She Has A Heart!

The Cardiology Follow-up

In keeping with the March theme of transitioning to healthy via several follow-up visits with doctors, we met with a cardiologist earlier this week.  She confirmed that I have a heart - it's a medical fact.

She also addressed the fluid around my heart, which we believe to be related to Louie since he was so close to that general area.  My oncology doctor expected the fluid to have reabsorbed by now but the cardiologist says it will most likely simply take more time.  She described what I have as a small amount of fluid, a small pericardial effusion, which is good because the PET scans have picked this up as well and have described it as a moderate to large amount of fluid.  Shows you what they know.  It hasn't changed since early November and has been checked multiple times so she doesn't expect it will worsen.  She expects it will improve just as our oncology doctor thought, given more time.

So there will be another echocardiogram in my future but not until late May.  At that point if the fluid hasn't reabsorbed we will have a couple of options.  One is to be prescribed large doses of ibuprofen, which decreases inflammation in the area and encourages reabsorption.  Under normal circumstances the cardiologist may have just gone ahead and prescribed that course of treatment but I am too anemic right now from the chemo.  A second and more invasive option would be to remove the fluid but that carries some risk given that an outpatient procedure is required that involves inserting a long needle and navigating a very small space (and avoiding poking holes in my other organs).  

Bottom line: we'll hope that the fluid is gone or reduced by late May, indicating that we can either leave it alone or try the ibuprofen option, and in the interim the fluid is not impacting my heart function so it's fine to just sit there and think about what it's done.

We did learn one interesting tidbit and that is that my anemia is causing my heart rate to be higher than normal.  I had worried that the fluid was causing a problem or that I couldn't increase my physical activity without risking further problems but the cardiologist explained that it's my anemia that's causing my heart to work harder than normal to distribute oxygen and that my heart function is perfectly normal.  She says that increasing physical activity will make me tire easily and breathe heavier than normal but that it's the anemia talking and not a heart problem.  She also did not hear a heart murmur so that's been consistent since the second round.  The murmur must have been Louie pounding on me.

Effects & Side Effects

Chemotherapy causes both the side effects they warn you about, of which there are many, and also, in my experience, all sorts of oddball other things.  With the chemo out of my system now I have bested the common ones - nausea and mouth sores and the like.  But it will be interesting to see how long it will take for these other things to improve.  In case you're keeping track, what lingers with me during this recovery phase includes:

• energy - my anemia is not something that can be addressed through diet because it's related to my bone marrow production (so no, i don't need to start eating steak).  anemia makes me tire easily, requires more energy than normal to do the most basic physical activity, and increases my heart rate
• fingernails - my fingernails  are striped as if each round of chemo left a mark like a tree ring. i think i'll be able to start painting my nails again after my next oncology appointment so at least i won't have to look at them
• fingertips - my fingertips feel (and look) like they do when you've been in water too long. i have feeling in them but it's somewhat stunted and my manual dexterity is diminished

Basically what I'm telling you is that if you were to challenge me to a game in which we have to race back and forth between two jigsaw puzzles, I have an excellent excuse ready for why I would lose (though it sounds kinda fun).