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Thursday, July 05, 2018

First things first

Tonight there’s a major change in this health journey, and in three weeks, some more investigation may lead to some definitive answers. First things first, and then the rest later. It’s the only thing to do.

Tonight I take my last dose of the beta blocker, and tomorrow I begin the calcium channel blocker, diltiazem. Two weeks ago, the cardiologist had me begin to wean off of the beta blocker by cutting the dosage in half, and that ends tonight. Over that time, I’ve felt better: Less tired, and with more and better mental focus. I’ve given myself some simple memory tests, like remembering small things that were unimportant over a couple days. For the past year, I haven’t been able to do that, and instead have had to rely on writing myself notes while hoping I’d see the note or remember I’d written one, ideally both. Plenty of times I did neither.

Slowly over the past couple weeks I’ve definitely felt clearer mentally. The memory tests were successful, though I still really haven’t felt focused enough to read a long-form article, let alone a book. But blogging has been easier and more productive, something that also requires focus. So all of that has been really great.

Against that backdrop, there’s a bit of worry. I’ve changed drugs before and had problems, after all, so I know that could happen now, too. Right now, I also don’t know for sure that I won’t have to go back to beta blockers, but there may soon be an answer for that, something that will answer a nagging question I had.

The first time I saw my new doctor, she explained to me why I was on beta blockers. I thought it was because of the tachycardia, but she thought it was something else:
I knew that people who’ve had a heart attack are put on the drug to help their heart heal. I didn't have a heart attack. I also knew that they’re used for irregular heartbeat (and migraines, even). But it turns out that when someone has a heart attack, part of their heart is damaged, as we all probably know, and when someone has a blockage like I did, part of their heart is weakened. As a result, one half of the heart isn’t strong enough and has trouble keeping up with the healthy part. [emphasis added]
The part in that passage that’s in bold is the part of her explanation that stuck out for me—unfortunately, it was only later, after I was home and thinking about it. It was this: I thought to myself, “How do they KNOW, precisely, that half my heart isn’t working properly? Because if it is, they’re giving me medication I don’t need, especially because there are better drug options for people with my sort of tachycardia”.

This is the answer I’ll soon have.

I saw the cardiologist a two weeks ago, and exactly one week later I got a letter from our local District Health Board to ring them to make an appointment for a transthoracic echocardiogram, a procedure similar to how doctors check the development of a baby, but in this case it looks at the beating heart to look for unhealthy beating, rhythm, etc. When I have mine done at the end of the month, they’ll be able to see if both halves of my heart are working together and properly, and that will provide the definitive answer as to whether or not beta blockers were ever appropriate for me.

And therein lies my great fear: What if they were, and are, needed?

If the echocardiogram shows the two sides aren’t playing nicely with each other, then I may need to go back on beta blockers. There are several different ones, and maybe one might be a bit better than what I was on, but the fact remains that the fatigue and memory/focus problems are common with the entire class of drugs. If I have to go back on beta blockers, the problems will return, and, even though if I’m lucky they might not be as bad as they were before, they might be, and they definitely would return to some extent. Knowing this, it would be a little bit like being Charlie Gordon in Flowers for Algernon.

Now, I’m smart enough to know that there’s no sense worrying about something that may never happen, that even in the worst case, the drug I end up on might be significantly better. I know all that. But I also know that the past year has been among the worst of my adult life, and there were times that life meant little more than merely existing. I don’t know how I could cope with that if it was, essentially, a life sentence.

When I had the disaster with the last beta blocker, I considered getting a second opinion from a private cardiologist, but was still too burned from that very bad experience with the drug to pursue that option. Now that I’ve had that consultation, I’m switching drugs to a better, kinder sort of drug, and proper investigation will be done into how my heart is actually functioning, and that will determine what happens in the future.

At the very least, I should get some definitive answers, and maybe even a better way forward. First things first, and then the rest later. It’s the only thing to do.

Important note: This post is about my own personal health journey. My experiences are my own, and shouldn’t be taken as indicative for anyone else. Similarly, other people may have completely different reactions to the same medications I take—better or worse. I share my experiences because others may have the same or similar experiences, and I want them to know that they’re not alone. But, as always, discuss your situation and how you’re feeling openly, honestly, and clearly with your own doctor, and always feel free to seek a second opinion from another doctor.

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