{"id":504,"date":"2015-08-29T03:38:26","date_gmt":"2015-08-29T03:38:26","guid":{"rendered":"http:\/\/michelledevon.com\/?p=504"},"modified":"2021-01-02T03:41:47","modified_gmt":"2021-01-02T03:41:47","slug":"new-hospital-new-clinic-new-outlook","status":"publish","type":"post","link":"https:\/\/michelledevon.com\/index.php\/2015\/08\/29\/new-hospital-new-clinic-new-outlook\/","title":{"rendered":"New Hospital, New Clinic, New Outlook"},"content":{"rendered":"<p><span data-offset-key=\"8eqap-0-0\" data-reactid=\".r.1.0.1.0.0.$editor0.0.0.$8eqap.0:$8eqap-0-0\">This week, I met with a new cardiologist at Baylor. I love the whole Baylor setup so much better than where I was before. It was really nice. Clean, beautiful, gorgeous offices with comfortable multiple sized chairs. The offices are nice and well kept. The tables are comfortable. The computers and equipment are new and up-to-date modern technology-wise.<br \/>\n<\/span><\/p>\n<p>The most important part was the doctor, though. He\u2019s a heart surgeon, a cardiologist, specialist in his field. I\u2019ve grown accustomed to them really being jerks, but he wasn\u2019t. Then today, I met an associate in his clinic, another cadiologist, who was super kind as well. They both listened to me. What I had to say mattered. They both complimented me on being an informed patient (where the doctors at UTMB always made me feel bad about being well-informed, like it was an affront to them or something). I feel like this is easily my new medical home. It sucks that it\u2019s an hour\u2019s drive away, but for quality and comfortable care, you take what you can get.<span id=\"more-3393\"><\/span><\/p>\n<p>So after meeting with him, he heard a murmur and ordered a snap-shot EKG. I showed an ST abnormality and inverted T waves anteriorly. He said I had tricuspid regurgitation. He also said that whatever it was on the EKG usually only happened with aortic stenosis. He wanted my records right then and he wanted me to do an echocardiogram as soon as possible. They even wanted me to do it that day, but I didn\u2019t have enough oxygen with me to stay for several more hours. We rescheduled it for today.<\/p>\n<p>So today, I came in, they were ready for me. I ended up getting three completely echocardiograms. First, the medical tech did one. The doctor wanted something else done, so a second, more experienced technician came in and did a second one, and they did a saline push to determine my pulmonary pressure to determine if they could do one with contrast or not. (something about the contrast being contraindicated in people with pulmonary hypertension). The doctor okayed doing the contrast, even though I was showing moderate to severe pressures, because he really wanted to get some really clear images.<\/p>\n<p>So\u2026 the bad news.<\/p>\n<p><span data-offset-key=\"8eqap-0-0\" data-reactid=\".r.1.0.1.0.0.$editor0.0.0.$8eqap.0:$8eqap-0-0\">First, my pulmonary pressures were higher than I had hoped. They were estimated on echo \u2018splash\u2019 at about 43-45mmHg. That\u2019s better when first diagnosed, which was 55-60mmHg, but it\u2019s still a lot higher than they should be, and a lot higher than I had expected my resting pressure to be. So that\u2019s not good.<\/span><\/p>\n<p><span data-offset-key=\"8eqap-0-0\" data-reactid=\".r.1.0.1.0.0.$editor0.0.0.$8eqap.0:$8eqap-0-0\">Secondly, I have moderate aortic valve stenosis (symptomatic) with congestive heart failure of both the right and left heart. The left heart is left ventricular diastolic failure with preserved ejection fraction. The right heart is right aortic thickening and enlargement with tricuspid regurgitation causing congestion.<\/span><\/p>\n<p><span data-offset-key=\"8eqap-0-0\" data-reactid=\".r.1.0.1.0.0.$editor0.0.0.$8eqap.0:$8eqap-0-0\">Surprisingly, my heart is still really strong considering all that. My ejection fraction stays mostly preserved and as good as anyone without heart damage has. I think it\u2019s because my heart wasn\u2019t damaged due to lifestyle\/dietary\/hereditary issues but rather it was damaged due to the PEs going through it, so the heart is stronger than most people\u2019s when they have the issues I have. But when you throw in the adrenal insufficiency, the autoimmune thyroiditis and hypothyroidism, the fluid overload that is persisting, and the unspecified autoimmune condition that they treat for but still haven\u2019t figured out what to call it\u2013I don\u2019t qualify for PTE surgery\u2013which is, for those who don\u2019t know, the one they call the \u2018cure\u2019 for CTEPH.<\/span><\/p>\n<p>Reading about symptomatic aortic stenosis is super scary. What it basically means is that within two years, I will likely have to have the aortic valve replaced. That could potentially be a really big scary surgery\u2013which, with the PH, I wouldn\u2019t really qualify for\u2013but there is a new procedure that is a lot less invasive which I might qualify for, that would be similar to the right-heart cath and balloon valvuloplasty, where I won\u2019t have to be cut open, but just a tiny knick in the neck or groin area. Recovery time would be much faster and easier too.<\/p>\n<p>I think the doc was already thinking about that, because he was asking me if I could be sedated\u2013not a normal question docs usually ask at an initial office visit. He was also asking if I could lie flat on my back and still breathe (some PH patients can\u2019t\u2013I still can if I lie down slowly and am not short of breath before I lie down.)<\/p>\n<p>So I don\u2019t know what it all means yet. I\u2019m not processing it all yet. I\u2019m still reading. Survival rate without aortic valve replacement is 50% at 2 years and 10% at five years. That means 90% of people who don\u2019t get the valve replaced\u2026 die. So yeah, replacement isn\u2019t even an option. It\u2019s just a matter of how to do this safely as possible.<\/p>\n<p>So, there you have it. Have a broken heart, but not for any of the typical reasons most people have broken hearts, literally figuratively.<\/p>\n<p>I\u2019ll know more next week after the cardiologists have time to review the echo and the pulmos have time to review 600 pages of my history. Until then, I\u2019m in that numb \u2018research and read but don\u2019t panic\u2019 mode I\u2019m always in after getting \u2018news\u2019.<\/p>\n<p>I love and need you all.<\/p>\n<p>Love and stuff,<\/p>\n<p>Michy<\/p>\n","protected":false},"excerpt":{"rendered":"<p>This week, I met with a new cardiologist at Baylor. I love the whole Baylor setup so much better than where I was before. It was really nice. Clean, beautiful, gorgeous offices with comfortable multiple sized chairs. The offices are nice and well kept. The tables are comfortable. 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