Hello Friends,

I hope you had a good week. Mine was pretty good. Some not so much, but we are plugging right along.

I’ve started this new phenomena that when I exert myself (walk short distances, climb the stairs, etc), I get sick. It started two weeks ago after my month long stay at Hopkins. I was at a followup with my PCP on Monday, and was explaining the symptoms to him, thinking a virus or food poising. Except we were two weeks in, too long for both options. And with exertion, that was a no go.

He spoke with a cardiologist who has seen me at the hospital they cover (it’s located literally in the next building from his office) while I waited in the exam room. I knew what he was thinking. They both agreed given my “minor/small cardiac history” that I needed to be checked out, make sure I wasn’t having an active cardiac event (aka another heart attack).

His trusty medical assistant, Jack, wheeled me over to the ER and they ran an ekg. The EKG picked up something (I didn’t catch what, but it was explained as being from my previous MI) which caused them to call a Code: Stemi. But the ER doc cancelled it after repeating 2 EKGs. They kept me for 12 hours for observation, ran troponins and sent me on my way, with direction to call Dr. Martin at Hopkins.

I had a few appointments on Wednesday with my psychiatrist and psychologist that I didn’t want to miss, so I delayed reaching out to Dr. Martin for a day, knowing I’d probably be making the drive to Hopkins for an appointment.

This morning, after speaking with Dr. Martin, he wanted to see me this afternoon, so we made the drive to Baltimore. He spent over an hour with us, checking me for symptoms of heart failure, running an EKG, calling the cardiologist from Monday to get his opinion and then returned back to us.

He definitely thinks that my getting sick is due a lack of blood flow to the heart. We aren’t surprised at this symptom, as it’s how I presented before all my cardiac issues began. At this point we have no reason to believe any of my grafts have failed or that my stent has closed, so we are trying to make some medication changes.

We are adjusting 3 meds over the next week. We are doing it one at a time, every 3 days.

First with my calcium channel blocker, changing to extended release for more consistent heart rate control. This is instead of peaks and valleys on the regular release. This will help my heart not work as hard when I get up and move because the heart rate won’t jump up.

Secondly, we are adjusting my long acting nitrate, doubling it back to my previous dose. This helps relax the blood vessels and keep blood moving easily.

Lastly, we will adjust my anti angina med, Ranexa. He explained how it works but basically it functions to reduce angina.

I’m supposed to be in touch via phone over the next week. He is hoping these med changes will get better blood flow back to the heart. If we don’t see improvement, our next step would be a stress test. We want to keep me out of the Cath Lab, so we are trying these med changes/tests first.

Dr. Martin is motivated “now than ever” to keep me out of the hospital. The docs in the hospital always change meds, which throws my heart for a loop. It’s just too many cooks in the kitchen. We also agreed these long stays are not really helping the situation so we want to keep me out so I can work hard at losing the weight and prepare for the transplant.

We are going to have appointments every month, instead of every 6-8 weeks, in the hopes that seeing me that often, he can keep a closer look at things week to week. We both hope doing so will also get me on a stable medication plan versus constant changes.

Between my PCP and Dr. Martin, I hope we can keep me out of the hospital and get things more stable. I have two great docs leading the care between the two of them. My poor new PCP explains it best, “what am I going to do with you?”.

Pray, trust and hope for the best. God hasn’t failed us yet.