding. (I wear an oximeter whilst working out.) I have been not especially sedentary. Occasional walks around our subdivision, shopping, errands, etc. all in stride. I have been more conscious of having a single glass of wine or cocktail daily, but other than that, have not cut back on frequency. And occasionally I have indulged more as in having the cocktail and some dinner out with more than a single glass of wine.

So it was with some surprise that I had an episode yesterday. The scenario was almost identical (down to the kind of cocktail!) to the one that I had when last visiting SLC and the townhouse. The three of us had a single drink (a cranberry Moscow mule made with hard ginger beer), followed by a small Friday night supper of a toasted cheese sandwich and a bowl of tomato soup. (What, you were expecting haute cuisine?) I even refrained from the ice cream that was for dessert. 

This one popped up as a result of hiking up the flight of stairs to our area of the townhouse. It had the usual dimensions: hr between 147 and 160 and a duration of several minutes. Again, I attempted to relax the hr down. And, down it came in a few minutes. We watched television for a couple hours and I had to go downstairs to the kitchen to charge my water glass with ice for overnight. When I reached the top of the stairs as before, my hr again jumped up. Second episode again a seeming result of the exertion in climbing the stairs. 

In both of these cases I felt kind of pumped when the event occurred. The first I was a little high from the alcohol and the second a little high because we had just watched a stirring movie. What is annoying and unknown is why similar activities this past month have not had similar results.

Perhaps it had to do with the following: I have contracted yet another upper respiratory infection, this one brought to us by my sis-in-law who apparently contracted hers on the flight to SLC. She came up for Mother's Day (and Hamilton and Pink) and was sick by the time of the Pink concert. Enough bronchitis that it kept her from accompanying us to Jackson Hole on our annual Mother's Day outing. The high elevation of the Teton areas did not affect me more than usual, except it made me more tired. The flowering infection added its own fatigue. I slept almost 10 hours our last night there and then slept most of the way back home (while Lisa drove). I immediately hit the doc's for a Z-pac and have been hacking and expectorating now for a week. I am about half way through the antibiotics course. The doc suggested they were seeing a lot of what he called "walking pneumonia" but I am unsure (no X ray) that he referred to me.

So yesterday's heart events come in the middle of this bronchitis. On the bronchitis I am feeling better today. We are here until Tu next because of a semi-annual heart clinic visit Mon am and a jazz concert Mon eve. So I will have plenty more experience with the stairs in the townhouse between now and then.

We'll see what happens....

rhythm changes...

When I finished last week's post, it was about noon, but apparently I was not done with the races. That afternoon I was doing some chores--I don't know what now--and my hr jumped up to 139. I relaxed it down to 76 bpm. Later in the pm we had to meet with a person who wanted all of our remaining packing boxes from our storage unit. I humped some while he and Jan humped the rest. My hr jumped up to 160 bpm during this activity. I believe that it resolved itself during a slow down of activity and some slow breathing.

So, in one day I had 4 episodes!  That seemed to me to be pretty self-limiting. Thus, this past week I did no workouts. However, when our daughter came home for the weekend we were very active. We humped and put together some gorilla rack storage for the garage--you know the kind where if you know what you're doing it takes one hour, but when you do it, it takes two. That was on Saturday. That was also the day to load the tool box. Quite a bit of activity.

Sunday we decided to get a work bench that matched the tool box. That was 6 ft assembled and we could not lift it without help from the store. We opened the packaging in the 4Runner and removed individual parts so that we could manage the load. So, another one hour project that took 2 hours. Alot of hands and knees stuff on that assembly.

Throughout this activity, the old heart was steady. That led me to arise this morning and once again approach a workout. On this occasion I adopted the successful strategy of the prior week. Omit the sprints from the bike ride; cut the reps in half on the weights while maintaining the weight. Success! The old heart stayed between 85 and 91 on the  bike ride. (My resting hr on morning arising is mid- to upper-60s.). Hopefully over a half hour that is sufficient increase to produce somewhat of an aerobic effect. It was in a similar state during the lifts. 

We'll try again Wednesday to see whether several outings a week are possible.

I got rhythm...

Well, after recording my first gallops about 10 days ago, I have had 3 more episodes. The first was a week ago during my workout. It occurred while I was on the abductor/adductor machine. This machine exercises the muscles on the inner and outer thighs. One either pushes the knees apart against resistance, or starting apart brings them together, also against resistance. I cannot remember which is which, nor which provoked the occurrence. As before, I stopped the activity, commenced my cognitive relaxation therapy and felt the hr--which was at 137--come down to normal. 

Then there was a hiatus of one week, that is, until today. During the week I was pretty careful with the alcohol consumption--no whiskey--but an occasional glass of wine. We entertained last evening and I had several glasses of wine. I also did an easier workout 48 hours after the initial occurrence on the machine. I cut my sets in half and still felt good about the overall exertion. There was no flutter. Friday we blew off the workout all together. For the most part it was a pretty sedentary 5 days.

This morning the first high rate--that's right there was more than one--occurred during the cool down on the recumbent bicycle. I ride for 30 minutes without much resistance at 60 rpms and every 5 minutes do a 1 min easy sprint, say up to  80 rpms. I have been doing the sprint based on what I read about interval training for several months now. My hr went up to 147 during the 27th minute after I had cut the (minimal) resistance and slowed the rpms to 40 or so. Again the relaxation worked, but it seemed to take longer.

Then I did all my lifts without a problem (2 sets each of 20 reps) until I was once again on the adductor/abductor machine. My hr went up during the third of the 4 sets and again was brought down by relaxation therapy. Again it seemed to take longer. But, as I am not recording the length of time it takes to make the change occur, I cannot be sure of this. I  will have to think about starting a stop watch and recording if I want to pursue this.

I don't know what variables are responsible for this. When I felt it start on the recumbent bike I knew exactly what it was after the first misfire. Not so much on the second instance. Is it happening more with lower body exertion? Maybe working the lower limbs changes bp more. I have no idea.

Still: no panic. We'll keep to schedule and see what happens...

things may be what they used to be...

It has been now about 6 weeks since I discontinued the amiodarone. All has been proceeding well until...yesterday.

The shock doc met with me on March 6 to say again that he was worried about the spirometry results, hence the discontinuance in Feb. We discussed options. There is another drug that he will use, but until we see how I do, we will hold off. The reason is that this drug requires 3 days of hospitalization to see whether one tolerates it. Once, that is established, there are few side effects he says and much lower toxicity. The drug has been around a long time.  I asked that if it had lower toxicity, why he didn't start with it and the hospitalization was the answer.

In the interim we have successfully moved into our new home, Most unpacking is complete, and we are just dealing with bits and pieces to end our involvement with the process. E.g., landscaping has not begun--too wet; paint touch ups still on; garage improvements in process, etc. Other than these few things, we are enjoying our new environment including the neighbors and the 'hood.

I have restarted my workouts which took a hiatus of about 3 weeks during the move and I feel great. Also, I seem to be stabilizing on water retention. This last couple of cycles I have gone 8 days between torsemides. I can tell that something has changed in my body because I am getting stronger urges to urinate, more normal that is, and I am producing more urine, suggesting less retention. I don't know what accounts for this but I am happy about it.

Yesterday we drove to SLC to spend the Easter weekend. We did a little shopping, etc. then had a preprandial cocktail. During this process there was lively family discussion and I noticed my heart thumping away. A quick check of the pulse with the oximeter showed 139 beats per minute. This rate, while high, was substantially lower than the 155-165s that I was getting in the last round of these. Interestingly, I was able to close my eyes, engage my relaxation procedure, and the hr dropped quite quickly to normal, that is, high 60s, low 70s. I hope that this will work everytime. The shock doc has told me that these episodes are not fatal, which may mean to me that I should relax and deal with it--which I did.

So it will be watch and await further developments until we see whether I need this new drug with its hospitalization, etc. 

I don't know why also, but this past week or so preceding this flutter, I have had some latent anxiety, more like old times. Could it be related to something? Doh! Of course it is. But what?

there'll be some changes made..

I don't think I have posted lately on my use of amiodarone. This is a toxic substance that helps regulate heart rhythm. When, post ablations, I began to get episodes of rapid heart rate again--which involved repeated ER visits--my shock doc put me on this substance. In my case it has lived up to its purpose. I have had no fast heart rates since--not a detectable flutter.  And I have been only using it once a day when the standard dosage is 200 mg twice per day.

But, I say toxic because it has some serious side effects including making problems for eyes, lungs, liver, etc. The docs take the side effects seriously. So, I have been undergoing some tests of late. I had a metabolic panel done yesterday the results of which imply no problemo for the chemistry which would measure liver, thyroid function, etc. I also did some spirometry--breathing into a tube to check pulmonary function.  Eye tests are forthcoming.

The bug bear at this point is the spirometry results. They are on my health pages but as yet I cannot access them. I do know that they are significantly below average. The shock doc wants me to dc the amiodarone which I have done.

The whole life of the amiodarone in my system is supposed to be about 3 weeks. We'll see then how I do without it.

Of course, this will be concurrent with the move into our new home.  Sounds stressful, eh?

Really good timing for a dicky ticker..

more observations on water retention

What a thrilling title! 

The pendulum is swinging back up again: 

Date         Weight (lbs)        Torsemide          BP
                                               (Loss)

29 Jan        221.7                   Yes                     131/83
30 Jan        216.1                   (-5.6)                  122/76
31 Jan        217.1                                              126/77
01 Feb        219.6                                              126/79
02 Feb        220.1                                              132/81
03 Feb        221.1                                              126/77
04 Feb        223.4                  Yes                      126/76

So, the torsemide on 29 Jan produced an overnight weight loss of 5.6 lbs. That weight has been regained in a week, hence the torsemide today. 

This week blood pressure has been outstanding, both systolic and diastolic pressures near normal ie 120/80. This is only worth commenting on because it seems to me that my bp has been higher than this, eg as much as 140/90 during times of greater weight. Is it because of the extra water I have been carrying?

The foregoing paints a common, perhaps representative, picture of my water retention.

In re validity of the weights: We purchased a Weight Watchers digital scale a number of years ago. I weigh each morning--buck nekkid--before doing anything else. This scale correlates well with a similar WW scale in the townhouse. When I take a weight, if I wait a minute and step back on the scale the reading is the same. The device seems reliable. Validity is another story. I'll settle for reliability.

water, water, everywhere....

Well, it is clear that I am going up and down, weight-wise. As I indicated in my last post, I have begun to reflect more carefully on this after the heart failure docs worried about my gains. Recall that they want me to take torsemide (Lasix) whenever I get an overnight gain of 1.5 lbs or more. I have resisted at least in part because these gains seem to be related to eating and drinking too much the day/evening before. Also, I seem to plateau for awhile suggesting that the gains are real weight.

Abandon that last thought! On 22 Jan I was 226.3. That was a 1.1 lb increase from the day before, but was determinative because I could see water in my ankles after a day on my feet. So I took a pill. Result--as I posted last time--was a loss of 8.1 lbs to 218.2. That was the most water-weight I have expelled in one day ever.  The following day I put back on 2.1 lbs. By rights I should have taken another pill at that time, But I did not. The next day I jumped another 1.6 lbs (221.9). Clearly another torsemide was necessary. The following day I had lost another 6.3 lbs to 215.6. In other words I had gone from 226.3 on 22 Jan to 215.6 lbs on 26 Jan, a loss of 10.7 lbs in 4 days. Since then I have gained I have gained 5.1 lbs to today's weight of 221.7. I am going to have to take another pill.

The pills themselves are innocuous enough except that they require one to be near a urinal about every half hour for about 6 hours. I have begun taking them in the early afternoon so as not to impede workouts and errands and not interfere with sleep at night. One also takes a potassium pill as the dehydration is apparently hard on the kidneys and the potassium helps with that.

Yet I want to be careful about dehydration. It is and was signaled this past week with leg and foot cramps during sleep at the 215 lb level.

Stay tuned....

2018 and all's well

Another month goes by and I dither about writing a new post since I don't have much to offer. On health: the antibiotics did their thing and I am newly well again. It took a number of days--maybe even a week--to get most of the debris out of my lungs after the antibiotics were done. I'm back working out, reasonably consistently, watching the weight--hovering around 223 (3 lb above goal)--cutting back a bit on the alcohol. Doing the stuff that every one seems to do as we start a new year.

To be alive this long is amazing. I know when I was young that I thought I would be lucky to see a new century turn. I was 62 when that happened and my cohort's average time on the planet was running out. Now here we are some 18 years later. There are several times that in days of yore I would have died. Thanks to modern medicine, that did not happen. For that I am thankful.

The only real issue that concerns me currently is the tendency of my body to store water. In my last heart clinic checkup they wanted me to take the Lasix pill whenever I gained a pound or two  overnight. My tendency has been to wait and see whether the gains continue each day. So I had a week recently in which it seemed I gained near a pound every day, let's say 5 lbs for the week. I took a pill and lost 5-6 lbs. But in the succeeding days I put back on half of that. And I felt very dehydrated until I did. Since that time my weight has gone down occasionally along with up occasionally. The variations seem related to eating out and booze. Much lower variation if those two conditions are absent. Now it seems that I may gain a pound or two for a day or two and then I expel that water and drop two pounds overnight. The latter seems a very good sign. I am wondering whether I may see less of this as my heart strengthens.

Still awaiting house completion but the end of the tunnel may be approaching.