FEELING A BIT WAN – Marilyn Armstrong

RDP Thursday – WAN

After yesterday’s doctor visit, having to go to yet another doctor seems like charging up the same hill — and there’s a guy at the top with a machine gun. Nonetheless, gotta do it. I still don’t know where to put my head. I feel like I carry poisonous genes and have passed them down the line.

But, speaking of wan, I’m still in the process of trying to work my way out of anemia — the last of the repairable issues on my medical agenda. I’ve actually found an iron pill that seems to work and doesn’t make me ill. I’m not taking enough of it, I know, but it beats out the nothing I was taking before.

I’m beginning to really resent DNA.

Junco and I think a House Finch

Isn’t what you inherit supposed to be a sort of grab-bag? You get some of the stuff, but not ALL of it? Because I seem to have collected everything and be in the process of passing it along.

The good news? Yesterday’s doctor seemed to think that I didn’t look particularly anemic now. My gums have stopped being pale and that’s a good sign. Now all I have to do is worry whether or not I’ve managed to pass everything along to another generation. Or two.

So feeling wan? Literally and figuratively. At the same time!

A GOOD NEWS-BAD NEWS KIND OF DAY – Marilyn Armstrong

Hypertrophic obstructive cardiomyopathy.

That’s what was wrong with me.

I had my heart surgery 4 years 11-1/2 months ago. As far as I knew, I never got an explanation of what exactly was wrong with me or what was done during the surgery. I didn’t know I had TWO valve replacements until a few weeks ago and I don’t know which artery was bypassed during my bypass.

To be more technical, the surgeon apparently explained everything, but I was so heavily drugged I’m not sure if I was awake for the explanation. I know I missed the whole thing about the second valve replacement because my best friend knew about it, but I didn’t. She wasn’t floating on Fentanyl.

The good news? UMass and Beth Israel are now connected so they can get my medical records. Eventually, it might sift down to me.

The bad news? My son needs to be checked for the same problem. His father died from heart-related problems as did both of his grandfathers and only luck kept me from sharing the same fate. So he has reason to be concerned about the condition of his heart. His father was only three years older than he is now when he died.

So, you ask, what exactly is “hypertrophic obstructive cardiomyopathy”?


From the Mayo Clinic: Overview

Hypertrophic cardiomyopathy (HCM) is a disease in which the heart muscle (myocardium) becomes abnormally thick (hypertrophied). The thickened heart muscle can make it harder for the heart to pump blood.

Hypertrophic cardiomyopathy often goes undiagnosed because many people with the disease have few if any, symptoms and can lead normal lives with no significant problems.

However, in a small number of people with HCM, the thickened heart muscle can cause shortness of breath, chest pain or problems in the heart’s electrical system, resulting in life-threatening abnormal heart rhythms (arrhythmias).


NOTE: I had no symptoms that I noticed — which is not the same as not having symptoms. If it weren’t for my primary doctor’s alarm at the sounds my mitral valve was making, followed by serious testing that I had done at another hospital because the cardiologist to whom she sent me suggested I not worry about it until I had serious symptoms.

In this case, the serious symptom would have been sudden death, so I’m glad I realized the man was a jerk and went elsewhere for care. Even after all the testing, no one had any idea how serious the problem was until I was already in surgery. At which point, it was oh so clear.


I did not have chest pains, but I did have serious
shortness of breath.

Since I had asthma, I assumed my shortness of breath was asthma acting up. But I was wrong. It was not asthma but my ventricle packing its bags and trying to leave home without me. This is one of the problems of having multiple issues. Symptoms can (and do) overlap.

It’s really easy to assume that the problem you’re having is something familiar — like asthma. Except — shortness of breath can mean many different things. Heart disease is only one of them.

I once badly misdiagnosed a dog who had a known problem, but her problem was not the one I thought she had but something else. She died. We never found out what killed her, even after an autopsy. We assumed it was Lyme, but we never got a firm diagnosis. Lyme is funny that way.

Moreover, I never imagined I had a heart problem because my father’s heart problem was asymptomatic. As mine was until suddenly, it wasn’t.


Symptoms

Signs and symptoms of hypertrophic cardiomyopathy may include one or more of the following:

            • Shortness of breath, especially during exercise
            • Chest pain, especially during exercise
            • Fainting, especially during or just after exercise or exertion
            • Sensation of rapid, fluttering or pounding heartbeats (palpitations)
            • Heart murmur, which a doctor might detect while listening to your heart
Causes

Hypertrophic cardiomyopathy is usually caused by abnormal genes (gene mutations) that cause the heart muscle to grow abnormally thick. People with hypertrophic cardiomyopathy also have an abnormal arrangement of heart muscle cells (myofiber disarray). This disarray can contribute to arrhythmia in some people.

The severity of hypertrophic cardiomyopathy varies widely. Most people with hypertrophic cardiomyopathy have a form of the disease in which the wall (septum) between the two bottom chambers of the heart (ventricles) becomes enlarged and restricts blood flow out of the heart (obstructive hypertrophic cardiomyopathy).

Sometimes hypertrophic cardiomyopathy occurs without significant blocking of blood flow (nonobstructive hypertrophic cardiomyopathy). However, the heart’s main pumping chamber (left ventricle) may become stiff, reducing the amount of blood the ventricle can hold and the amount pumped out to the body with each heartbeat.


Risk Factors

Hypertrophic cardiomyopathy is usually inherited. There’s a 50 percent chance that the children of a parent with hypertrophic cardiomyopathy will inherit the genetic mutation for the disease. First-degree relatives — parents, children or siblings — of a person with hypertrophic cardiomyopathy should ask their doctors about screening for the disease.


Complications

Many people with hypertrophic cardiomyopathy (HCM) don’t experience significant health problems. But some people experience complications, including:

            • Atrial fibrillation. Thickened heart muscle, as well as the abnormal structure of heart cells, can disrupt the normal functioning of the heart’s electrical system, resulting in fast or irregular heartbeats. Atrial fibrillation can also increase your risk of developing blood clots, which can travel to your brain and cause a stroke.
            • Sudden cardiac death. Ventricular tachycardia and ventricular fibrillation can cause sudden cardiac death. People with hypertrophic cardiomyopathy have an increased risk of sudden cardiac death, although such deaths are rare. Sudden cardiac death is estimated to occur in about 1 percent of people with HCM each year. Hypertrophic cardiomyopathy can cause heart-related sudden death in people of all ages, but the condition most often causes sudden cardiac death in people under the age of 30.
            • Obstructed blood flow. In many people, the thickened heart muscle obstructs the blood flow leaving the heart. Obstructed blood flow can cause shortness of breath with exertion, chest pain, dizziness, and fainting spells.
            • Dilated cardiomyopathy. Over time, the thickened heart muscle may become weak and ineffective in a very small percentage of people with HCM. The ventricle becomes enlarged (dilated), and its pumping ability becomes less forceful.
            • Mitral valve problems. The thickened heart muscle can leave a smaller space for blood to flow, causing blood to rush through your heart valves more quickly and forcefully. This increased force can prevent the valve between your heart’s left atrium and left ventricle (mitral valve) from closing properly. As a result, blood can leak backward into the left atrium (mitral valve regurgitation), possibly leading to worsening symptoms.
            • Heart failure. The thickened heart muscle can eventually become too stiff to effectively fill with blood. As a result, your heart can’t pump enough blood to meet your body’s needs.
Prevention

Because hypertrophic cardiomyopathy is inherited, it can’t be prevented. But it’s important to identify the condition as early as possible to guide treatment and prevent complications.

Preventing sudden death

Implantation of a cardioverter-defibrillator has been shown to help prevent sudden cardiac death, which occurs in about 1 percent of people with hypertrophic cardiomyopathy.

Unfortunately, because many people with hypertrophic cardiomyopathy don’t realize they have it, there are instances where the first sign of a problem is sudden cardiac death. These cases can happen in seemingly healthy young people, including high school athletes and other young, active adults. News of these types of deaths generates understandable attention because they’re so unexpected, but parents should be aware these deaths are quite rare.

Still, doctors trained in heart abnormalities generally recommend that people with hypertrophic cardiomyopathy not participate in most competitive sports with the possible exception of some low-intensity sports. Discuss specific recommendations with your cardiologist.


If this wasn’t a good news-bad news day, I don’t know what would be. The good news? All things considered, I’m doing fine. As far as I know, the valves are doing their valve-thing.

I’ve got 8 years — 5, realistically — before I’ll need a replacement battery. I also learned why I will never be able to live without a pacemaker. I had thought that maybe my heart would start doing the job all by itself one day, but that will not happen. But, assuming the rest of the tests next month indicate that all is well, I need to worry about my son, not me.

I think I’d rather worry about me.

If there is a moral to this story, it’s don’t self-diagnose. If you think something is wrong, don’t assume you have the answer. The odds are, you don’t. The internet is a good place to look up an existing diagnosis, but a bad place to get a new one. If it turns out your best guess was right, congratulations, but this is one of those times when an error can prove fatal.

I still think this problem wouldn’t have become such a life-threatening issue had I not also inherited my mother’s breast cancer. The drugs they feed you when you have cancer … well … I’m not even sure the doctor’s know what they do.

For the avoidance of goriness reasons, I decided you don’t need more pictures. You can always Google this yourself and see all the gore you want.

THE MELODY LINGERS ON – Marilyn Armstrong

“The song is ended but the melody lingers on.
You and the song are gone.
But the melody lingers on.”

My mother hummed all the time. While she worked in the kitchen. While she sewed. When she was hauling a vacuum over the rugs and when she was tending the kids. I doubt she knew she was humming.

When I was studying music in college, I occasionally recorded myself, just to see how I might sound to an audience. Turns out, I was humming as I played. I had no idea I did that.

Maybe it’s genetic?

72-music-keyboard-090216_05

I’ve been to concerts where the pianist was humming. I’m sure they didn’t know, either (but I hope someone tells them).

Melodies get stuck in my head. They roll around and around. Sometimes, I have to think of another tune, just to change the recording. I’m sure this song is going to be playing until something replaces it.

Come to think of it, “The song has ended” has — for now — taken the place of the theme for “West Wing.” It’s a welcome, respite.

A BOUQUET IN THE MIDDLE OF THE WEEK – Marilyn Armstrong

BOUQUET – FOTD – O2/19/2019

I needed that bouquet. Sometimes, a bunch of flowers really helps. Not always, but sometimes. This was one of the times it helped.

Of course, I took pictures.

These aren’t flowers I can grow in my garden, but it’s a pleasure to enjoy them in my living room.

Bouquet
Chrysanthemums
Beautiful pink rose in a beautiful bouquet

MORE SNOWY BIRDS – Marilyn Armstrong

The red finches (House Finch) are back. I’ve heard them called both Red Finches and House Finches and be interested to know if both are accurate or red is just one of many colors for the House Finch.

Regardless, they are back. There were a couple of them a few weeks ago and quite a gaggle of them now. Can finches be gaggled?

I’m still in a ridiculous battle to get some more pictures of the cardinal. He comes by every day. I see him, head for the camera and he is gone when I turn around. It’s definitely personal!

This is a Purple Finch even though he isn’t purple.
Junco and a House Finch. I looked them up. The one in the earlier picture is a different bird. Red Head notwithstanding, this is probably a regular House Finch.

And then, there are woodpeckers. We live in the woods, so I don’t know why I’m surprised we have so many woodpeckers.

Lots of trees. Lots of woodpeckers.

By size, I THINK this is a Downy Woodpecker, but it can be very hard to tell.
And a feathery farewell.

INTREPID BY ROAD – Marilyn Armstrong

FOWC with Fandango — Intrepid

Intrepid will always be the name of one of Horatio Hornblower’s ships. Somewhere in my 20s, I discovered Horatio Hornblower … and that’s how I learned that there was an actual use for trigonometry! If only they had mentioned this in school, I might have had a clue what I was doing instead of random calculations used to reach an answer that meant absolutely NOTHING to me.

We probably should have named The Duke “Intrepid.” He is quite the intrepid voyager. Except he likes when we come out and let him IN the yard, even though he jumped out. I guess out is easier?

Today I am off to see the wizard, also known as my cardiologist. He’s a new one. I’m trying to finally shake off Boston and get all my physicians lined up locally. Boston made the news the other night as officially (who is the official calculator of such things?) having the worst traffic of any city in the U.S. Not in the world. I think there are quite a few cities in Europe (and how about the traffic in London!) that could compete.

Boston has gotten terrible. When I moved here in 1988, traffic wasn’t great, but you could get from one place to another and generally even park when you got there. Not any more. Not only can it be impossible to get there, but if you do parking will cost the price of feeding two people for a week. Or more.

Bad. Very, very bad.

We spent something like 50 billion dollars to remodel our road and I swear they are worse than they were before we spend more than a decade redoing everything. The thing is, they move things around, but they didn’t make them bigger. Just stuck them underground (cough, cough, cough) or straightened out the crooked pieces.  So we’ve got nice straight bumper-to-bumper traffic.

Boston traffic is only for the intrepid.

We’re away shortly. As we head for UMass, a mere 20 miles away, call us intrepid. Also, please hope they don’t find anything new or interesting.

TEXTURE: CEE’S FUN FOTO CHALLENGE – Marilyn Armstrong

Cee’s Fun Foto Challenge: Texture

Fluffy is a texture, right?
Old bricks on Beacon Hill
Feathery
Woolly
Leaves on the deck