reading the tea leaves...

I followed up on the report of my TEE--trans-esophagyeal echo-cardiogram, since it left me in limbo as to how to proceed. Our health system here has a computer portal that one can log into and contact the docs, and see clinical reports, and lab results. It is a great site. They promise to make contact to answer questions sent to them in 48 hr--and for the most part--they do. First, my layman's summary of the TEE:

1. My ejection fraction is around 35%. My last but one was 50%. 50% or higher is considered normal. The ejection pressure is produced by the action of the left ventricle. I have a weakened left ventricle. That was established earlier and still exists. Its weakness apparently results in the lowered ejection fraction.

2. My aortic valve function shows mild-moderate stenosis. They only remove and replace the aortic valve if it is severely stenotic. So I am not a candidate at this time. 

The NP who is following my case answered my written enquiry with a telephone call that was quite productive. Since the outcome of my TEE is non-conclusive for what they expected, that is, the aortic valve is not the problem, they still don't have an acceptable reason why my heart went into the beginnings of failure again. She talked of my experience this time as an event for which they have no cause. I liked that wording since it seemed to me to more mimic my experience which seemed like a sudden onset after a long fight with an upper respiratory virus. 

One possible cause is the RCHOP--the acronym for the chemotherapy I had for my cancer 8-9 years ago.  Apparently there is some evidence that those poisons can produce organ damage at much later dates.

To rule out other possible causes they want to do an angiogram. In this they poke the femoral artery in the thigh and thread their way up into the heart where they can check pressures, and arteries for blockages, etc. She called this angiogram the gold standard. It is scheduled for Aug 12. It will require most of one day since although the procedure is relatively short, they have to make sure that the hole they make in the artery heals enough before they let you go.

In the meantime I am permitted to exercise so long as I don't become anaerobic that is, breathless. But that means that I can do more than I am currently. I am contemplating retrieving my road bike from my daughter and seeing if I can make some simple rides around the flat, back streets of town.

We'll see.....

nothing to see here...

Much ado about little. I had the TEE (Trans-Esophygeal-Echo cardiogram) on Wed. Most of the 5 hrs was spent waiting for the doc to do the damn thing. As I figured, having experienced a number of upper GI endoscopies, this was little different. I have misled you all earlier by speaking of a camera taking pix: actually it was ultrasound. But they still take pictures, I believe. In any case the entire procedure was about 20 min of the 5 hrs.
The result is that I have mild to moderate aortic valve stenosis. And they only R and R the aortic valve if the stenosis is severe. So then they had to decide which team there in the Heart Institute was going to continue to monitor me--structural or heart failure--and the heart failure group won (?). I am scheduled with them for a 2-month follow up.
I am ambivalent. On the one hand I thought that a new aortic valve might make me feel better; on the other hand I have to continue to manage myself in such a way that I feel better--and I am not sure how to go about that. I have tried recently to exercise and to walk but they don't together seem to do much but make me weaker. 
Is it possible that I am simply in the waiting period? end of an era? end of life? don't call us, we'll call you? etc ad nauseum? Well, except intellectually, I am not going to worry about all of that.
Instead, it is a gorgeous morning, and I am going to go for a walk....