Doctor, Doctor Give Me the News

Terry had a follow up appointment with the cardiologist two days ago.  Dr. Brown has been really good about seeing him more often post thyroid cancer and pheochromocytoma, so it was a chat about how things are going.  It truly is hard to know how much those two separate conditions played into his overall cardiac health, so I have appreciated the additional visits with him.

It has been frustrating, however, that he has not been willing to consider how the nausea and vomiting that have occurred for almost seven years might be tied to his cardiac condition.  After some discussion regarding theoretical causes, he was willing to consider a problem with either a blockage or potential limited blood flow to his intestinal system.  Dr. Eck, his endocrinologist, has supported that idea with us, so we were able to secure a referral for a dye contrast scan to look at blood flow.  

He gets that scan on Tuesday, the 10th of May.  That gives us the opportunity to get those results to KU Med for his appointment with the GI department the following week.  It was the vomiting that prompted the referral to KU Med last year, but once they found the other problems the vomiting issue went to the bottom of the heap.  Discovery and treatment of the two conditions last year did not have the additional benefit of eliminating the nausea and vomiting, so we have hopes this test may yield information.  There has to be a physiological cause.  End of discussion.  Just because they have not determined what it is yet does not mean it is not real.   

All things considered, his cardiologist is pretty encouraged he's doing as well as he is.  Terry did admit to him, and had not admitted to me, that he's noticing he's getting winded and needing a break if he's out in the garden or trying to work on something for 30 minutes or more.  There have been several times when I felt he was breathing harder than usual, but he always minimized any concerns.  Listening to him confess to the cardiologist confirmed what I've noticed.  He's not having much swelling to his hands or feet yet, so I hold onto that piece of good news while we have it.  

While it won't surprise me, it will be disappointing if we find out his nausea is a by product somehow of his cardiac disease.  I realize everything he's gone through has been difficult to diagnose, which I reminded Dr. Brown, but I have pushed hard on the cardiac side of things for answers for a while now, and we could not get any doctors, much less the cardiologist, to consider the connection.  As long as we finally get some answers I'll forgive him if it turns out to have a cardiac component.  We just need to know.

You Gotta Have Heart

Today was the appointment with the cardiologist. Dr. Brown has been the cardiologist since the major staph infection in Terry's heart in 2004. He's been equally frustrated with Terry's refusal to take his meds. He told him last summer that in his experience, patients who did not take their medications for 2 1/2 years or more had a 50% higher mortality rate. Terry has not taken his heart medications since February 2007.

Dr. Brown looked at the results of the last ECHO he had, which was in July of 2009. He said there had been a decline in his ejection fraction, down to 20-25 from 25-30 at the one prior to that. Now...when he had that test last July, I didn't accompany him to the appointment. Big mistake...BIG mistake....

He came back from that ECHO telling me the ejection fraction had been at 30-35, and the technicians who ran it told him everything looked great and he should keep doing what he was doing....when what he was doing was nothing. And I remember feeling frustrated at the time that despite his lack of attention to his own health, he was being given validation that he was doing everything he should.

That was negated today when we learned that he has had decreased function for the last two scans he's had. He's been so consumed with his nausea and pain that he's completely lost track of the fact that he's first and foremost a cardiac patient. He does not see the forest for the trees, even though it feels like I'm yelling "timber!!" on a regular basis. It confirms for me that making the decision to back away from work is the right decision. I think I have my work cut out for me.