Wednesday, December 31, 2008

December 30, 2008--A Visit with the GP

Paul saw his general practioner today. This is a doctor that he has seen for 23 years and who knows Paul well. He had good advice and information for Paul concerning his heart medication and was also eager to guide Paul in a healthy strategy for continued recuperation and future re-entry. It was an encouraging visit and he was glad to be in good hands.

December 29, 2008--Moderate Exercise--Yay!

Paul spoke with the cardiologist's nurse today. She told Paul that the doctor said the results of the nuclear adenosine stress test looked good and that he would meet with Paul in January to give him a more detailed explanation of the test results. She also said the doctor released Paul to increase his exercise conservatively (he has already been walking a bit). That was music to his ears.

December 24, 08--Rx: Snow!

The 5th medical prescription: Snow! It makes you feel like a kid again...

December 22, 2008--Nuclear Adenosine Stress Test

Paul had a nuclear imaging adenosine stress test today. After the nurse prepped him for all the strange things he might feel, I (Nancy) could see that this test was not for the faint of heart.......hmmm....and so I asked myself, "Now, why do they perform this test after a person has a heart attack?" Paul walked very slowly on the treadmill while the adenosine coursed through his body. His heart pounded as if he were sprinting 400 meters, while his lungs thought he was lounging on the beach. An odd experience, to say the least.

This was a 2 part test: the nuclear imaging evaluates blood flow to the heart. During the test, a small amount of radioactive tracer is injected into a vein. A special camera, called a gamma camera (photo), detects the radiation released by the tracer to produce computer images of the heart.

The tread mill part of the test is when the patient is injected with adenosine to help determine if there is adequate blood flow to the heart during activity versus at rest. Adenosine dilates blood vessels leading into the heart, increasing blood flow, therefore simulating exercise for patients unable to exercise on a treadmill.

I don't think you'll see this as a virtual Disney ride in the near future.

Information taken from:

December 10, 2008--Angiogram Review

Paul saw the cardiologist today and he reviewed Paul's angiogram with us. While Paul was in the hospital, the coronary angiography was the procedure that helped the doctor determine if Paul had a heart attack and what caused it. The doctor showed us 2 narrowed arteries that were considered the culprits--the left anterior descending artery and the circumflex artery. He also showed us where one of the ventricles appeared sluggish; he thought that this was injury resulting from the heart attack and that rest and time would aid its return to full strength.  The doctor expected the tightness that Paul was feeling in his chest to soon dissipate. 

The coronary angiography is used for diagnosis and is the most common type of heart catheter procedure that can both diagnose and treat heart and blood vessel conditions. It uses X-ray imaging to examine the inside of the heart's blood vessels. During coronary angiography, a type of dye that's visible by X-ray machine is injected into the blood vessels of your heart through a catheter (a long, thin, flexible plastic tube ) that is inserted into the body through the groin. The X-ray machine rapidly takes a series of images (angiograms), offering a detailed look at the inside of your blood vessels.

December 9, 08--Still a Little Tightness

Since returning from the hospital, the tightness in Paul's chest has not resolved entirely. He is still taking a periodic nitroglycerin tablet and checks in with the cardiologist tomorrow.

December 6, 2008--Resting & Reading

Paul is home from the hospital and is trying to rest with some good books. According to the doctor, sleep and rest are integral to heart repair. So, now it's just a matter of winding down the ol' brain. The doctor has also prescribed four medications to help the heart recuperate:

  1. A beta blocker-Beta blockers are medications that reduce your blood pressure. Beta blockers work by blocking the effects of the hormone epinephrine, also known as adrenaline. When you take beta blockers, the heart beats more slowly and with less force, thereby reducing blood pressure. Beta blockers also help blood vessels open up to improve blood flow.

  2. An ACE (Angiotensin-Converting Enzyme) inhibitor helps relax blood vessels. ACE inhibitors prevent an enzyme in your body from producing angiotensin II, a substance in your body that affects your cardiovascular system by narrowing your blood vessels and releasing hormones that can raise your blood pressure. This narrowing can cause high blood pressure and force your heart to work harder.

  3. A Statin (a cholesterol lowering drug) blocks a substance your body needs to make cholesterol. They may also help your body reabsorb cholesterol that has accumulated in plaques on your artery walls, helping prevent further blockage in your blood vessels.

  4. Plavix (Clopidogrel) is used to lessen the chance of heart attack or stroke. Clopidogrel reduces the chance that a harmful blood clot will form by preventing certain cells in the blood from clumping together.

December 5, 08--So it Wasn't a Dream?

It's the first day home from the hospital and unlike Scrooge, when Paul woke up this morning, this "matter of the heart" didn't turn out to be a dream, but it does appear to be a life-changing experience --knowing that God takes all things and uses them for our good so we can grow to be more like Him. Although Paul was physically fit, made an effort to work out and watched the foods he ate (this heart attack certainly surprised the doctors), it looks like there are other ways he will learn to care for his heart. The first step is to rest and avoid stress. Thank you all for your care, concern and prayers for Paul and our family.

December 3, 08--A Little Christmas Drama

Dear Friends and Family,

T’was two evenings before today and Paul went to the gym--to discover a little Christmas drama was waiting for him……

And this is how it went: He had a great workout lifting weights and running on the elliptical. On his way home he stopped to pick up some groceries to make a partridge and pear pie (okay—so it was raspberry and pear) and came home. While I was making dinner, he commented how good he felt after his work out. He then went to the bedroom to take a shower and get dressed. While showering, he discovered that his post-work-out-good-feeling was eclipsed by a growing pain in the bottom front part of his neck. He finished his shower, dried himself and by the time he was dressed, the pain migrated to his sternum and he thought it must be indigestion. When he walked into the kitchen he wondered if his esophagus was spasming, at which point the pain forced him to sit down. He leaned back in the recliner, rubbed his chest, twisted and turned a bit and strained, “, “Is this what indigestion is like?” I stopped cutting vegetables, walked over to him as he muttered, “I don’t know what this is….it’s getting worse….and… I really don’t want to go to the hospital.” So, I said, “How ‘bout if we just head toward the hospital and if you feel better we can always turn around and come home.” He liked the escape-option... and over the river and through the woods to the emergency room we went.

It turns out that on the first day of December, our SW Medical Center gave to Paul: one electrocardiogram, 2 nitro-glycerin boosts, 3 draws of blood and 4 doctor evalu-a-tions. On the 2nd day of December, SW Medical Center gave to Paul: one echocardiogram, a very important angiogram and a head-ache from the nitro-glyc-er-in.

And several nursing shifts and 4 hospital rooms later, we can now tell you that in this Christmas drama, Paul was not influenced by “a bit of undigested beef, a blot of mustard, or a crumb of cheese” after all, but he did indeed have a small heart attack—bah humbug. The angiogram identified 2 blockages—one artery was 50% blocked and the other was 70-80%. The doctors deliberated and felt that medication would be the best way to address the blockages (versus stints).

But there’s good news--Paul feels fine and is doing well. There appears to be no damage to the heart and his heart muscle looks strong. He’s in good physical condition which shines a favorable light on the future. But best of all, God is always on the throne.

God Bless Us, Every One!

Nancy--for all of us at the Jackson house