We finished our latest round of testing with the pulmonologist around 10:30 this morning. He was a sweet, young lad in a very adult suit and thoroughly knowledgeable and willing to communication at length. The office, in the same complex as Hubby's cardiologist, was small so I sat in the waiting room while the testing took place but was invited in for the consultation with the doctor.
Upshot: Hubby does not have constrictive lung disease, even a mild case. Hubby was greatly relieved hearing we were not adding in a new problem. Hubby does have a red throat and so they believe he has on-going allergies, even if he does not admit to them (he never has, he never will) that can be handled with the nasal spray and over the counter meds which he is to take daily for here-on (Claritin and Flonase).
Hubby does have sleep apenia and is going to be fitted for a CPAP machine that will include a humidifier to see if he can tolerate it. I think all the physicians have worn Hubby down about this problem -- and assure him that he will both breathe better with it, as well as sleep better. He now seems (thankfully for a stubborn old coot) open to the procedure, though whether he will actually wear one once he sees how big they are, is anybody's guess.
All the tests show that the frozen larynx and the sleep apnea combined with the A-Fib and CHF have caused all Hubby's throat problems.
The web has some good articles on the frozen larynx problem for pets -- it seems to appear most often in animals. The technical name is laryngeal paralysis and, quoting from a pretty decent article on the subject: in its closed position, the larynx prevents food and water from
entering the windpipe, or trachea. When speaking and breathing, the
larynx opens to allow airflow in and out of the lungs. When frozen the larynx causes problems when swallowing food (Hubby pretty much sticks to a soft diet now), changes in the sound of the voice, and difficulty in breathing -- all the symptoms that Hubby has experienced. The solution is working with a speech therapist which he was doing in the late summer, but stopped when he couldn't function as the congestive heart failure worsened. We must must start back with his therapy.
On Monday Hubby wore a heart Holter monitor to keep track of his heart's electrical activity for 24 hours. This was the simplest and easiest of the tests we have undergone except that you had to be fitted for it in the hospital at the cardiac unit which is in the middle of very long corridors in the bowels of our local hospital. We turned the monitor back in at 8 a.m. this morning.
Throughout all these procedures I'm learning more and more about what is causing Hubby's problems, especially with the throat congestion that has annoyed him so cruelly. The larynx is the initial cause of the phlegm while the erratic and poor heart beat have exacerbated the problem. Then add in the post nasal drip from the allergies and the poor sleeping from the apnea and you get a pool of misery in Hubby's throat that his frozen larynx cannot handle. It just builds up and Hubby feels like he is drowning in it. We finally, after five years of requesting help for this problem, actually been given a cause -- and to know that if Hubby is unwilling to wear the CPAP or take the allergy meds properly he will have this for the rest of his life. Hopefully, the speech therapy, once we resume it, will also help Hubby learn to exercise his larynx and regain some of its function. There is no magic pill and some problems we just have to accept and do the best we can to alleviate.
The cardiac nurse team will now review all Hubby's tests and will also consult on the meds to make sure they are adequate and efficient. Hubby will be fitted for a CPAP to see if he will use it -- as well as make sure the one he is given is helpful to him.
Next week we meet with our GP and Hubby completed his physical therapy training. We both joined the gym at the hospital so we can continue to exercise and gain strength. In early December, we meet with a second cardiologist to discuss some alternative therapies for the A-Fib. Then we consult with the cardiology nurse practitioner about how the meds are working. At the start of the new year we meet again with pulmiologist to see who the CPAP is going and with Hubby's own cardiologist.
Currently, Hubby is struggling with being very cold -- undoubtedly because his blood thinning level, which should normally be at 2 to 3 has risen to level 4 (normal is 1 to 2 -- but his blood is thinned to made sure the heart has an easier time pumping) -- but we are still not in a dangerous zone (6 to 8).
All Hubby's heart meds are now at their highest dosage point -- but he is no longer filled with fluid, his heart beat is within normal range, and his blood pressure is really good. Stand up and cheer!