Tuesday, July 28, 2009

People, we have results!

Hi everyone:

As you can see from the photo, good pain management involves spending a large portion of your time unconscious.

We do finally have some results, although they're (sadly) not of the, "Turns out it was the vapors" variety. Wouldn't this be a nice deviation from the norm--two Rolaids and then on our way?

Tests of Patty’s blood revealed elevated levels of two markers associated with inflammation in the body—erythrocyte sedimentation rate (or "sed rate") and C reactive protein. Sed rate tests measure the clumping quality of red blood cells; when inflammation is present, red blood cells tend to clump together.

Patty’s cells are clumped.

C reactive protein is generally only traceable in the blood if inflammation is present, and appears with some frequency in those with autoimmune conditions such as lupus. It may also appear in heart patients when inflammation is present in areas surrounding or including the heart.
If you're in the market for C reactive protein, Patty's got it. And, as I mentioned previously, she also has white blood cells to spare.

The blood test results, along with the echocardiogram, have led Dr. Costanzo to believe Patty is suffering from pericarditis. This is the swelling and irritation of the pericardium (the sac surrounding the heart.) You may recall that a small incision was made in Patty’s pericardium to allow for the insertion of the HeartNet. I gather that the pericardium is no fan of being touched; Patty’s apparently threw a tantrum.

Certainly, many of the symptoms I’ve described yesterday and today are consistent with pericarditis; the one strange variation is that while discomfort is most often felt toward the left shoulder, Patty’s pain has tended from the right to the center. From what I’ve read, the condition can become serious if untreated, but most people recover without any long-term consequences. Please knock on any wood in your immediate vicinity.

This new wrinkle in Patty’s storied medical history will result in her being treated to an all-expense-paid five-week trip on the good ship Prednisone (a corticosteroid). This is a journey Patty had little interest in taking; in fact, I think she's fairly heartbroken.

These steroids can have a number of somewhat unpleasant side effects, including weight gain and water retention. Many people describe a condition dubbed “moon face” because the patient’s face tends to have a round, swollen appearance while the person is taking the steroids. I think Patty will ultimately cope just fine (just don't expect to find a smile on her moon face). For my part, as long as Patty doesn’t grow (a) a handlebar mustache, or (b) a penis, we're golden. She took her first three pills (60mg...the maximum starting dose) at 5pm today. Thirty-five minutes have passed and she looks just like she did at 5:00.

There’s a touch of irony here, because until today we hadn’t heard mention of lupus and/or other autoimmune disorders in some time, nor did we expect Patty to be taking steroids without having a heart transplant. It's ironic, but not amusing.

Needless to say, Patty is by no means thrilled about these latest developments, but the enemy you know is almost always better. Still, I’m frustrated that Patty seems to be ailing so much from a procedure that for many seems to promise a better quality of life. She may well get there, but the first few weeks haven’t exactly been a picnic.

If it seems that I'm being a bit light about this, credit too little sleep and too many days hanging around hospitals…it makes one punchy. To be frank, this really sucks. I wish so much that Patty was feeling better. She was so hopeful going into this study, and now she's starting to feel down about the choice to participate.

One last little interesting tidbit – a couple of times over the past 24 hours, Patty’s EKG revealed an inverted T wave. This is sometimes indicative of a pulmonary embolism, which I guess most of us don't want. Fortunately, the CT scan last night ruled that out. Also, she had a venous ultrasound of her legs today to ensure she doesn't have any blood clots. She doesn't. See? It's not all doom and gloom.

I’ll provide more details as they become available. We've been told Patty should be able to go home sometime tomorrow. I'd like to see her at home; steroids or not, she looks better there.


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