Carmen "Dixie"'s Posts

I had a visit with my Cardiologist last Friday....a scheduled visit... a year and one week post-op...I am so fortunate to have this Cardiologist because he listens to me...and as a result, we are a team. My focus for this visit was to have him d'c the warfarian I had been on since surgery. I was up to 7.5 mg. daily and was to have it checked before the visit and the "new machine" wouldn't work... He proceeded with my visit.... As you know I had requested my chart from that 8 day visit at the Hospital where I had my surgery and I have told all that it was 390 pages long and wt: 3 1/2 lbs....I was able to present to my Cardio Md, the Surgeon's last progress note on the morning of my discharge. "she is on Coumadin and should only be on it for 2-3 months until the MAZE procedure is healed and with no "a-fib" occuring". I also read in the operative note that I had my left atrial appendage removed. This is a left over from the embryolgic stage of our development....it is a muscular pouch connected to the left atrium of the heart. In A-fib blood clots arise from this area in more than 90% of cases. If you have read my early notes, you will know that I did have "A-Fib" when I arrived at the "Rehab" facility and it was diagnosed the next morning. I was transfered to our local Hospital which was next door. Cardioversion was attempted and drug therapy. Finally ammodadrone (sp?) was used and this controlled my heart rate. I had a pacemaker put in and after 8 days in that hospital returned to the Rehab. Facility. I was on this drug until March when this Cardio MD discontinued it. With a pacemaker in, it is checked every three months - twice by phone and twice by an office visit. My record for this year has been - no evidence of A-Fib....I also know when I go into A-Fib and I hadn't had any bouts at all.....When I presented this information and the Surgeon's notes, he said....."let's discontinue the warfarain"........I was so happy.....than he asked me to take an Aspirin daily and I discussed the dose...."a 325 mg. tablet". This made me very happy. Than I told him I had discontinued my "beta-blocker medication" because of dizziness and the fact that my BP which I check daily was normal. We discussed the need for "a beta-blocker" and he wanted me to try another one....it is more for "rate-control"......so I agreed and am taking one that I had taken in the Rehab.Facility.....so now I take this twice a day........with no issues.. As our visit was coming to a close....he said..."Dixie, you are only on four drugs".....yes, lasix 20 mg. daily, KCL 10 meq. BID....metopoalER 25 mg. BID and ASA 325mg daily...I guess that most folks, one year post-op open heart surgery and at my age of 80 yrs. and 9 months old........usually take lots more.. I was happy and he was amazed and happy for me. This Friday, I will have my Echocardiogram and this will let him and me know how well my "poor ole diseased mitrol valve" is working and also how my new aorta valve is working.......I always get a copy of his report and do compare this with the last one...My daugher who is a Critical Care R.N. asks me why?....well I am a retired R.N. who must know all about my issues and this helps.. Once a nurse, always a nurse..... Well I must close........may all who read this be well and blessed as I am..... I continue to be proactive in staying healthy and God is blessing me abundantly. I am so fortunate..........

I can hardly believe that this year has passed. I must remember that I am "80" years old and know that time passes so much faster when you are a "Senior".... I am blessed that I have done so well. I had written in my last note that I was having INR issues and thought that hypothryoidism could cause this....however my blood work that I had done shows that all of my values are good. I have an INR due on Friday....my one year anniversary of H.S. and hope it is where it needs to be..... I was left with a "mitral valve" that couldn't be removed but so far it is still working as it should. My aorta valve which was replaced with a bovine valve is working away and has no issues. I see my Cardiologist on the 15th....It is just going to be a short visit. I usually have my history since seeing him on March 3rd....written for him....So he will review it and know what questions I have for him before I am taken to the exam room. My big question is......when should I expect my "diseased" mitral valve to fail???.....He had told me in March that it would and "heart failure" would occur....treatment would help for a while and than no more..........I know that when I have my first "heart failure" issue, I will be treated only once and than refuse any other treatment when it occurs again. I plan on entering a "hospice" program and remain there until I go to my rest. I had heard about an external "heart pump" which is used for patients waiting for heart transplants and I thought it might work for me, but I am not a candidate. I have had more years of living than most folks and I really know that when it is time to go......I will go peacefully.......... I am glad that I did have my Heart Surgery even tho I couldn't have both valves replace. Oh, yes, I did have a MAZE procedure and that has been effective. A lot of Cardiologists don't believe it is that great. I also had a Pacemaker implanted last October 22nd. and every three months, it is checked and there hasn't been any history of A-Fib at all which tells me that the MAZE procedure worked...(I am not on any drugs to prevent A-Fib)....I thank my Surgeon for doing this. Oh, yes, I am going to write him a letter to share with him my progress for the year and that I am also happy I had surgery. His practice doesn't see patients after discharge from the Medical Center.....the Cardilogist of each patient in their home towns....care for them. Well I think I had better close down for the evening..........take care....all who read this and are also recovering from their surgeries....

This is my second attempt to write about this. My computer got crazy and I lost what I had written....so this will be short and to the point. I am on "high" doses of warfarin and find it hard to get the INR to my target range - 2.5 to 3.5... I have been searching the internet to find the "Why"? and think that I may have "hypothryoidism". I was on this drug - aminodorone for over four months post op. heart surgery. It is high in iodine and can affect the thyroid. The blood work done in June shows my thyroid has been afftected. I am no longer on that drug. I will be tested next week and see if the test is still positive for "hypothryoidism" if so ...I will be treated and than I know that my INR will be easier to maintain. I have been very careful with my diet and eat the healthy foods with out much Vit. K in them.....It is so frustrating to have to visit every ten days to 14 days for INR's and than they swing up and down....mostly down....I have learned that many of the supplements that I took had "soy bean oil" in them and that is high in Vit. K.(no longer take them) I shared this with the staff doing my INR .... they hadn't heard of this but were happy to know....I have spent a lot of time trying to figure out why?????........and have learned much. I think now that I need to complile s "fact" sheet that that staff can share with the patients they do INR's on....Of course the "large group of Cardiologists" would have to approve this....so maybe I will give it a try....I am an "Old Nurse" and never stop researching problems....the internet is such a wonderful invention......I am thankful that I am computer "savvy"...........well this is all for today......My Blog....I will be back sooner than I was the last time.....