Diagnosis (sort of)
So, I was admitted for hypoxia and suspected congestive heart failure. My oxygen level was low and that troponin level (heart damage indicator) was high. On the second night I had an “attack” of pericarditis, an excruciating and frightening episode of extreme chills and intense chest pain, caused by inflammation of the sack around the heart. Enter the “Rapid Response Team”. Exit Paulie’s composure.
For the next five days they lowered my blood pressure, raised my blood pressure, increased my oxygen, decreased my oxygen, raised my heart rate, slowed my heart rate, dehydrated me, rehydrated me….felt like I was a set of human Etch a Sketch knobs. This way, no that way, up no down. And let’s wake her up every hour and poke her tiny veins just for fun.
On day four, they did a cardiac Stress Test. This is usually done on a treadmill. For patients like me, who can’t do that and are hooked up to a bunch of IVs, they do a chemically induced stress test. In other words they hook you up to a bunch of wires, tell you to wiggle your feet and then GIVE YOU A FUCKING HEART ATTACK.
Worst. Experience. Ever. I’ve had chemo, radiation burns and torn during childbirth. No comparison.
After I recovered from that, and was breathing without oxygen for two consecutive days, I could be discharged. It took a day longer than we hoped because no one was available to do the cardiac CT over the weekend. The Stress Test, Echocardiogram and Cardiac CT showed that my heart has no blockages or other traditional causes of heart failure. Good. My ejection fraction was down from my normal rate, so my heart was weak. Chest xrays continued to show fluid on my lungs, because my heart wasn’t pumping at full strength. Not so good.
So what happened?
The consensus is that the oral chemo Lapatinib is the most likely culprit. Her2NEU chemo agents are known for this issue, thus the frequent baseline Echocardiograms I’ve had every six months through my treatment.
So, they’ve added four more medications to the mix. I wore a heart monitor device for three days to collect data on my rhythm (I was tachycardic occasionally). I have a cardiac MRI next week, more blood work and the usual round of appointments. Lucky for me, my care system has a cardiologist specializing in chemo related heart issues. He’s 12, but I trust him. He and my oncologist will consult and decide what to do next. In the meantime, I’m going slow, conscious of every breath and I hate stairs.
Speaking of heart stopping moments, I already got a “We reject your hospital stay claim because your doctor has not sent proof it was medically necessary” insurance letter. Bwaaaaaaahaaaaa, ok.