My Journey with Cardiac Health: Recent Developments

It’s been a while since I shared anything. A lot has happened, and I’ve been rather overwhelmed.

The last few days have been interesting, to say the least. Even before the heat wave got going here in Pennsylvania, I was having some issues with arrhythmia, and elevated heart rate and blood pressure. I was writing it off to stress and angst over the severity of the state and federal governmental and SCOTUS attacks on transgender people. That was a reasonable supposition.

Life as a transgender person right now is hard, and so many powerful people are doing all they can to make it worse. To suggest that a genocide is in progress is not hyperbole. I’m not going to address that now though. Anyone paying attention knows what I am talking about. Anyone else can do some basic reading of recent events and at least see the parallels.

No, I am here to update my loyal readers on my cardiac status. Late last year, I reported my diagnosis of a bicuspid atrial valve. This past Tuesday morning, I received a phone call from the electrophysiologist in Wisconsin who is still following my implanted cardiac monitor (ICM). It’s going to be late August before I get in to see one here.

They called to let me know that the device had recorded multiple AFib events Monday evening, as well as several tachycardia episodes. One of the AFib episodes had been twenty-eight minutes in length. That’s quite significant for me. My usual episodes, when they were happening, were at most two to three minutes in length. I say “when they were happening” because it had been some eighteen months since the monitor reported an episode prior to this.

During the conversation, I let them know that I had moved out of state. I had an appointment scheduled to see my new general cardiologist for next week, and I would definitely let them know that this had happened. I thanked the nurse for calling to let me know.

I recently acquired a Kardia six-lead personal ECG device, and had taken a couple of strips, by chance, during the time this was occurring. I reached out to the doctor whom I was scheduled to see soon. I let their office know what had happened, and that I had strips from that personal device. As it happened, in the time it took to get a reply, I also received the documentation from the ICM. I uploaded all of that documentation. The response was fairly quick once they had time to see the ECG strips.

The doctor asked if I could get in sooner than the previously scheduled appointment. I said that I could and was told that the scheduler would be contacting me ASAP to arrange an earlier appointment. That call came about half an hour later. It was now about 9:30 am. I was told that there was an 11 am time slot available, and asked if I could do that. I agreed that I could, and began to get ready.

I think it’s noteworthy that the typical time to get an appointment with a cardiologist is in the range of three to six weeks, not three hours. Not an emergency, but clearly “urgent.” They had opened a work-in slot for me, same day. This was with a cardiologist I had not yet seen for a first appointment.

If I am honest with myself, that made me a touch nervous. I got myself ready, and ran down to fill up the gas tank. That alone was over fifty dollars, as I had been postponing buying in the clearly vain hope of a price drop.

I had a few minutes to kill, and grabbed a small brunch. Then it was time. I got in the car, and off I went. I had to wait for a few minutes in the lobby, and ultimately was called back. That’s when I found out they planned on running an ECG on me there and then.

My clothing choices were, shall we say, sub-optimal for that need. But we worked it out, and the strip was run. It was mildly abnormal. My heart rate was elevated, as was my blood pressure. Prior to the past few days, both had been very normal to even occasionally low.

The doctor’s PA was who I was there to see, and she came in fairly quickly after the ECG technician was done. She asked if the technician had left papers with me, and I said no. She left to go find that strip, and was back in just a couple of minutes.

She reviewed the records, asked a few questions, and we discussed me going back on a blood thinner. That’s costly with the newer ones, and warfarin (the previous generation drug) requires very frequent blood testing.That’s yet to be decided, but it’s highly likely. She wanted to discuss that directly with the doctor, who was out of town this week at a conference.

Other changes were more immediate. She proposed, and I agreed, to doubling my metoprolol dosage. There are possible side effects from that increased dosage, and I am to let the office know if I am troubled by any of them. She ordered updated labs, which I will have done on Monday.

I am to schedule a transthoracic echocardiogram (TTE), as well as a chemical stress test. The TTE is a straightforward enough ultrasound, and I’ve had those before.

This stress test, though, I have never done. I have done the more traditional treadmill one, which I realistically could not do now with arthritic knees. I must admit I am not looking forward to it. I am told to plan for it to take three to five hours. So basically an entire day in a nuclear lab. The last time I had to get an IV it took five jabs to finally place one.

That alone has me nervous about that test. Given all my chronic pain and fatigue issues, the test will be exhausting even if they get the IV on the first try. We shall see how that goes.

There is some good news in all this. I started the increased dosage of the metoprolol last night by taking two of the smaller pills instead of just one like before. Despite the heat wave, and having to go out to pick up a prescription today, my heart rate never went over 105. During the event Monday, it was as high as 222. I felt no AFib symptoms today, and didn’t even feel anything worth running an ECG on.

As I noted at the beginning, it’s been an interesting few days. It’s not over yet. The journey continues.

Tags: Afib, Cardiac Health, medical tmi, Paroxysmal Atrial Tachycardia, Transgender