Thursday, June 23, 2011

Pulmonary Heart Valve Replacement : 2011 - 18

Thursday June 23, 2011:
Yesterday was the first follow up appointment with my cardiologist. It included an echo cardiogram to establish a baseline post surgery. He orchestrated the test in person and examined the results from in the room and a distant location.

I like to check out what is happening on the monitor off and on during the testing. One of the views of the echo cardiogram shows color coded blood going through the valve. Past views were red on both sides of the valve. The view of yesterday showed red on one side of the valve.

My heart no longer sounds like me. It was sureal when I listened during the echo cardiogram in process. No whoosh, whoosh, swish. I cannot describe it because it did not sound right.

I was surprised by my nervousness during this. It seems the never ending medical issues of the past year are catching up with me when I least expect it. I was bracing myself for something along the line of, "Where did that come from?" There were no surprises.

My heart and lungs and stomach were listened to the old fashioned way. Ankles were checked for swelling The incision site was pressed to determine any tenderness or swelling. He found one spot.

I described the sensation of the incision as that of shoe laces holding together a shoe.

The job of a PA (Physician's Assistant) needs to be clarified to establish the importance of her participation in my medical care. You may think nurse with Rx writing privileges. The reality is so much more. She makes sure all the details are taken care of so the doctor can focus on his expertise. She understands everything the doctor does and has the ability to relate this to me (the patient). She also has skills to set up the details of a solution to the medical challenge when a direction of treatment has been determined.

Think Ginger Rogers to Fred Astair. He led and she did it backwards in high heels. My strongest advocate going through this medical process was/is the PA.

That said: Guess what the PA gave to me at yesterday's appointment? Something I did not think I would see. I was given photos of the original valve in various forms of deconstruction. This was very exciting. The PA explained what each photo was and I tried to remember as much as possible what she said. I took a digital photo of the photos and posted them below.

The top photo is the valve in it's entirety. I am not sure if it was still attached to my heart at that point.

The next photo is the valve laid out. The tiny dark nubs are the flaps that could not hold back the blood. I was taken by the cleaness of the valve.

The last photo is the valve in pieces. Note the scale is metric. For a conversion consider 2.54 CM is equal to 1". 5.08 CM is equal to 2". 7.62 CM is equal to 3".

So, you got through the visuals.

There were other things determined and changed at this appointment. I have lost 16# since my February appointment. This pleased all. Weight watchers does work.

I asked about reduction of dose of the Rx with the nastiest side effects. That dose will be reduced from twice daily to once a day July 1.

Two OTC meds were added bringing my morning total to 8. It seems like a lot until it is broken down for the purpose of training my heart to function 'normally' over time.

1- controls atrial fibulation: this will be reduced to once a day. My goal is to be free of this by 4 months out from the surgery.
2- establishes a strong heart beat. This is to help the right atrium shrink after decades of working harder than it needed to causing it to expand to the point that lead to the surgery. This should go away in about a year.
3- beta blocker was something I began in 2007 to reduce extra beats. I am not sure why it is still part of the mix, but when I was not taking it in the hospital my heart noticed. I will push to have this go away after the first two are gone.
4- Anti-cancer drug. This will go away in 4 1/2 years.
5- two baby aspirin. SOP for anyone with cardiac problems. It is better than Warfarin.
6- multivitamin. My gynecologist recommended I take a multivitamin prior to surgery 2 1/2 years ago. He said it would help healing.
He was right. I have been told I heal well.
7- New introduction today 'triple strength fish oil'. There are jelly beans smaller than this pill. It is promoted by cardiologists... I think because it is an anti-oxidant.
New introduction today CoEnzyme Q10 400 mg . Think horehound throat loszenge in size. I forgot why this was added to the list. I do know that a buy one / get one free promotion for #7 and #8 was $60 for two months. The insurance nurse suggested usin as a resource for less expensive OTC drugs.

My first time driving since May 31 was to the craft class at church last night. I stopped at a Target to buy the OTC drugs recommended. Target did not have what I needed so I drove to Walgreens. This was in addition to the stop at the local fabric store on the way back from the doctor's appointment earlier in the day. This was a lot more activity than the day before, yet no fallout from it. I am not more tired due to the extra activity.

Maybe today I will do the farmers' market with a luggage tote to collect my purchases.

How am I to keep track of my 'exercise' when I am not doing a formal program on the days I am active? Did I walk 15 minutes yesterday. Yes, I did in Target and at least 30 minutes in the fabric store. Did I do light calestetics? Yes, when I hand washed and put away dishes, folded laundry, straighten out the sofa and picked bolts of fabric off the floor I knocked off the table at the fabric store.

I do not do organized exercise well. Yoga works because it is social. I do not understand why walking for the sake of walking is such a desired thing to do. Yep, and I live with two distance runners. I love them. I do not understand them.

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