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.

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