Looking back and looking forward

I had an echocardiogram and consultation yesterday at Hopkins. I'm glad to know the heart issues of the summer are behind me :-)  The new valve is doing just what it was intended to do, and the pressures that had been high are where they belong.

My lungs seem to be healing well and haven't held me back. While I haven't yet returned to my normal exercise level, I did enjoy a superb 58 mile bike ride on Saturday. It's great to feel more and more like myself. I also feel lucky how relatively easy my clots were to deal with... I've met plenty of people who had more serious complications than I did.

We now resume focus on the rest of the heart (left side), especially the aortic root (where the aorta connects with the heart).   Docs will review recent and historical CT's and echocardiograms to see how things have changed.  The hope, of course, is "not much".

Next regular checkup is in March. Thanks for listening in, and for all your kind words.

Back from vacation

We're back from 10 great days in California for vacation plus 3 in New Jersey for a Krahe-Buettner family reunion. All fun.

I've been feeling great, but I do know my lungs are still recovering. Had a small amount of discomfort during a chest cold I had early in the month, then felt a bit if restriction bicycling this weekend (riding moderately fast).

Next appointment is September 4th.

Background noise

Today was amazingly one of my longer appointments. Almost 4 hours.

We saw Dr Ringel twice. After the first time when all seemed well, he heard a murmur through the stethoscope that he heard just after the Melody valve insertion a few weeks back.  At the time he had written off the sound as coming from the leaking tricuspid valve, but now that the leak is gone, he wanted an explanation. A second echocardiogram was needed.

The murmur, it turns out, is coming from my Aortic valve. It is not a cause for immediate concern. In fact it is likely this murmur has been there for some time (after my surgery in 2008), but was masked by the big sounds of the pulmonary craziness.

We will watch this over time. The question, less important than the sound made, is the valve's performance. The valve has been categorized as mildy insufficient (leaky) since it was replaced , and may have slipped into the early stages of moderate. Time will tell.

Good numbers

My echocardiogram this morning thankfully shows pressure across the Melody valve where it belongs, or at least nearly so!  While they can no longer measure the right ventricle pressure, they are comfortable that it too has improved since my tricuspid valve is no longer leaking.

This is all a dramatic improvement from just 2 weeks ago, and a wonderful feeling.  Next appointment is September 4th.  Until then I'm free to start exercising as long as I keep in mind the right lung is still recovering.

Smiles all around :-)

Testing and theories

A sonogram of my legs yesterday showed no lingering blood clots. That's of course good news, as it means there shouldn't be any new embolisms coming.  What it doesn't tell us is whether the original clots came from the legs or from the valve itself.  The leading theory is the legs, or, more specifically, from the insertion points for the catheters.

Knowing the original cause of the clots would help future patients.  Could clots like mine be prevented in the future?  Was I more susceptible this time compared to 2009?  Am I hyper-coagulative (prone to form clots more quickly)?   For my short term, knowing is moot, partially since it's behind me, and also that I'm on a blood thinner for six months.  I'll have bloodwork for hyper-coagulation sometime soon, so that may add a piece to the puzzle.

That I'm feeling better each day is a good sign.  Less pain.  No fever.  Good energy.  I even walked a mile last night with Eddie, stopping to rest now and then, but light years better than a short walk to the corner with Alli I think on Sunday.

Because nothing like what I've experienced has happened in the ~3,000 other United States Melody valve cases to date, the next step was jointly determined by Dr. Ringel and his trusted colleagues around the country.  On Monday we'll do an echocardiogram to estimate what change, if any, has occurred with the pressures in and near the heart.  It could be that my body is still adjusting to the valve and reacting to the clots, or it could mean there is something else going on.  The results from Monday will tell us if we wait longer or if we do more tests (probably a catheter echo and camera inspection).

In the meantime, thanks for reading.  Enjoy the weather if you live near us!  The Washington Post gives the rating for today a subjective 10 out of 10 ... superb for a DC July.

Taking a deep(er) breath

Saturday evening and Sunday required a healthy dose of expletives, I'll be the first to admit.  The peaks of pain from my right lung weren't as high as the 24 hours previous, but for sure, they weren't far behind.  There were periods without pain, where I could lay down and sleep, but those rarely lasted more than about 90 minutes.

Granted, I had avoided the narcotic Oxycodone as my pain med, partly because of how it makes me feel (not like myself), and partly because I didn't need more of a departure from normal digestion (one of its side effects). I relied instead on Tylenol and Tramadol.

I was ready to start Oxycodone Sunday night, but a funny thing happened. Overnight I could lay down (on my left side only), and breathe, without pain. And I could easily fall asleep. Although I was up every 2 to 3 hours, I could always return to laying down and sleeping shortly after.

As you can gather, the days previous were not comfortable. While I could always get reprieve by standing, the need was far too frequent. And while I wasn't doing anything that required more than shallow breathing, I knew that deeper breaths were important to avoiding pneumonia, something to which, for the moment, I'm more susceptible.

Today was entirely different. Alli said it first, just watching me come into the kitchen to write a note while on the phone with Dr Ringel. I was clearly feeling better.

It sure helped that Ann Marie and kids were taking care of things at home, and my teammates doing the same at work. It let me rest and take care of myself.

I'll post later about my appointment at Hopkins today, and the next one scheduled for Monday. As for now,  I'm going to take advantage of the remaining sunlight :-)

Heading home

And it's before sunset, yay!