Tag Archives: cardiologist

More Test Results

I received the results of my 3rd heart echo.  It did not show any fluid around my heart, which the cardiologist was looking for since I’m still getting winded.  My ejection fraction has increased from 40-44% to 45-49%!!!  My cardiology team is ecstatic that my heart function has improved.  Normal range (according to my cardiac nurse) is 55-60+.  While I can’t believe it has ONLY increased 5% with all the changes I’ve made and all the cardiac rehab I’ve gone through, the cardiologist thinks this increase is huge…especially considering it was 15-20% after my heart attack.  Also, due to the damage that my heart has, it isn’t really expected to get back to normal from what I gather from the doctors.  They also say at least we are moving in the positive direction and any increase is great!  As for the results of my bloodwork for BNP and BMP, my BNP level was 114.  The PA (physician assistant) said that 100 or below is the normal range, but 114 was a good number for me.  They don’t start to really worry until the level gets to 300 or greater.  Within my BMP, my glucose was 99, which is good, so I shouldn’t be considered pre-diabetic anymore since the last my glucose was measured was in the hospital during all of my drama.

The kicker on this one is that I received a letter from my insurance company saying they will not cover the blood test for BNP because it is determined to be “experimental, investigational or unproven for the diagnosis” submitted with the claim, which is Coronary Atherosclerosis of Native Coronary Artery.  Of course, I think this is ridiculous.  Thank goodness it was only blood work, but I have NO CLUE what my bill will be!!!  If it is a small amount (like under $50) then I don’t have a huge problem with that; but if it’s a large amount, then I will have to appeal their decision, which is allowed.  It also says that health care professionals in my insurance network generally can’t bill me for services if they know they are not covered (yet necessary) and they tell me that in advance and I agree to it in writing.  No one advised me of such, so I’m wondering if I will get billed.  Maybe I will take it up with my doctor first if I do receive a bill.  Speaking of…I’m still waiting on a refund from the GI Surgeon for paying for my outpatient procedure in advance when everything was switched to in-patient/hospital stay.

On another positive note, my doctor did say that I can now ride roller coasters and start jogging (I asked about both!).  The jogging part is what excites me the most because it’s the only thing that will help me lose weight (I can’t believe I’m not losing weight with all of the changes over the past 3 months).  My doctor ordered another heart test, which I’m having done this week.  It will be a nuclear stress test while exercising.  He said it will help answer all of our questions as to why I’m getting winded when I go up stairs and why I’m having chest pains and tightness.  It will take pictures of my heart at rest and under stress to show how my heart is responding. Once the results are back from that, cardiac rehab will let me start jogging (based on the results) so they can monitor me before I start jogging on my own.  Ironically, my dad, who now sees my cardiologist, is going for a nuclear stress test (non-exercising) at the same time on the same day but at a different hospital.  Cardiac rehab told me that “no news is good news” when I’m waiting on results of the stress test.  The unfortunate thing about this stress test is it has a $200 co-pay.  Luckily, it’s happening on pay day.  Otherwise, not sure how I’d be paying.  Medical bills are adding up, and it’s taking a huge toll on my finances and budgeting.  Having a heart attack is expensive, people!

Tests

I had another visit with my cardiologist this week.  Since I am still having symptoms (chest pain, chest tightness, and feeling out of breath), he decided to send me for more tests.  He wants to check to see if there may be fluid around my heart.  I went for blood work – he ordered BNP (B-type natriuretic peptide) and BMP (basic metabolic panel).  I also had to get another echocardiogram of my heart.  Hopefully, I will have results within the next few days.  It was really kind of creepy watching my heart pump on the ultrasound machine.  I kept wondering if it was pumping normal (the echo tech is not allowed to give results) and watching my valves move was just mesmerizing.  The echo tech was extremely friendly and pointed out parts of my heart as she went along once she learned that I once wanted to be a cardiovascular surgeon and had a pre-med background.  I kept wondering in the back of my mind if she was being so overly nice because she saw something bad on the ultrasound.  But I am just normally paranoid about my health nowadays anyway.

My cardiologist decided to also increase my Carvedilol, although I forgot to ask why.  Normally, I take one pill in the morning and one pill in the evening.  He increased it to 1.5 pills in the evening, so I am breaking them in half.  Luckily, that prescription was already filled for a 3 month supply, so I have plenty for now.  I told him that I’m still having mild abdominal pain and I’ve been getting severe headaches, so he said I should schedule appointments with my GI doctor and my PCP.  I scheduled the GI appointment for next week.  In the past 3 days, I’ve also had heartburn, and I haven’t eaten anything different.  One night I had pretty severe heartburn, so I took a Nitroglycerin tablet.  The heartburn went away.  My cardiologist thinks the chest pain and tightness I’ve been having are skeletal muscle.  But I wasn’t having the heartburn when I had my appointment, so that will be something new to bring up to him at my next visit.  Heartburn is definitely not skeletal.

I’ll report back on my test results as soon as I have them.

Changes in Meds.

My cardiologist has decided to change some of my meds since I’ve been having so many reactions to them.  First of all, he decided to take me off of Lisinopril.  He believes it is what caused all of my severe abdominal pain when they doubled the dose.  Instead, I will now be taking Cozaar, which does the same thing but works differently in the body.  So far, so good.  I still have mild abdominal pain that comes and goes to the left and right of my belly button, but it hasn’t been severe enough to worry.  But I am worried – wondering if it is GI or related to my surgery.  

Since I’ve been off of a statin since I had severe reactions to both that I tried, my cardiologist consulted with a cholesterol expert and they found a new one for me to try.  It’s called Livalo (pitavastatin), and luckily, the office gave me samples for 3 weeks.  Every little bit of savings helps in case I’m allergic to this one, too.  I hate that I lost so much money on the Crestor.  Ugh.  Since I am taking the Cholestyramine (prescribed by my GI doctor), I cannot take the new statin at the same time.  Since statins work better at night, I am taking it around dinner time.  I take the Cholestyramine before bed when I take my other nightly meds.  On the Livalo, so far, I’ve had two hot flashes (I got really hot on the first statin I took) with no fever.  I have noticed that my chest tightness and pain is much more frequent and longer in duration than it was before.  Not sure if that is due to either of these new meds or if it is something else.  I’m documenting my symptoms to report back to the doctor at my appointment next week.  

I also learned that my EKG is still abnormal, even though someone said it was “beautiful” at a recent appointment.  When I asked the nurse about it, she said they aren’t sure what my new normal may be.  My current EKG, and I guess all EKGs since the heart attack, have had T inversions.  I’ll ask more questions about that at my next appointment since they do a new EKG every time.  

First Appointment With My Cardiologist.

The first appointment with my Dr. went as well as it could.  Everyone is so nice.  First, I met with a nurse who took my bp on both arms and did an EKG on me.  Next, I met a PA (Physician’s Assistant) who talked to me more about the tightness I’ve been experiencing in my chest and to go over other details of symptoms and side effects I’ve been having.  I explained all of the pain I’ve been experiencing (back, chest, arm) and let her know that I’ve still been very tired and worn down, especially when trying to walk for exercise.  I asked her how my EKG reading looked, and she said it was beautiful.  That felt great to hear!!  Then, I met with my Dr.  

I explained in detail everything I experienced over the weekend and anything I was still experiencing.  He said he will have to talk to a cholesterol expert to see what they recommend because I have to be on a cholesterol medicine.  In the meantime, he asked me to no longer take the Crestor and start taking 2 Advil every 8 hours to see if that helps.  He thinks the pain and tightness could be from the sac around my heart and wasn’t sure if the feeling was musculoskeletal or not.  He also wants me to start cardiac rehab, so I can learn my limitations.  Once again, he reminded me that he saved my life!  🙂 And he told some of the story again.  My dad came with me to my appointment (so he could make his own appointment with my Dr.) but waited outside.  The Dr. asked about my parents, and I let him know my dad was here, so the Dr. called him in so he could listen to everything he said to me.  It was good to have 2 sets of ears to remember everything.  I wish I could bring a voice recorder into my appointments so I remember everything.  

I had my list of questions ready, and before the Dr. left, I let him know I had a few more questions.  He said I can’t do roller coasters or go running 3 miles or do anything that would quickly increase my heart rate for a couple of months at least.  That is fair.  I also asked for clarification on the foods that he originally told me to remove from my diet.  Again, he said NO fried foods, NO egg yolks, and NO cheese.  I asked if that meant forever…he said I could have cheese on a rare occasion.  I told him I was trying the vegan route (but eating fish/seafood), and he told me he never said I couldn’t have meat.  I knew that, but I was taking it a step further.  He said his wife is a vegetarian and because vegetarians can’t eat meat, they supplement with a lot of cheese in most of their dishes.  As a result, his wife’s cholesterol is higher than his!  So, it didn’t sound like he was forcing me into the vegan lifestyle, which I’ve found very difficult.  I took that as my queue to relax a bit on the strict diet I was on.  Plus, I haven’t lost any weight.  

He decided to put me on a Holter Monitor for 24 hours, which I picked up a few days later.  I’m so glad he did that so he can see if everything is normal when I’m not at the Dr.’s office.  And he wants to see me again in a few weeks.  

It’s been a few days, and I haven’t heard from his office yet regarding the new cholesterol medicine.  They also haven’t contacted me about setting up my next appointment with him or Cardiac Rehab, so I will follow up with them tomorrow.  

Meds.

I did not have a great weekend or 39th birthday, for that matter.  I called the Heart Center nurse 3 times!!  On Friday and Saturday, I began feeling a mild tightness in my chest (on the left side).  This was unsettling.  I waited until Saturday night to call when I realized it just wasn’t going away.  The nurse said he didn’t want to alarm me but that I should keep my nitroglycerin pills close by and use them, if needed, if the pain got worse.  Luckily, it never got worse, so I didn’t use them; but it was scary.  I was on high alert all weekend.  The nurse also said I should call my cardiologist on Monday to let him know what was going on even though I already have an appointment scheduled for Wednesday.
On Sunday night, things got worse (but no pain).  I felt dizzy, lightheaded, and very weak late that evening.  I hadn’t felt great all day, and my face was extremely pale (maybe jaundiced).  I took my night meds around 10pm, and around 11pm I started to feel not well at all.  I felt like I might get arm pain or break out into a sweat, but I didn’t.  I just had a weird feeling when I was getting ready for bed. The dizziness, lightheadedness, and weakness are so severe so quickly that I decided I needed to call someone.  Although, most of it went away while lying in my bed.  I called my mom to see if she would come stay with me for the night in case something happened.  When she got to my house, she called the Heart Center nurse.  We all agreed that it could be the Crestor causing these reactions.  The nurse advised that I should not take the Crestor the next night but to still call her at the same time to let her know how I was feeling.  She also explained that the doctors PAY THEM to be on call throughout the night and on weekends, so to always call if I needed them…that’s what they’re there for.  That relaxed me knowing that I have this lifeline that is a phone call away.
The next day (Monday) was my 39th birthday.  This is the birthday I’ve been most thankful for yet I was unable to celebrate at all.  I felt nauseous the entire day and very weak.  I spent the day checking my Facebook messages on the couch.  Happy Birthday to me!  Later on that evening, I felt a little better.  I had read that Crestor has a half-life of 19 hours, so I’m sure that’s why I was feeling better as the night went on.  Today is Tuesday, and I feel SO MUCH better!  I have a little color back in my face and have no nausea.  Hooray!  I am bothered by the fact, though, that my brother saw me last night and said I was pale – like yellow-y skin – like jaundiced.  This is a side effect of Crestor, so I plan to share this with my doctor on Wednesday.

One fun new ritual I got to do this weekend was filling my pill container!  How fun this is!?  It is not as

easy as some may think.  I do need to organize all of my pill bottles and all the paperwork that comes with the medicines.

I plan on putting together a large binder that holds all of my paperwork, including the pill descriptions, so I can take this binder to all of my appointments.  Since I am daily tracking my hr, bp, and weight, I’m thinking a monthly calendar page may help so I can list all of this date as well as any side effects I’m experiencing.  This will be a super easy reference for the nurses and doctors, I think, if I can just show them this at each appointment.  Why don’t they still make Trapper Keepers?

I need to put together my list of questions for the cardiologist tomorrow.  Doctors’ appointments are now like Christmas to me!  I’ll post later about my appointment.  Wish me luck!

2 Weeks Post-MI.

MI stands for Myocardial Infarction (scientific name for Heart Attack), so you may hear medical staff refer to it as “MI”.  

I had my first appointment today with the Heart Clinic.  It wasn’t with any of the doctors who saved my life; this was with nurses from the Clinic to follow up and gather all of my information/medical history. This first appointment took a while, but they said it was because they needed to gather so much information at the initial appointment.  Everyone was extremely nice and only had great things to say about the cardiologists that worked on me in the hospital.  

I came in with a list of questions (as usual), but I hardly slept the night before because this appointment was like Christmas to me!  I couldn’t wait for this follow-up so I could ask questions that I hadn’t yet asked and talk about side effects, prognosis, etc.  They had a lot of questions for me, too.  First, they needed to get my medical history, then my family’s medical history (mainly my dad’s and my Uncle Edward’s).  Due to my strong family history of heart disease, the clinic will be watching me closely so I don’t have another MI.  My dad had a quadruple by-pass (it was an emergency open heart surgery when he went in for a routine appointment) when he was about 53.  He is still alive.  My Uncle (dad’s older brother by 2 years) had a quadruple by-pass (emergency open heart surgery when he was in surgery for stomach cancer).  He had also suffered a heart attack during the surgery for his stomach, which is how they caught his problem.  He was about 43.  He survived but went on to have another minor heart attack a few years later and then a massive heart attack, which killed him, when he was 60. I believe all of my dad’s siblings and both parents have had open heart surgery (multiple bypasses).  Only one Uncle is left (everyone else succumbed to ailments other than heart failure), and as a result of hearing of my “episode” and the symptoms I had leading up to it, decided to pay his doctor a visit the next week because he was having similar symptoms.  Turns out, he has a blockage (not an emergency) and will be getting another stent placed next week.  

I digress…so back to my Heart Clinic visit…

I mentioned to the nurses that I had what I thought were heart palpitations 2 days ago, along with a low blood pressure reading (80 something over 50 something).  They said that I should have contacted them right away so they could assess the problem.  I told them that I also have anxiety and wasn’t sure if it was actual palpitations or the fluttery anxious feeling I get when I’m stressed or nervous (nervous about my health!).  They said that palpitations could be brought on by low blood pressure and if it happens again to drink a lot of water (however, I cannot drink more than 2 liters of liquid in a 24 hour period) and to call them.  What I didn’t realize, and much to my RELIEF, is that the Clinic is 24 hours – rather, they have a night nurse.  So I can call at any time, day or night, and a nurse can assist me…unless I’m having a known emergency and then I should call 911.  They would rather treat me as an outpatient rather than put me in the hospital again.  I now need to program these #s into my phone.

They suggested that I could purchase a sphygmomanometer (fancy word for blood pressure cuff) online that could sync to my iPhone.  They also suggested that I get my current one calibrated (I’m using my dad’s) at the fire department as the readings seem to be low.  How exciting!

I also addressed the allergic reaction to my statin.  Last week, I broke out with a rash all over my torso.  I’ve never had a rash before.  I was told to stop taking my statin and to take Benadryl until my appointment today.  The rash has cleared up.  Although the nurses today didn’t really think the statin caused me to break out, they have changed my medicine to Crestor* (from Atorvastatin).  

During the appointment, the nurses were looking through my hospital records and discussed my ultrasound results with me.  The ejection fraction of my heart the night of my heart attack was about 15-20%…it should be at least 50%.  However, they were missing the results of the 2nd ultrasound that I had 3 days later.  Those results showed the ejection fraction to be about 45%, which shows my heart is healing and getting stronger; but it is still not strong enough.  The nurse had to call my Cardiologist to get this info, and my Cardiologist asked to say hello to me on the phone!  So the nurse handed her cell phone to me so I could speak with my Cardiologist!  What great and personalized service!  He did remind me that he saved my life and had it not been for him, I would not be alive.  I am forever grateful!!  He said he would like to see me next week in his office and he’d like for me to have a follow up with the nurses in 3 weeks.  This is great!  I want to see my doctors as much as possible so we can learn from each other, and so they can take every step to get me healthy again and track my heart’s progress.  

I asked about exercise to see what I can and can’t do and what I am capable of doing safely.  They recommended that I walk for 30 mins everyday.  Of course, I can build up to that with 10 mins a day to start.  They would like to see me gain my independence back.  And on that note, I moved back to my home today (was staying with my parents after the hospital).  

The nurses did give me homework until the next appointment; and although I’m not in school, I welcomed this homework with open arms!  I need to track my blood pressure, heart rate, and weight every single day.  This will help them gauge how well my meds are working and how my heart is responding to them.  They will also have a dietitian and a pharmacist meet with me on my next appointment so all of my diet and drug interaction questions can be answered.  For example, the doctor said I cannot eat dairy or fried foods anymore – does that mean forever??  It is so hard being a pescetarian vegan.  I want cheese SO BAD!  But let me take this moment to remind myself that CHEESE may be the reason that I had the heart attack!!

All in all, the visit to the Heart Clinic was great.  I look forward to my next appointment.  

*Crestor – the new statin they’ve prescribed me – is a brand name drug and was going to cost $48 with my insurance!  I paid $66 for all of my cardiac meds combined when I left the hospital!  Thankfully, I searched online and found a coupon from Crestor’s website for a free 30 day trial.  I took this to the pharmacy.  They were not able to process that 30 day free trial (for whatever reason), but they found another coupon for Crestor that brought my co-pay down to $18!  I would hate if I paid $48 for this and find out I am allergic to it, too.  It pays to do a little research, and it’s great to have a pharmacy that is patient with me.  🙂

I went to the fire department tonight hoping to meet a hot firefighter who could calibrate my blood pressure cuff.  Disappointment!!!  I was told that fire stations do not calibrate blood pressure cuffs!!  However, they were super nice and researched it online and called the cuff company to find out how to get it calibrated.  Turns out, it is cheaper for me to just buy a new one.  I will look into the ones that sync up to iPhone.  I wonder if my insurance will pay for it…


I apologize for not making this all so much more inviting and interesting with photos and such, but I just got a new iPhone today, so I will be sure to experiment with the camera function.  

Changes.

I now have cardiologists that I will be seeing for the rest of my life.  I also have tons of pills (like 8 of them) that I have to take everyday for the rest of my life.  The doctors told me “no more dairy or fried foods”.  I took it a step further and am trying to be a pescetarian vegan.  I may have made that up – but I am cutting out all animal products except for fish/seafood.  Not sure how long this can last.  I may end up changing to vegan entirely.  

So far, I’ve tried a vegan cheese – so I could eat grilled cheese.  Instead of butter, we used olive oil to toast the bread on the stove.  I don’t think the cheese had any flavor, but otherwise, it was just like a grilled cheese.  

Other meals I’ve tried:  Cuban Beans and Rice (found a recipe online), Crabmeat pasta salad, Baked Salmon with rice, guacamole, and tuna fish with vegenaise.  I’ve also switched to Almond Milks – I especially love their Chocolate Milk!!

I also have to weigh myself everyday, which I’ve always done anyway.  If I gain more than 2 pounds a day or more than 5 pounds in a week, I have to contact my doctor because that means my body is retaining fluid.  I’ve had a problem with this for a couple of years now, so I’m not sure how strictly this will apply to me, as I’ve been known to gain or lose 4 pounds in a day!!