As you recall from the last post, the advanced heart failure doctor ordered two tests: a cardio treadmill stress test and a cardiac catheterization. The purpose of these tests was to determine whether I fell into the category of a heart failure patient who has a 50 50 chance of being alive within one year. Patients who are in this category are put on the heart transplant list, and perhaps receive other devices to help them in the meantime. I guess if you equated this with an appliance in your home, it is like figuring out if the warranty on your heart has expired and whether it is time for a new heart.
I was scheduled to perform the treadmill stress test a few weeks after I saw the advanced heart failure doctor. The test actually had a few different components to it, and all of them were performed in the pulmonary lab of a hospital. Before my doctor arrived for the treadmill test, I had to do two separate pulmonary tests for a medical professional. The first test involved blowing into a tube that looked like an attachment to a vacuum cleaner. I was to take as deep a breath as possible and then blow as long and hard as possible into the tube.
I don’t know what experience others have had with this test. But each time I repeated this particular test, I collapsed into a violent fit of coughing. I think the technician made me perform the test about four times. I was beginning to think something was wrong with my lungs. It turned out that the test results were fine but the technician thought I had a “better one” in me. I realize the technicians are probably trained to have their patients provide the best results possible. But seriously, I’m a rabid type A who puts enough pressure on myself. I don't need anyone else to egg me on.
The second pulmonary test involves blowing air in and out of your lungs as fast as you can. I call it “hyperventilate till you drop”. At least I didn’t have the coughing fits with that test, nor did I have to repeat this test as many times as I repeated the other test. But suffice it to say that I was happy when we finished the pulmonary tests.
The technician then put a chair on the treadmill and had me sit on it while she fitted a mask around my nose and mouth. She also put a number of electrodes over my chest and back. I learned that the mask and the electrodes were necessary for me to breathe into so that the computer could get a reading on how my heart and lungs were performing during the test. Honestly, I looked like a cross between a Star Wars trooper and something out of Young Frankenstein. The doctor came in as the technician was finishing up with the mask. He commented on my snazzy sneakers. Hey – I may have retired from my career, but I will never retire from being a fashion diva!
I ended up asking them to stop the treadmill at around 12 minutes. To be honest, the first time I had this test (and each time after) I don’t know if I stopped the treadmill because I was tiring out, or because I still flashback to the fall off the treadmill in 2012. I was afraid that was a crummy result, but the doctor seemed very impressed with this first result and said he couldn’t wait to see what I would do the next year.
The cardiac catheterization was performed in early September of 2014. While it was clear that I still had heart failure, dilated cardiomyopathy or whatever other names I have seen applied to my condition, this test did not show any immediate need for a heart transplant. Happily, the recovery from the procedure was easy, and I was able to get back to as active a life as my heart would allow soon.
So by the early fall of 2014, I returned to the advanced heart failure doctor to receive a reading on the results of all the tests, as well as his opinion on where I fell in the world of patients who needed heart transplants. I remembered that he said he will always be one of my doctors, and I will probably see him about every four to six months. I will have to do the cardio treadmill stress test every year for at least the next couple of years. But for the time being I am not in the category of people who need a heart transplant. I think the way he put it was that we would be seeing each other a number of times during each year, but we would not be best buds. I really really liked this doctor, but I was happy to not fall in the best buds category! I think he also said that he hoped to get me into my 80s without needing a heart
transplant – and God knows, I’m down with that!
He reviewed the things I could do to help him keep me out of the heart transplant category: continue to make sure I have a fluid intake of less than 64 ounces a day and a sodium intake of no more than 2000 mg a day. I needed to be very disciplined in taking my heart drugs, keeping an eye on my weight, and calling them when my weight increases within certain ranges. (In this regard, those dreaded fitness police who monitor my scale readings each day come in really handy). We talked about exercise and he was very supportive of me doing no only the cardio but also weight lifting and Pilates and any other strengthening exercise I can perform. (Just no power lifting!).
I would need periodic blood work to make sure that the heart failure and/or the heart drugs are not adversely impacting my other organs. We also discussed the fact that the increase in the beta blocker had been really effective for me, but did make me tired at night. What has remained consistent since the time I increased the beta blockers is that I am not inclined to engage in a lot of social activities at night. I don't know if it is the impact of the beta blocker itself, or the combination of beta blockers and heart failure. But I have just learned to listen to my body, and when my body gives me a message that it is tired, I need to listen to it. No dancing on the table till 2 a.m.!
But the opinion delivered by the advanced heart failure doctor was overall really great news for someone who has a disease, especially where the goal is to kick the can down the road until hopefully research kicks heart failure in the butt.
My sister asked him to rate where I am on a scale of 1 to 10. (This was a really good question, which is another reason why it helps to have a companion at these really serious appointments). He said that on the scale for the people he treats (people who need heart transplant), I'm a 9 or 10. But in the scale of the whole population, I'm a 4, 5 or 6.
So I think it is safe to say that my heart still has some mileage left on the warranty. If only I could get the warranty on my Type A personality to expire, and trade it in for a more mellow personality…
Melanie discovered that she had heart failure in 2013. Since that time, she has been learning how to live with the condition, and how to achieve balance and personal growth.