Archive for the ‘Doctor Visits’ Category
4
Jan
Written by Mike on January 4th, 2012
So, yesterday’s visit with with my primary care doctor was quite revealing. Given the fact that she called me directly and said we needed to discuss a letter she received from my cardiologist, I knew it would be an interesting visit going in.
As I mentioned in a previous post, the results from a recent round of testing performed by the cardiologist indicated that the strength of my heart has deteriorated again, and my ejection fraction is back down to 35%. I knew that going into the appointment yesterday. And I knew that the cardiologist had ordered a more intensive test to confirm that result. What I didn’t know was what he was planning to do if the results were confirmed.
His plan, should the test I’m having next week confirm the ejection fraction is indeed less than 36%, is to arrange for a defibrillator type device that would, hopefully, protect me from sudden cardiac death. In the event that I should go into cardiac arrest due to ventricular fibrillation, the device would shock my heart and restore a normal rhythm. Which in turn should give me a fighting chance to get to the hospital.
Now, that could mean a couple of different things. Worst case: I have to undergo surgery to implant a defibrillator. An operation that, while routine, is fraught with the potential for disaster. Best case: I have to be fitted with a wearable external defibrillator, involving no surgery, etc. If I must have something like that, I’d much prefer the non-invasive option.
At this point, either option is on the table. And what happens next will be determined after the test next Friday. And while I truly hope the results are better, and that the results of the last test were just wrong, the pain in my chest is telling me otherwise.
My primary doctor and I both agreed that obtaining a second opinion from an independent cardiologist was a good idea, so between now and next Friday, I’ll be meeting with a new doctor to have them review my case. Again, I’m trying to be optimistic that fresh thinking on this will result in something good, but as I said, I’m struggling with that.
Until then, it’s a wait and see what happens game. And I’m not good with these games. I can’t begin to describe what all of this is doing to me mentally.
But there was one bit of good news that came of that office visit. My A1C was 7.0, down from 7.4 in September. And given everything that I’m dealing with right now, that’s a damn respectable number.
And at a time when things are quite dark and miserable, it’s nice to see that something I’m doing is still working.
11
Dec
Written by Mike on December 11th, 2011
I’ve been struggling with writing this post since I got home Friday night, trying to find the right way share the news I got at the Cardiologist that morning. There really isn’t a good way or good time to disclose bad news, so, I’ll give it to you straight. No sugar coating, no bullshit.
My appointment on Friday was scheduled so that I could get the results of the most recent round of tests the doctor had ordered. The results of the Echocardiogram, or ultra sound of the heart, were not only bad, they were shocking. And might I add, damn right disheartening.
The results indicated that my ejection fraction, which measures the amount of blood pumped out of the heart during each contraction, is down to 35% again. That’s exactly where it was when I was diagnosed on December 29, 2008. And it’s disheartening to hear that because I was at nearly 60% just a year ago. And even more troubling is the fact that we don’t know why.
I take a metric shit ton of medications every day to fight this battle with congestive heart failure. These are the best and strongest medications available for treating this condition. I eat well, I get as much exercise as my heart will allow, and generally do what I’m suppose to in order to continue making progress. And come to find out, it’s evidently not working. That, my friends, is disheartening. It begs the question, why bother?
Now, don’t take that statement as any indication that I’m giving up. Quite the contrary. There’s a hell of a lot of fight left in me. But I just don’t get it. I don’t understand. I don’t know what to think, to feel, to believe. I’m at a loss.
The next step is to undergo more intensive (read invasive) testing to try and determine what’s going on now, and what the best course of treatment might be going forward.
Right now, I’m as scared of this shit as I was when I was diagnosed. If not a little more so. I have a lot of questions to which I have no answers. And what I don’t know can and will kill me. That’s not negativity, that’s the reality of this situation. I only pray that we find the answer soon, and that there’s enough fight and strength left in my body to climb this mountain one more time.
Many thanks to all of you who have offered well wishes, hugs, support, thoughts and prayers. I truly appreciate them all. Lots of love, my friends!
6
Oct
Written by Mike on October 6th, 2011
When I went to see my doctor Monday morning for a routine checkup, I went with the expectation that I would be receiving a lecture about my blood glucose numbers being higher than she would like and about my A1c rising to 7.4. I had intentionally called for the result last week just so I would know what to expect from the doctor when I saw her. Paranoid much? No, I just know my doctor. And my expectations of receiving a lecture would have been met had I not prepared one of my own. And it went something like this:
“I been battling with type 2 diabetes and congestive heart failure for nearly three years, all the while trying to balance my care with working a crazy night shift 50+ hours a week, the stresses of trying to figure out how the hell to pay all of my bills, pay the co-pays for doctor visits & more than 10 prescriptions, and still have money for food. And by the way, the last year has been spent dealing with April’s mother being diagnosed with stage 4 uterine cancer and all of the hell that goes along with such a diagnosis. YOU try living with all of that and see how well you do with maintaining good diabetes management all the time. Then come talk to me!”
Yes, I had something of an emotional fit in the doctor’s office and it ended with my telling the doctor in no uncertainly terms that “I’m doing the best that I can considering the hell that I’m going through right now, but I’m beyond tired of all of it. I’m f**king Burnt Out!”
Would you believe that I felt much better after getting all that off my chest? Sometimes, you just have to let the frustration out.
After my rant was over, and the doctor stopped looking at me in shock, she suggested we adjust increase the dosage on my Byetta to the full 10mcg dose, which should have been done a couple of months ago, and she also thought it necessary to increase the dosage on my blood pressure medication. Gee, I wonder why. And, of course, before I left the office, I got the usual ‘try and take care of yourself and we’ll see how things are in a few months” talk.
And that’s what I’ll do. I’ll keep taking my medications, trying to eat well, and doing the best I can to care for myself. And everything else!
23
Jan
Written by Mike on January 23rd, 2011
After I was diagnosed with congestive heart failure at the end of December 2008, I spent a good deal of time researching the condition, treatment options, and the various limitations that the condition would place on my activities. One such limitation that I came across was air travel.
I read countless articles, studies, etc… that indicated that patients with CHF should, in general, avoid air travel because of potential problems and the additional stresses the body endures during high altitude flights. And those who did travel by air, needed to meet certain parameters, like being able to walk certain distances and climb stairs without getting winded, and have doctor approval, etc… before doing so.
At the time, my heart was in pretty poor shape; it was only pumping at around 30% of its capacity, and was very weak. And I couldn’t walk or climb many stairs without becoming tired and short of breath. And so, with the knowledge of my condition and the research I had done, I just let the thought of traveling anywhere by air leave my mind. It just wasn’t safe for me to attempt, so I left it at something that I just wouldn’t be able to do.
Now, two years later, things have changed for the better. My heart is pumping at 50% now, which is what the doctor considers a normal level. I’m feeling stronger and have more energy than I had in the past. Since things are better now, it made me wonder whether air travel would be something I could do now.
So, when I went to see my cardiologist on Jan. 10th, I discussed the topic of air travel with him. And much to my delight, the doctor told me that he had no reservations about me flying at all.
And you know what that means right? Another hurdle to attending diabetes conferences and d-meetups around the country has been cleared.
More importantly, though, it means part of me is on the mend, and that I’m a step closer to enjoying the opportunities life presents me to the fullest. And that’s pretty awesome!
17
Jan
Written by Mike on January 17th, 2011
So here we are, one week after my visit with my primary care doctor, and I’m just now getting around to writing about how it went. Better late than never, or some bovine fecal matter like that.
This was a follow up appointment, and I was to receive the results of my latest A1C. And I went into it expecting to hear bad news. And, as I expected, that’s what I got.
The result was 7.1 this time around. And despite how prepared I thought I was for hearing that my A1c was back above 7.0, it still came as a shock. Considering where I started out at two years ago though, at 9.6, that 7.1 is still looking pretty good. And that’s how I’m trying to look at it. POSITIVELY! I have my good friends in the D-OC to thank for helping me out with that.
Thankfully, my doctor was rather understanding about the situation, and I didn’t receive the posterior chewing that I was expecting. When she asked what had happened, my reply was simply “life with diabetes happened”. I explained the situations that I’ve been dealing with over the last few months, and left it at that.
We agreed that it would be best to switch my medications, and I’m now taking Janumet 50-500 twice a day to see if that will work better than metformin and januvia did separately. And thankfully, just in a weeks time, I’m seeing a big difference in my blood glucose readings.
We also discussed anti-depression and anti-anxiety medications as well. More on that later.
And finally, the sinus infection I’ve been battling was addressed. My prescription from the last SI I had was refilled, and fortunately, it’s finally working. Feeling much better today than I have the last week. Still a few sniffles though.
Now, if you’ll excuse me, I must go catch my nose before it runs off.
