Wednesday, March 25, 2009

Long Overdue Update...

Okay, here it goes! If you will please pardon my severely medicated brain… I’d like to add some recent diagnosis information, updated medicine regimens and long-term outlook.

Let’s start with some great news… the left ventricular apical thrombus (blood clot) has dissolved! Praise the Lord! When first diagnosed in November, the doctor immediately started me on heavy doses of Coumadin in hopes the clot would begin to dissolve in 6 months. It has only been 4 months and it is completely gone! Definitely a reason to be praising the Lord.

Below, I have decided to give you some information from the Merck Medical Dictionary. I will make notes in bold italics, to help you understand my specific condition.


First a quick recap…
Dilated Cardiomyopathy
is a group of heart muscle disorders in which the ventricles enlarge but are not able to pump enough blood for the body's needs, resulting in heart failure. Usually, the first symptoms of dilated cardiomyopathy are becoming short of breath during exertion and tiring easily. Looking back, I have probably had this for quite sometime and just ignored it because I am a single mom, always tired, always busy, always something! They result from a weakening of the heart's pumping action, which is called heart failure (see Heart Failure). Whatever the cause of dilated cardiomyopathy, if the heart damage is severe enough, the heart rate eventually speeds up, blood pressure is normal or low, fluid is retained in the legs and abdomen, and the lungs fill with fluid.
Because the heart is enlarged, the heart valves may be unable to close normally and often leak. The valves most often affected are the mitral valve, which is positioned between the left atrium (upper heart chamber) and the left ventricle (lower heart chamber), and the tricuspid valve, which is positioned between the right atrium and the right ventricle. During my last echocardiogram, March 18, 2009, it was discovered that my mitral valve has some mild leakage. Leakage causes murmurs, which doctors can hear with a stethoscope. Damage to and stretching of the heart muscle may result in abnormal heart rhythms (arrhythmias), which may cause awareness of heartbeats (palpitations) or death. I have been noticing palpitations for over a year already, prior to diagnosis. The leakage of the valves and the abnormal heart rhythms may interfere further with the heart's pumping action. Blood pools in the enlarged heart, increasing the risk of blood clots forming on heart chamber walls. The clots can break into pieces (becoming emboli), travel from the heart to blood vessels elsewhere in the body, and block them, causing damage to the organ they supply. If the blood supply to the brain is blocked, a stroke can result. This is what has just dissolved in my heart. Because of the continued risk of a recurring blood clot, my doctor and I have decided that I will permanently be on Coumadin.

Now onto the medicine regimin:
1.Vasotec 2.5mg (2x daily)- is an ACE inhibitor. This medicine is used to treat high blood pressure and heart failure. Angiotensin-converting enzyme (ACE) inhibitors help relax blood vessels. ACE inhibitors prevent an enzyme in your body from producing angiotensin II, a substance in your body that affects your cardiovascular system by narrowing your blood vessels and releasing hormones that can raise your blood pressure. This narrowing can cause high blood pressure and force your heart to work harder.

2. Coreg 3.125mg (1x daily)- is a beta-blocker. Beta-blockers reduce the workload on the heart and help it to beat more regularly. Beta blockers work by blocking the effects of the hormone epinephrine, also known as adrenaline. When you take beta blockers, the heart beats more slowly and with less force, thereby reducing blood pressure. Beta blockers also help blood vessels open up to improve blood flow.


3. Coumadin 10mg/7.5mg (1x daily) - is an anticoagulant. It is used to treat or prevent clots in the veins, arteries, lungs, or heart.


4. Spironolactone 25mg (1x daily) - is a diuretic. It helps you make more urine and to lose excess water from your body. This medicine is used to treat high blood pressure, and edema or swelling from heart, kidney, or liver disease. It is also used to treat patients who make too much aldosterone or have low potassium.


5. Asprin 81mg (1x daily) – is used to additionally thin the blood.


6. Fish Oil 1200mg (1x daily) – is used to raise the good cholesterol found in your body.

Long-term outlooks can be hard to swallow sometimes. I am already in heart failure. Eventually, I will be in complete congestive heart failure. This will require a heart transplant. The doctor has been clear that I probably have a long road to that point. But that it will be inevitable one day. Cardiomyopathy is a disease that progresses at a different rate for different people. Statistics show that 70% of people die within 5 years of their first symptoms, unless they receive a heart transplant. Because I am so young, there are not a lot of statistics on survival and long-term diagnosis. My doctor is hopeful that with medication and good health, I will have a good 10 years before any major heart failure. Of the 4 classes of heart failure, I am only in Class II. That is encouraging… coupled with the fact I have no other heart failure issues: no clogged arteries, no diabetes, no high blood pressure, no long-term alcohol or drug abuse. The longer I can stay free from other health complications, will help my heart and my chances of a heart transplant when the time comes.

Yes, all of these facts can be very hard to swallow most days. However, I know the great physician…I know the creator of my body, soul and spirit…I know the Sovereign God who ordained not only my eternal destiny, but also my physical destiny… I know that as easily as the Lord gives me life, He can heal or take my life away. Were it not for my absolute faith in My Lord and Savior, each day would be hard to live. Psalm 118:6 – “The Lord is on my side, I will not fear; what can man do unto me?”