The follow up...

Here is a little history for those who don't know the situation. In Jan 2007 my husband, Bob Jones, was admitted into the hospital with CHF (Congestive Heart Failure) after being told he had bronchitis for 3 months. They determined he had Cardiomyopathy, which is damaged muscle of the heart. Also an irregular heart heart beat. His problem was that his heart beats were too close together creating a dangerous rhythm that can cause heart attacks. To make a long story short after 7 days in the hospital and 4 months of meds his heart was functioning as good as new and removed off of all medicines.

Jump ahead to July 2010...

Bob was admitted the beginning of July for not only Heart Failure,but  A-Fib rhythm, and of all things a "Nasty" (as the ultrasound tech put it) Gall bladder. His heart had picked up an additional irregular beat as well as the original one and his heart was shimming instead of beating. So basically his heart had a function (injection fraction) of 10-18%, a very irregular beat in two chambers, AFib rhythm, and sporadic heart rate that would range anywhere from 50 beats to 180 beats a minute. (racing heart). During the hospital stay they removed his gall bladder (which resulted in a night in the ICU due to a reaction to the meds) and got him on 6 meds that seemed to be helping. Two heart function pills, (lisinopril, coreg), One rhythm med, (amniodrone), A blood thinner, (Cumadin), as well as a lasix and potassium pill. He takes these every day. In September they shocked his heart back into a normal rhythm. Bob as worried sick about it but afterwards he said it was painless. Sometimes it takes several tries to get it right but we got lucky and it went back on the first try.

Now... January 19, 2011... the follow up visit.

The week before the follow up Bob had an echo cardiogram done on his heart. Then when we got there they did an EKG. He's had both of these done so often its almost routine for us. They also took his blood pressure which has been running on the high side since his episode in July. (previously it ran very low). His heart rate was on the low side. Bob told the lady that the reason his blood pressure was always high because he was always nervous coming. He said every time he goes to the doctor he ends up in the hospital or with some expensive testing. She laughed and told him she hadn't put him in the hospital yet.

Our doctor(nurse practitioner or whatever her title was) asked all the usual questions which Bob answered honestly. No shortness of breath, of course I reminded him I always accuse him of panting. No shortness of energy, and of course I remind him he's gotten lazy. No fluttering in the chest which as far as I know is at least true.

The results of the EKG were good. The heart is still in a good rhythm and the extra beats they worry about are few and far between. A plus! The echo however showed that his heart function (injection fraction)  was still in the 40%;s, Which is what it was 3 months ago. Ideally they wanted this to go up. Normal is 65%. It was kinda a let down because we really expected this to be at least on the low side of normal by now. At least it didn't get worse. That's something to be thankful for. So we talked about what we could do to help it. 1. They want him to exercise. (Not that I haven't been telling him this for months) and maybe take off a few pounds. He is at 216. He isn't really overweight but shedding a few wont hurt him a bit! 2. Eating better. We don't eat totally unhealthy but we def don't follow a heart healthy diet either and Bob loves his salt. (which I try most of the time to keep hidden.)

We also discuss the meds. The amniodrone is the Rhythm pill. It's not meant to be a long term pill. Long term side effects include damage to the liver, thyroid and Lung function. It requires monitoring every six months. So we discuss alternatives. The only alternative to medicine is an ablasion inside the heart where the irregular beats are coming from. They go in through the groin and the neck with wires and burn inside the heart. It has a 60-75% success rate. We opted to stay with the meds for another 6 months and discuss again.
Because his rhythm was still good they agreed to let him stop taking the blood thinner. This thrilled him more than anything else. The blood thinner makes the cold feel so much colder and makes his small cuts bleed like a siv. I believe nothing they could have told him would have made him happier than this.  All other meds stayed the same.

So now all that was left was to get an order to have the blood work done to check his thyroid and liver. (lungs were being checked this summer). She left us and told us she'd be right back. I should have known that when she didn't come right back something was up. We waited, and waited, and waited. finally about 15 minutes later she comes in and looks at Bob with this pained expression on her face. "your gonna hate me" she says. I almost want to laugh. What now?! Is all I can think. "I ran into Dr. Rimawi (our cardiologist) in the hall way and asked me how you were doing. We sat down and talked about your progress and he is going to take a diff approach with you." At this point, I am ready to laugh. They change things so often. "We looked back in your chart and in 2007 the rhythm drug you took was called Sotalol. You had a good success rate on this drug at the time. We are going to put you back on this first. There are no long term side effects." So my first thought was Heck yea, this is great. Then I realized there was a catch. She went on. "See you cannot just be put on this medicine. You must be monitored for 2.5 days on it. so it requires a hospital stay." Right then, I looked at Bob in time to see his eyes pop and jaw drop! It was priceless. Yes, in order to be put on this new medicine that will be better for him in the long run and maybe will even help his heart function he has to spend 2.5 days in hospital. Then she kicks the man while he's down. "Also, because you have to be off the current rhythm medicine for a few weeks before we can switch you you'll have to stay on your blood thinner." BAM! She ruined his day, right there. Poor guy. He was so excited about getting off of it.  I think he was more down about it than the hospital stay. Not only for a few weeks but also while for a while to make sure the new rhythm pill works. Poor guy. Bob's next words cracked me up! "I told you every time I come here you put me in the damn hospital!"

Luckily we got to pick the 3 days of the week so we picked Friday - Sunday so we only missed one day of work. As of right now we are scheduled for Feb. 18-20. Guess my story ends for the moment but its def not over. Stay tuned to hear about our hospital stay! :)