Thursday, May 14, 2020

knowledge...

Since last I posted I have met with a couple docs and had several tests that appear illuminative:
1. I have tested negative for CORONA19. I was retested again today.
2. Chest x-rays showed some striations (?) in the lungs, apparently leading to my primary doc getting me back on torsemide (10 mg/day). He suspected I was carrying water and making it harder for my heart to work against that. He was right!. Though I watch my ankles for swelling and my weight for consistency, neither was a good enough signal. The torsemide has shed me of 5-8 lbs of water to this point. I can feel my ankle joints starting to ache which means I may not have much more to give. Weight today = 210.8 lbs. Haven't been there in years.
Another upshot of the torsemide: the first night I had the best sleep in months. That has continued. I am sleeping a lot which may mean I need a bunch of it in the bank. And I have some more energy, not normal amounts, but definite gains.
3. Blood work I don't know enough to comment on except to say that whatever measures sugar in the system, mine is too high. (With no appetite, sweet is where one goes!)
4. Echo cardiogram. This is the one where the tech rolls a ball around on your chest and shoots a million pix of the heart doing its work. This order surprised me because I thought we were going to do a regular 12-line ECG. I had forgotten about a datum from this test that is among the most significant in re heart function: the ejection fraction. This is the amount of blood forced by a ventricular stroke from one side of the heart to the other. 
Normally the ejection fraction is above 50%. When I had heart failure in 2015 and arrived at IHC Murray, mine was a 12 or 13%. When I left there a couple of treatment weeks later, I was back over 30%. And I was a couple weeks after that too high (>35%?) to qualify to have cardiac rehab here in Logan, My last ejection fraction was taken in 2018. It was 50%. 
My echo cardiogram was this morning. Normally, the techs like to give nothing away because they only get the data they don't interpret it. Often they are terse. But my tech today told me the number was around 30%. Definitely diagnostically important. After it is read today, my doc will get the results tomorrow. 
He also said there was some concern about pulmonary pressures. The pulmonary arteries and veins convey used and fresh blood from and to the heart from the lungs. So that is something to ponder.
In sum, looks as though I have some heart failure again. We'll wait to see what my primary doc's next move is. I think maybe a consult via telephone will occur before my next appointment which is Tues. A repeat of chest x-ray is scheduled then no doubt to check how the lungs look after the torsemide regimen.
I am optimistic.

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