Well checking back I see that there is a little news that constitutes an important update (at least to me). After the kerfuffle with the lisonpril (see prior post) the heart failure team wasted no time getting me scheduled with the structural team. I had forgotten that they all wanted another test. That test is a naso-pharyngeal echo cardiogram called a TEE (the T is for Trans-). So, I am not yet scheduled for a removal and replacement of the aortic valve. This is where getting ahead of myself comes in.
The TEE consists of inserting a camera into the esophagus where it is very close to the heart. Thereafter it is just an echo-cardiogram in which over 30 min or so they take a bunch of pix. It requires mild sedation and fasting, etc, but is essentially out-patient. My appoinment is for 3 pm on Wednesday and they say to budget 4-5 hrs with them. The long time is to wake up from the anesthetic and get stable. Obviously, one does not drive oneself home! Fortunately I have a driver who has been with me (and I with her) for 58 yrs (Yea!!) The results of the TEE will, presumably, determine the possible RandR of the aortic valve.
The scheduling of the TEE involved its own set of problems. To wit, when the doc doing the TEE was informed that I have acalasia (no esphageal motility), he freaked. I had forgotten to mention this condition to anyone because it was sometime before I understood what the next test was that I would get. The doc wanted me to cosult with my local upper GI guy (whose practice may be on hold while he fights his own cancer. His office never got back to me. In the meanwhile the Clinical Coordinator for the Structural Team had a chance to visit further withe the doc doing the TEE. He told the doc that I have been living (successfully) with the acalasia for some 30 yrs. That doc removed the requirement for the consult and we rescheduled the TEE for the second time. Then they didn't call me to schedule yet another COVID-19 screen for the TEE. When I asked about that we again had to reschedule the TEE to fit in a COVID test that fell within 48-72 hrs of the TEE. That in turn meant that I needed to find a testing place in Logan that was operating on Sunday (yesterday). No problem as it turned out. The usual place (this is my third swab) in North Logan was open for 4 hrs. I got 'er done.
(If you've not had one there is little to be troubled about: it does feel funny to have a probe that far up your nose being swirled for 10 sec but most of the time for me that has been novel, not painful.)
So barring additional screwups we proceed to SLC Wed for the TEE and thence, who knows? I say this because my diagnosis at this time appears to be mild stenosis of the aortic valve. Would they replace it if the TEE still shows mild? We'll see.
Stay tuned....
Monday, June 29, 2020
Wednesday, June 3, 2020
but wait....
I finally heard from the IMC Heart Failure Clinic today. But before that:
At the prior appointment the NP wanted me to start lisonopril. It will help my heart's efficiency, she said. I said, that stuff destabilizes me, makes me light headed and feel like I'm passing out. She prescribed the smallest dose possible: 2 mg once a day at bedtime. I took it the first night--no problem. I took it the second night--no problem. The problem came after breakfast the next morning when I started to pass out when getting up from the table. I was wooly and staggery for some time thereafter and solved the problem with my CPAP machine with its 2 liters of O2 and a subsequent nap. I emailed the clinic to tell them I was taking no more lisonopril. (This is Sat morning). This experience was eerily similar to the one that put me in the ambulance from Hyde Park a number of years ago and presaged the cascade of events that preceded my heart failaure soon thereafter. The same drug was the catalyst..
Then yesterday I had an extensive consult with an oncologist at the Logan Gossner Cancer Center. He wondered why I was there. Seemingly it was a result of a couple high readings of gamma globulin in recent urinalyses. A raised gamma globulin level is an outcome of the body fighting some invader. The Center was responsible for a follow up urinalysis in which I collected every drop for 24 hours. They were looking for proteins which shouldn't be there. I think they are somehow measured by weight. We talked of my earlier mantle cell lymphoma. He examined my lymph nodes. The upshot was that I didn't really have a measurable amount of this protein in my urine. A hint, no more. Could he have meant the result was maybe a false positive? He seemed to buy the possibility that the raised levels of gamma globulin may be associated with my chronic upper respiratory stuff which has abated somewhat with the warmer weather. Conclusion: watch and wait. They will see me again in 3 months.
Then this morning, the Heart Failure Nurse calls me to see if I am getting my blood labs done today. I say, what labs? My understandng was they would reread my file which contains a bunch of blood tests recently. (Apparently not a metabolic panel.) Then we could see whether we needed more. She went away to discuss. Come to find out the metabolic panel was to see the effect of the lisonopril which since I had discontinued it was now moot. Of course it was good to hear that I was not ouf of sight and out of mind.
She affirmed that I was referred to the Structural Team on Monday. This was the remaining question I had. So, the game is truly afoot.
At the prior appointment the NP wanted me to start lisonopril. It will help my heart's efficiency, she said. I said, that stuff destabilizes me, makes me light headed and feel like I'm passing out. She prescribed the smallest dose possible: 2 mg once a day at bedtime. I took it the first night--no problem. I took it the second night--no problem. The problem came after breakfast the next morning when I started to pass out when getting up from the table. I was wooly and staggery for some time thereafter and solved the problem with my CPAP machine with its 2 liters of O2 and a subsequent nap. I emailed the clinic to tell them I was taking no more lisonopril. (This is Sat morning). This experience was eerily similar to the one that put me in the ambulance from Hyde Park a number of years ago and presaged the cascade of events that preceded my heart failaure soon thereafter. The same drug was the catalyst..
Then yesterday I had an extensive consult with an oncologist at the Logan Gossner Cancer Center. He wondered why I was there. Seemingly it was a result of a couple high readings of gamma globulin in recent urinalyses. A raised gamma globulin level is an outcome of the body fighting some invader. The Center was responsible for a follow up urinalysis in which I collected every drop for 24 hours. They were looking for proteins which shouldn't be there. I think they are somehow measured by weight. We talked of my earlier mantle cell lymphoma. He examined my lymph nodes. The upshot was that I didn't really have a measurable amount of this protein in my urine. A hint, no more. Could he have meant the result was maybe a false positive? He seemed to buy the possibility that the raised levels of gamma globulin may be associated with my chronic upper respiratory stuff which has abated somewhat with the warmer weather. Conclusion: watch and wait. They will see me again in 3 months.
Then this morning, the Heart Failure Nurse calls me to see if I am getting my blood labs done today. I say, what labs? My understandng was they would reread my file which contains a bunch of blood tests recently. (Apparently not a metabolic panel.) Then we could see whether we needed more. She went away to discuss. Come to find out the metabolic panel was to see the effect of the lisonopril which since I had discontinued it was now moot. Of course it was good to hear that I was not ouf of sight and out of mind.
She affirmed that I was referred to the Structural Team on Monday. This was the remaining question I had. So, the game is truly afoot.
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