Date: July 25, 2024
Current Mood: A little concerned
Not sure where to start with this blog. Gosh, I haven’t blogged in a lonnnng time…
Well let's start off by saying it's happened again. I find myself once again being the youngest patient in the waiting room of my new cardiologist. I'm too young to have cardiologist!
Well here goes…
So I’m turning 53 this year, on September 12th
and I know it’s not a milestone birthday per say but for me It’s kind of a big
deal. See my Mom was 53 when she passed
away and my Dad was 53 when he had his heart attack.
Now for those of you closest to me and know how my Mom
passed, you know I’m not worried about that but I am worried about my Dad’s
health history side.
As you know I’ve recently had hip replacement surgeries and
have gotten myself back in shape which makes me extremely happy. It’s not just about the weight it’s about
being back on my bike and enjoying something that makes me overall happy. I love challenging myself and pushing myself
to be better.
So prior to my second hip replacement surgery, I had to go
for a pre-op physical, why I didn’t for the first hip I don’t know. My primary Dr did not have any open
appointments so I had to see another Dr in the office. I wasn’t a fan, he seemed cocky. He had two medical students with him so maybe
he was showing off but that’s a whole different conversation but needed
information on how I felt at the time. He
asked if I had a heart murmur. I was
like, no. I did tell him, I had one when
I was little but the Dr back then had told my Mom that I had “out grown”
it. Back to the present, so this Dr told
me it would not affect him signing off on my prep-op physical but that I should
follow up with my Dr in the future. I
filed it in in the back of my mind and was like sure.
So after my hip surgery, my swelling was out of control and
one night while getting up to go to the bathroom I noticed that my leg below
the knee was bruising. I had not
experienced that with my other hip. I
had almost passed out in the bathroom and my first thought was I had a blood
clot. So I ended up in the emergency
room and later admitted. I won’t go
into too much about this because it doesn’t have to do with the blog but I will
tell you I did not have a blood clot. It
was just post-op swelling that was causing the bruising. But what I will tell you is that the Dr that
was on my floor did mention hearing a slight murmur when he took my vitals on
his rounds. Interesting I thought, I
never mentioned to anyone in the hospital that I had been recently diagnosed
with a heart murmur, so now two doctors have heard this murmur. Now I’m getting a little concerned.
After being released from the hospital and weeks of
rehabbing the hip, I’m off on the bike again.
Pushing myself every ride and getting stronger. I completed my first metric century and was super
proud of myself. I look at my overall
average pace and heart rate, those number looked great for where I was in my
recovery. But in the back of my mind was
that conversation about following up with my primary Dr about my new found
heart murmur. Of course once again he is
booked out for months so I decided to see the Dr I saw when I had my shingles
outbreak, I really liked her. So I go for
the appointment and the PA can’t hear the heart murmur and neither can the Dr. I told her about my experience with the other
Dr in their office and said I really wouldn’t be concerned, however the Dr at
the hospital heard it as well. She
ordered me to have an echocardiogram.
The echocardiogram comes back somewhat normal. My mitral valve has slight regurgitation, but
overall nothing too alarming. Still I
wanted to see a Cardiologist to have them tell me I was OK. So off to the Cardiologist I go.
Now prior to this visit my head is of course spinning. What could cause this valve issue? Is the valve issue what’s causing the
murmur? Then of course my mind goes back
to my cancer days, cause all that chemo that was pumped through me wasn’t
exactly healthy. I remember one of the
drugs called Herceptin. Prior to
starting, at the mid-way point and end of treatment, I was sent for a MUGA scan
because Herceptin can damage the heart.
Just to put it in perspective, I had Herceptin every 3 weeks for an
entire year starting at the same time I was given another chemo drug Taxol. Could this be the cause of my heart
murmur/mitral valve slight regurgitation?
So I meet the Cardiologist and love him. He’s probably my age and an avid cyclist too
so we talk local trails and stuff. Then
we get to why I’m there. He reviews the
echocardiogram and asks me some questions about tightness in my chest or
shortness of breath. Nope, I have not
experienced any of that. I tell him
about the two different times the Drs heard the heart murmur and the one time
the Dr did not. He said, let’s take a
listen and jokingly said I bet you don’t even have a heart murmur. He places the stethoscope on my chest and
within a millisecond says, nope you got a murmur. Fabulous!
Now what? He told me it is a benign
heart murmur. So he’s all set to release
me when he asks, any heart problems in your family. Well… my Dad did have a heart attack at what
will be my age this year. Well that
changes everything now he says. He tells
me that a stress test wouldn’t work on me because my bike rides/workouts are
stronger than a stress test and if I’m not having symptoms then there was no
point in taking one. He did order another echocardiogram but wanted “his” guy to do it and ordered an angiocardiogram which looks at the arteries for any blockage. That kind of made me feel good cause I’m not
going to lie every time I would get on my bike and push myself in the back of
my mind I was like is this too much am I going to die on this trail. I know so melodramatic but at some level
these thoughts were very true. So my angiocardiogram comes back clean, no calcium build up in any of the
arteries. Great News!
So now I ask about my low resting heart rate at night. My apple watch sent me an alert the other
morning that my heart rate got as low as 35.
Now that has me concerned. So off
to see another cardiologist who specializes in Electrophysiology, so basically
the electrical Dr to make sure I’m firing on all cylinders. So fast forward to his appointment where I
get an ECG right in the office and he diagnosis me with an irregular
heartbeat. He calls it sinus arrhythmia
with vagal tone, which means it’s the vagus nerve not doing it jobs properly. Also I have what is called an incomplete
right bundle branch block which sounds bad but it is actually good meaning right
bundle branch block (RBBB) can cause an irregular heartbeat, or arrhythmia,
when the electrical signal traveling down the right bundle branch of the heart
is delayed or blocked. This causes the right ventricle to contract later
than the left, and the ventricles to beat out of sync; Unlike complete right
bundle branch block, incomplete right bundle branch block doesn't increase
your risk of heart attack and death.
So now the next step is to wear a heart rate monitor 24/7 for 10 days. I'm good with that because that will not only capture my resting heart rate at night but also give me a chance to have some workouts/bike rides in there too for the Dr to analyze. Another words am I pushing myself too hard, do I recover well after my workouts etc.
So in the 10 days of having my heart rate monitor I have talked to one of my dearest fellow BC cancer survivors and she asked me about Adriamycin and I was like I didn't' know Adriamycin caused heart problems I thought it was just the Herceptin. So now I go down a dark rabbit hole and find out that women whose chemo treatment consisted of both drugs are causing a higher risk of heart damage. Fabulous! They talk about cardiomyopathy, which is damage to the heart muscle. Now I don't know how you test for that but that is going to be my next follow up question for the Dr. It also mentions arrhythmia so now that leads me to, is this new found issue from cycling too much, past chemo or a combination of the two.
See the Dr on Monday, July 29th and will continue to update...
So the conclusion is...
Saw the Dr on July 29th and I came to that appointment with my i's dotted and my t's crossed. I did my research, knew my questions and wasn't leaving until I felt I had covered everything.
Here's is the link to the article that intrigued me the most about possible chemo treatment side affects.
https://www.fredhutch.org/en/news/releases/2022/04/major-study-links-breast-cancer-treatment-with-increased-risk-of.html
So my vitals in the office were BP: 118/66, oxygen was at 100% and my resting heart rate was 44. Never had my bottom number on my BP so low before but the PA didn't seem concerned since my resting heart rate was 44 at the time.
Now the Dr comes in and we discuss my sleep study first; no signs of sleep apnea. He did say that I snore. OK, no big deal. Next we talk about my heart rate monitor and I am curious to see how accurate my apple watch data is compared to the heart rate monitor. I did get one notice that my heart rate dropped below 40 from my watch while having the heart rate monitor and I asked the Dr if there was any data that showed the same and he said yes and told me the date and time and yes it matched my apple watch which made me happy, meaning my watch is accurate.
I ask him about the heart muscle and how you can tell if there is damage and I talk to him about the chemo treatment drugs I had and what the study said and asked about my ejection fraction which is something the articles speaks about as well. He said there is test that can look at the heart muscle but since my ejection fraction was 71% that I need not worry. The normal ejection fraction for a healthy person is between 50 and 70%.
So now my questions about cycling and am I doing too much. He said no such thing, cycling is very good for the heart.
We discuss my plan to see him in a year to run another echocardiogram and see if anything has changed.
All good news!!!
Now I can reclaim my life again and not worry anymore; cancer and side affects ain't got nothing on me!!!
