Over the past several months, Patty's unease has heightened about the gradual reemergence of heart failure symptoms we had happily relegated to the category of distant memories.
Last year, Patty started noticing angina (heart pain) whenever she exerted herself, most often at work. Her cardiologist questioned whether these pains were, in fact, heart-related; Patty seemed too strong. Still, the discomfort persisted--enough to unsettle Patty, but not enough to command much in the form of intervention. As a layman, I imagined these as twinges related to Patty's heart growing accustomed to the HeartNet placed two summers ago. I always have theories, most of which are pure fiction.
Over the past month, more old "friends" have started to drop in: weakness in her legs when walking, coughing in her sleep, shortness of breath, nausea and frequent urination. While Patty sleeps, I often rest my head on her chest and listen to her heartbeat; in the past couple of weeks, the pace seems faster than usual, as though Patty had just gone jogging. Still, none of the symptoms was severe enough to justify a trip to the emergency room; she's still functioning at a pretty high level.
To set Patty's mind at ease, her cardiologist ordered a nuclear stress test--essentially, a test in which the strain on the heart is induced by chemicals rather than physical exertion. Patty did the test. Early last week, her cardiologist's nurse called to tell Patty that although the results did not show any major anomalies in how her heart responded to the strain, they did contain a surprise: Patty's ejection fraction, or EF (a measure of how well the heart functions in pumping blood through the body) had dropped from the past time it was measured, from 38 percent to 21.
As is so often the case with the medical community, Patty's cardiologist was out of town when the results came in, so we were told to sit tight until the end of the week. Last night, while checking messages on her cell phone, Patty retrieved one from her doctor's nurse. Patty's cardiologist wants to perform an angiogram to get a closer look at Patty's heart. In the past, doctors have shied away from doing more angiograms, because the risk of perforating an artery increases the more often they are performed. The nurse explained that there's some concern she may have a restenosis (a regrowth of arterial tissue around one of the two stents in her heart, or possibly a new blockage). We're hoping this isn't the case, because we had been told, in the past, that another stent may not be an option, and that bypass surgery would be the logical next course.
Patty is understandably shaken by the prospect of another angiogram, because each time these have been performed in the past, the results have been alarming. In one, the procedure itself caused her to have a second, minor heart attack. We're hoping this one goes off without event.
Please understand that we're doing a lot of speculating right now based on little concrete information. Patty has to call on Monday to schedule the angiogram. As soon as there's more to share, I will post an update here and on the Facebook page I created to discuss Patty's health issues.
We have a family road trip to Canada, for my parents' 50th anniversary, planned for next weekend. We're keeping our fingers crossed these new developments won't affect our ability to make the journey.
Please keep your fingers crossed that we're worrying more than the circumstances deserve.