Hospital Follow - Up - April 20 2015

                                                           Alan with Dr. Mellicor

                  With apologies for the photo that doesn't quite fit the blog boundary .

Today was my return visit to the hospital for some  follow up Lab tests and consultation up - date with my primary care co - coordinator . Today's lab results showed normal for Sodium and Potassium levels but still have elevated Uric Acid levels . However , even the elevated Uric Acid readings were considerably lower than on my initial hospital check in .

Biggest change has been the elimination of excess fluid in the form of edema . Which explains why my energy level has increased significantly . When i checked into CUMC i could not walk 40 - 50 meters without pain in my legs and having to stop and rest before proceeding . This am i walked to the front gate and beyond with only mild discomfort in the buttock area which was probably due to a lack of walking .

The 100 - 130 meter walk this am without substantial discomfort was no doubt due to the reduction in fluid retention . When i checked into CUMC with Edema my weight was 165 bs. Today it was 146 Lbs . That's 19 lbs of fluid that has been removed and as the Dr. says explains why i have more energy . The heart is not having to pump through all that excess fluid and as a result circulation throughout the body is better .

Next visit will be to the Cardiologist in May to determine how much improvement has resulted in terms of the Heart's  Rhythm  and other functions .

The photo above shows why one should not spend hrs. inside hospitals with Coffee Shops , Canteens and other venues while waiting for lab results . Truth is probably spent more in Canteen and Coffee Shop than for Lab work and consultation .  But , hey - it's more fun in the Philippines !   :-)

Going Forward

What does the future hold for any of us ? Who knows but as of today my physical condition is much improved . The Diuretic has been discontinued with diet becoming the primary factor in controlling fluid retention . Emphasis is on eliminating sodium and uric acid producing foods and beverages which contribute greatly to fluid retention .

Next visit to doctors overseeing my care will be on April 20 . I would expect at least some improvement though i am not certain heart meds have had sufficient time to have much effect . In the end it will come down to personal decisions i make within myself and the will of the source that puts us all here in the first place .

I don't relate much to a religious framework simply because i struggle with the idea of placing a boundary or limitation around something i perceive to be infinite in the first place . In the end i doubt it much matters whether we label whatever is as the universe , source , first cause , God , etc . As Spock would say.. Live Long and Prosper !

Into The Lions Den - The Echocardiogram

The title of this post is a bit of a misnomer of course as there is nothing particularly difficult about having an echocardiogram done . This is especially true when having the standard noninvasive one as i did . Other than the fact that the technician doing the procedure just wants you to shut up and quit asking questions while being still it can be quite interesting  to watch your heart work on your behalf .

After returning home and doing some research regarding this procedure i now have a better understanding of why a significant portion of my imaging was done in the left atrium - left ventricle area of the heart including the mitral value . This is the chamber of the heart that pumps oxygenated blood to the other parts of the body and where most of my problem lies .

The Cardiologist

As my imaging procedure was not done until late in the day i did not receive a visit from the Cardiologist until the following day . Upon entry the first thing he said to me was " make a fist " . So , i made a feeble fist smug in the thought that i knew he was  going to tell me the heart was the size of my fist .  In fact , i was even ready to crack a joke about having small hands ..   :-)

The joke never came as what he actually said was " your heart is twice the size of your fist " . Worse , or at least it sounded worst to me was the accompanying detail that the heart was operating at about a 50 % rate of efficiency . Now , 50 % or a 500 batting average in baseball would make you the greatest ever in the sport but 50 % in terms of your heart function sounds more like an F for failure to me . And as it turns out that was exactly the diagnosis.. " Heart Failure " .

Fortunately the term Heart Failure in medicine does not mean your heart has stopped functioning completely for obvious reasons . But , it does mean your heart is in the process of heading that direction if not dealt with in a fairly prompt way . My wife even says i had a heart attack though i don't recall that statement being made in my presence . Of course it's possible the statement was not made in my presence or that i was just fogged out at the time and don't remember it . 

Note; For comparison purposes only - the cost of my echocardiogram was listed as 3,700 peso . That was for the test only and did not include additional fees for the doctor(s) that interpreted the results( which can and do run higher than the test itself )   :-)

Going Forward - To Be Continued

Getting One's Foot In The Door

                                         Dr. Allan Melicor and his wife Blessie

The gentleman pictured above has been my " foot in the door " . A member of the church my wife attends he is a surgeon by specialty and though not directly involved he has been kind enough to co - ordinate my entry into the Capitol University hospital system by making the necessary connections with the appropriate medical professionals .

Dr. Melicor happens to be one of those rare individuals that you simply feel comfortable with upon meeting and feel as you have known for years  . The fact that he is a rather well know individual for his work in the medical missionary field i did not know until i Googled his name and pages of data appeared .   :-) 

Upon entering the hospital the first order of business was thought to be an ultrasound of the stomach region that might clarify whether the edema was associated with the Kidneys , Liver , etc . Because the ultrasound required a fasting state prior to being done additional tests were run that disclosed the " primary " problem was with the heart and other concerns were secondary effects brought about by the heart .

My EKG was essentially off the chart in terms of my heart's rhythm and it was at this point that i realized i might be in some very deep do do.. A visit by an Internist confirmed that fact as this individual lived up to her reputation as being " straight forward " ( political correctness applied here ) .   :-) What ensued with this particular doctor i only found out about later as my wife had tailed her out the door for one of those conservations you are never privy to as an expat spouse . 

As it turns out this particular doctor thought i was in denial regarding my diagnosis . This was apparently due to my BP remaining stable and my not having some sort of emoting experience resembling a cultural melodrama . Alas , i had already contemplated the possibilities based on my age , lack of previous medical attention and common sense . Also thrown in was a heavy dose of " if it's my time , it's my time " .

Into the Lion's Den - The Echocardiogram

To be Continued

In For A Checkup - Out With A Lifestyle Change

April 7 2015

 My personal day of infamy ? Perhaps , but it started out as a visit to Capitol University Medical City hospital for an overnight stay based on the need for a 12 hr fast prior to an Ultrasound of the stomach region as part of a comprehensive physical .  Little did i realize what lie ahead ! .

Before embarking on my personal journey through the world of medical lingo , needle sticks , peeing in pots and suffering through the pangs and sorrows of cold hospital food and a lack of hot water I wish to make something clear . This blog has everything to do with my need to sort through my personal thoughts and feelings regarding this experience and may be of little value to others .Having said that , if there is an entry here and there that helps someone that might be facing a similar experience may it be so .

It is not a valid excuse but none the less was my excuse to not go to a hospital for a checkup in the first place because it is so difficult to make the initial contacts with the appropriate doctors . I absolutely dreaded the prospect of showing up in a hospital corridor , signing in and maybe being able to see an actual doctor . In the end one simply has to accept the fact that there  is a shortage of doctors in this culture and getting to one can be frustrating to say the least .

The fact that hospital corridors in the Philippines can appear to be playgrounds for the young and restless with inadequate seating due to the family entourage being present ( think Many Pacquiao ) and you will get the drift . The fact that i had an appointment meant little as first come , first serve is the accepted practice . The fact that my BP hit 133/90 and was the highest recorded during my entire stay attests to the difficulty of getting one's foot in the door.     :-)

Getting One's Foot In The Door - To Be Continued