Wednesday, April 1, 2009

broken heart update




Welcome to My Broken Heart Blog.

This entry is another stop on a long journey.
I am definitely learning patience as a result of this adversity.



Patience (pā-shəns) is the ability to endure adversity without irritation.
Also steadfast, diligent, steady perseverance.





Today, my parents and I went to see Dr Magnano at
Diagnostic Cardiology Associates (also Dr Constantin's group)
about the results of the t-wave test I had on Monday.




Dr Anthony Magnano ("The Electrician")

The t-wave alternans test was negative (the results we wanted) so I do not have an increased risk of sudden heart failure from cardiac arrythmia. Those who are found to be at high risk would therefore benefit from the placement of a defibrillator device which can stop an arrhythmia and save the patient's life. The test examines the t-wave of the EKG or the measurements of the heart's electrical conduction. See diagram below.

The test was very simple and non-invasive stress test. Twelve leads were attached to my chest and midsection (after the nurse roughed up my skin with sandpaper at each lead site - OUCH!). Then I walked at a slow pace on a treadmill for approximately seven minutes. The leads fed data to a monitor that recorded the electrical wave patterns of my heart. The computer analyzed the data and issued its finding - My results were negative.





T-wave alternans testing acts as a risk stratifier between patients who need implantable cardiac defibrillators (ICDs) and those who do not. Patients who test negative for t-wave alternans are LESS likely to require a defibrillator than those who test positive.


Dr Magnano, nicknamed "The Electrician" by Dr Constantin, explained that my "electronics" are stable and my heartbeat is regular. If my t-wave alternans test was positve, a defibrillator would have been ordered immediately. Because of my age, both doctors are cautious of implanting this "machine" too soon, but they are very concerned about my low ejection fraction - still below 20%. Basically, my blood flow is good, my electronics are good, but my "ticker" is weak and can't push the blood at a healthy rate. Both doctors believe I will continue to improve as they slowly increase my medications.





I am gradually getting stronger and my stamina is increasing. The picture about was taken during a trip to Jacksonville Beach for dinner at Tacolu with my friend Toni. Lately, I move easier, with less effort, and my heart is not as stressed as before. For example, after helping my father give my dog Brutus a bath this week, I was tired, but not out of breath or palpitating.
I have had outings to First Friday in Five Points (below right)
and the Jacksonville Zoo and Gardens
(new Bamboo Gardens are a must see, below left).





I am still monitoring my sodium intake - learning about food along the way.
I am trying to move into the new Whole Foods - I hate leaving that place.




Get the Salt Out: 501 Simple Ways to Cut the Salt Out of Any Diet
by Ann Louise Gittleman

In this day and age, when fat is blamed for all our health problems, it's often easy to forget that salt can also be a dietary culprit. While salt is necessary for both bodily and cellular function, and is certainly crucial to the satisfying taste of some of our favorite foods, recent research shows that its excess consumption can also lead to hypertension, strokes, and a variety of cardiovascular problems.

In Get the Salt Out, nationally recognized nutritionist Ann Louise Gittleman reveals 501 ways to avoid excess salt intake by serving a variety of delicious low-sodium foods, taking advantage of tasty salt substitutes and steering clear of many surprising hidden sources of salt. She provides more than fifty delicious recipes for low-sodium foods, which will add healthful new staples to the diet of anyone who wants to "get the salt out."

Other features include:

¸ Advice on how to use herbs effectively to reduce sodium intake
¸ Tips for reading labels to expose salt where it is hidden as well as supermarket salt savvy
¸ Ways to reduce the salt level in your water
¸ Advice for avoiding salt when you eat out
¸ Tips for dealing with stress and other impediments you may face
¸ A week-long menu plan
¸ A resource section

Get the Salt Out has all the tips, menu plans and recipes to help you enjoy real foods again and create meals that both your taste buds and your body can truly savor!

ISBN:9780517886540
Author: Gittleman, Ann Louise
Publisher: Three Rivers Press (CA)
Subject: Salt-free diet
Publication Date:December 1996
Binding: Paperback
Pages: 240




Found this tattoo online - thought it was very appropriate.



NEXT UPDATE: June 30, 2009
Appointment with doctors regarding progress.



To my loved ones, friends, and colleagues.
Thank you for your love and support.
I could not have made it this far without you.

Tuesday, March 24, 2009

the state of the heart


I just returned from my cardiologist, lovingly nicknamed “Dr. Bling Bling.”


Last week, I had an echo-cardiogram to determine if my heart has improved since I was in the hospital four months ago. The test showed that my heart has strengthened and is returning to its normal shape. My ejection fraction has improved, but not enough to take me out of the danger zone. My ef is up from 10%, but still well below 35%, so I will be seeing a doctor that specializes in defibrillators next week. On Monday, I am scheduled to have a T Wave test.



What’s that?

The T wave alternans (TWA) test uses an electrocardiogram (ECG) measurement of the heart's electrical conduction.



The microvolt T-wave alternans (MTWA) is a non-invasive heart test that can identify patients who are at increased risk of sudden cardiac death. It is most often used in patients who have had myocardial infarctions (heart attacks) or other heart damage to see if they are at high risk of developing a potentially lethal cardiac arrhythmia.

Those who are found to be at high risk would therefore benefit from the placement of a defibrillator device which can stop an arrhythmia and save the patient's life.


For more information on the T-wave test,

visit: http://en.wikipedia.org/wiki/T_wave_alternans



Bottom Line


The results of my echocardiogram alone were not enough to determine whether or not a defibrillator is necessary. The T-wave test will provide additional information to determine this.


My heart is working better than it was four months ago, but still below the minimum acceptable levels.


I will continue to take medication – Coreg was doubled to continue the progress of strengthening the heart.


My heart is still alarmingly weak and I am still at high risk of heart failure.



To defibrillate or not to defibrillate?

After the test on Monday and the consultation with the "electrician" (cardiologist specializing in the electronics of the heart) on Wednesday, I will know more about the defibrillator.





Surgery to Implant a Defibrillator (According to hearthelp.com)

Implanting a heart device involves making a small incision, approximately 2 inches, in the upper chest, and guiding leads (thin insulated wires) through a vein and into your heart. It is not an open heart procedure. Patients are generally awake throughout the procedure, and a local anesthesia is typically used.


Your doctor will then connect the lead wires to the implanted heart device and program the device settings. Finally, the heart device will be inserted beneath the skin and the incision in your chest will be closed. Most people stay in the hospital overnight and go home the next day.


Before the procedure you will be given medication to make you sleepy and comfortable. After the implant you may see a slight bulge under your skin where the device is located. The leads are very thin and will not be visible.


You will usually stay in the hospital overnight and receive instructions for home care. You may be asked to restrict movement of the arm near the device for a short period after the implant.


For more information, visit http://www.hearthelp.com/sca/defibrillator-surgery.html

 
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