Thursday, November 29, 2012

Health, Doctors, Meds, All Day Everyday

It seems that everyday we are dealing with more doctors, more meds, more tests, more physical therapy, adding more pieces to the puzzle created by A-Fib and CHF.  The consequence is that we are both wearing out.

Today we were back to Dr. Tess, the nurse practitioner.  Tuesday we met with GP that we both share.  Tuesday night they conducted another sleep apnea test on Hubby hoping to find a sleep mask that would suit him. 

The knowledge that we can now add to our collective Hubby medical tomes include:
    1.  Hubby is pretty much always in A-Fib; this also means that a heart rate of 150 is probably going to be his norm (most people are around 60 - 100).  The A-Fib is on the right side, rather than the left which is unusual.  We learned this from the monitor he wore last week.  This news was not encouraging.  Being in atrial fibrillation so much of the time is causing Hubby to be worn out and his heart rate to stay elevated.  

    Hubby is now experiencing quite a bit of dizziness when he exercises or has to walk any distance.  This is to be avoided and the exercise should be paced to make sure he doesn't get dizzy (and fall down and break something). 

    3.  Hubby was anemic by the time he ended up in the hospital when his blood pressure was soaring and he had all the symptoms of congestive heart failure.  Since he was hospitalized I've been cooking three meals a day -- and it's paid off, thankfully (how I miss serving up a bucket of chicken and fries).  He's been taking a daily vitamin with iron and eating food with very low to NO salt content -- and he's lost six pounds.  I don't worry so much about the diabetes -- but I make sure every meal is full of things he will eat and that are good for his heart.  If that includes some food with sugar, so be it.  Ice cream is much preferable to salted nuts right now.  Some days the only thing I manage all day is the cooking.  Still everybody was pleased that his blood pressure was 125 / 63 this morning and that he had been losing weight (CHF patients gain weight suddenly -- one of the symptoms -- because they are containing water).  

    4.  Since we have now reached the limits of what the meds can do, we are going to look into ablation.  We meet in December with the heart doctor associated with our heart clinic that is the expert for electric shock therapies for the heart. 

    Research on the web shows:
    A specific form of catheter ablation is called AV junction ablation.  The goal of this procedure is to eliminate conduction through the AV node or adjacent structures.  Therefore, there are no heart beats that get from the top chamber to the bottom chamber.  The patient is therefore reliant upon a permanent pacemaker to maintain their heart rate in the ventricles.  Such as strategy does not prevent atrial fibrillation, but simply controls the rate, specifically the ventricular rate, in the patient.  Nevertheless, many patients have a significant improvement in their symptoms if they have had excessive heart rates previously on medication alone.  

    The treatment of catheter ablation of the AV node or junction is irreversible, and therefore should be only performed where it is certain that a return to conduction is not desired.  This is usually when all previous medication strategies have been excluded.  In addition, it has been determined that the patient is not an appropriate candidate for catheter ablation of atrial fibrillation itself.  
    5.  Hubby hated all four of the sleep apnea tools but he did last through the entire testing procedure.  He claimed that every machine dried him out so much that he found it more difficult to breath.  This was true even when they tried moisture with his treatment.  We are back to square one with the sleep apnea.  Yesterday was pretty much a wash for both of us as neither Hubby or I had slept much, if at all, Tuesday night while Hubby was undergoing the tests.  

    This morning was met with Dr. Tess at 9 a.m. It's good to know we have so many experts in our corner, trying to find solutions and offering help. Then we drove downtown and rented the "big car" for the trip to Houston over Christmas.  Holiday season rates showed that the Lincoln we usually get was going for $900 (we should have rented the car much earlier and we'd have gotten better rates -- but this chore, like many others, fell below the radar when Hubby got so sick).  We all compromised and rented at Crown Vic (Ford) for $400 instead.  Bah.  Then we drove to Sam's and got some light bulbs for the kitchen and dining room -- both had been dark for two days.  I picked up some paper plates and stocking stuffer for Houston and dang if the bill neared $200. 

    Gus is doing well from his teeth extraction.  We are so grateful that he survived his procedure.  We weren't so happy with the bills:  $93 for meds, $789 for the surgery.  Still, we have a very good vet and Gus experienced no health reactions at all -- and even though all his teeth except three very small ones in the sides of his mouth are now gone --and his tongue still stays in his mouth.  He looks a lot cuter without that tongue dropping down.  We can tell he's feeling a lot more perky without those infected teeth. 

    At 5:30 this afternoon we'll drive over to the Research Health and Fitness Center for a little workout (Hubby trying to keep from getting too worn our and thus dizzy and me trying to work out the kinks in my hip and back with some water aerobics).  My new swimsuit and swim shoes have arrived and I'm anxious to try them out. 

    Thankfully we have no more medical appointments until the second week of December.  We have an exercise regime to follow, though.  A diet to stick with.  A trip to get ready for.  Strength to build.  And prayers to offer up that life goes on.  We continue to try to keep the faith.  

    No comments: