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.
Sunday, May 27, 2018
Tuesday, May 22, 2018
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,
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,
Saturday, May 19, 2018
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....
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....
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