Thursday, June 02, 2016

Bless My Heart!

Today was Cardiology Day. For those of you who have not followed my comments on Facebook, my oncologist referred me for an echocardiogram and to see a cardiologist due to my elevated heart rate. I had the echo done this morning at 9am, and then saw the cardiologist at 2:20. Hence, Cardiology Day!

So...cardiologists are fun! Not really. I jest. My cardiologist was dry. And dull. And spoke with a thick Russian accent, necessitating that I translate Ruanita's questions for him and his answers for Ruanita. No, I don't speak Russian, but he definitely didn't speak Kentucky hillbilly.

When the nurse took my vitals when I first arrived, my heart rate was 135 - pretty dang high. The first thing the cardiologist said to me when he came into the room was that they only did a limited echocardiogram on me this morning instead of a full echoardiogram, so this was "unfortunate" because he could not tell the full extent of any changes to my heart function with only the limited echo.

That said, we do know a little bit and we do have somewhat of a plan.

It appears that the AC chemo has had an effect on my heart. At this point, we do not know the extent of the damage or whether or not it is reversible or permanent. There is something called ejection fraction, which is a measurement of the pumping power of your heart. On my baseline echo done before I started AC chemo, my ejection fraction was 65%. On this morning's echo, it measured 55%. This means that the chemo has decreased the pumping power of my heart by 10%. That said, a normal ejection fraction is between 55% and 65%. So while there was a decrease, it has not decreased to a necessarily dangerous point. But it is a decrease, so in essence, it IS damage to my heart.

The cardiologist recommended that I go on a beta-blocker medication - Metoprolol. This medication will not only assist with lowering my heart rate, but he said it also helps the heart with recovering from stress or damage. I am supposed to start the Metoprolol tonight. Friday of next week, I will have a repeat limited echo to determine if the Metoprolol is making a difference or if we need to adjust the dosage. I will also be having additional blood work done along with my regular chemo blood work next week to check my thyroid. Apparently thyroid issues can cause an accelerated heart rate. He also wants to do a blood test to check for congestive heart failure. What the fuck?!? Yeah, that one kind of took me by surprise. Needless to say, those three words scared the shit out of me. But I have to tell myself that he is just ruling things out and that I likely do not have congestive heart failure. I hope. I pray.

In four weeks, I will have a FULL echocardiogram done followed by another appointment with the cardiologist to determine next steps. Unlike oncology, cardiology does not move at the speed of light. A month out is the norm, I guess, for follow-up. I am used to everything regarding my treatment happening before I can even wrap my mind around what's going on. This time, I get a full month to ruminate on it. I think I might actually prefer the overwhelming speed of light. 

So, here is the gist of it (I am somewhat addicted to bullet points):
  • The AC chemo HAS affected my heart. We knew this was a possibility, but were hoping (of course) that it wouldn't happen. So much for feeble hope.
  • We don't really know the full extent of the damage. It may be minor. It may be as devastating as congestive heart failure. Or anywhere in between. How's that for cheerful news?
  • I will start Metoprolol to try to get my elevated heart rate under control.
  • I asked if this is a drug I will need to be on permanently. He responded with a shrug and a heavily accented, "We'll have to wait and see."
  • Metoprolol may make me drowsy and fatigued. (Yay! I definitely need more fatigue in my life!)
  • The drowsiness and fatigue should subside within 6 weeks. (6 weeks?!?)
Nothing is ever easy, is it? If there is one thing I have learned in the whirlwind of the last three months, it is that nothing about cancer treatment is straightforward or simple.

But I feel good today. So I am going to focus on that. My daughter starts playing soccer this weekend and she is super excited. I am going to focus on that. My kids have three days of school left and then...SUMMER, GLORIOUS SUMMER! I am going to focus on that. The sky is blue and the flowers are blooming and the weather is warm. I am going to focus on that. My kids are home, safe and sound and happy tonight. I am going to focus on that.

So no, nothing is easy. Cancer is not easy. Chemo is not easy. But life is still deliciously, beautifully good. And THAT is what I am going to focus on this Cardiology Day.


Madge Woods said...

Oy vey. Hopefully this will all correct after a few months. I feel it will. Are you on antidepressives? Some beta blockers block serotonin. Please if you get weird or want to drive off a cliff and feel weird call his office. That happened to me when I had one 2 hour period of high heartbeats. I was in the 5% that can't take beta blockers. Be careful and if he is too hard to understand go to someone for another opinion. Is he young, middle or old? What I don't get is if they are checking for damage why wouldn't they do the highest level of an echo? They must not be that concerned or they would see you sooner. I was on mine for 6 weeks and quickly weaned off. I was a depressed mess.
Please help Shannn with medical costs and co pays add up.

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