In a lot of ways, I've been lucky. First, the aneurysm was discovered before it reached a critical stage. Second, my aunt and uncle are both on the medical faculty of Stanford University. My aunt is a pediatric cardiologist. My uncle is a neo-natologist. From the beginning of my diagnosis, Aunt M. helped me understand my test results and provided wise counsel. Both of them encouraged me to see their surgeon colleague, Dr. DCM. They explained that he had extensive experience with valve sparing operations the best chance of saving my valve was to go with Dr. DCM. On their advice I had my test records sent to Stanford. After reviewing my file, Dr. DCM's team arranged an appointment to discuss my case on October 5.
Trip to Stanford
The night before the appointment, Meg and I drove to Atherton, CA where my aunt and uncle cooked a wonderful dinner after welcoming us into their home. We had a nice visit with them that night.
The next day I had new Chest CT and echocardiogram. The imaging technology at Stanford is so advanced that the Chest CT could actually show my healthy coronary arteries. I actually got a color picture showing my heart, the aneurysm, and the healthy coronary arteries. At about 5:00 p.m. Dr. DCM met with me, Meg and Aunt M. He said that my aneurysm was between 4.7 cm and 5.0 cm. He did not think my leak was as severe as Dr. M had concluded after my heart cath, but agreed that it was clearly visible from the echocardiogram. He said that I could wait for surgery and have periodic testing (maybe every 3 or 4 months) to monitor my aneurysm. In the meantime, I would have to stop competing in triathlons. Although I am in no hurry to give up triathlons, I considered it for a moment if it meant no surgery. I asked if waiting meant that surgery could ultimately be avoided. Dr. DCM said no. I would eventually need surgery, perhaps in a few months or maybe a few years. The only way that surgery could be avoided would be if I first had a catastrophic event. :( He showed me a risk chart which had me in the edge of the "green zone" for risk of such an event. Green meant the annual risk was just under 4 percent. It appeared that any enlargement would move me into the more risky yellow zone.
I had some thinking to do about the pros and cons of proceeding. However, just about everything pointed to proceeding. Dr. DCM is a recognized leader in the specialty of performing valve sparing operations. After showing me pictures of how the operation is done, he shared some pictures of former patients who had the same operation. These included a current NBA player, a geologist who climbs mountains, and baseball star Aaron Boone.
Meg and I talked about my options with my aunt and uncle that night. My aunt described the complexity and invasive nature of the procedure. But we kept coming back to the concept that there was no way to avoid the surgery. The next day I called Dr. DCM's nurse practitioner and told him that I wanted to proceed with surgery. I said that my goal was to recover from surgery, finish Vineman 70.3 in July 2010, and send a race day picture of me with my finisher's medal to Dr. DCM. I hope he puts my picture in his computer slide show between the geologist on Mt. St. Helens and Aaron Boone hitting a home run. :)
Surgery was quickly scheduled for November 6th. I have pre-operative procedures on the 5th. Exactly one week from now is my surgery. By that evening I should be in intensive care.
Friday, October 30, 2009
Thursday, October 29, 2009
Heart Catheterization Procedure
My heartcath was scheduled for July 23rd. In my case, the purpose of the test was to get a better sense of the magnitude of the aortic regurgitation, the size of the aneurysm, and a look at my coronary arteries. The only reason to read this post is if you want to understand the procedure from the patient's perspective. Otherwise it's kinda boring.
Preparation
I arrived at the hospital at 2:00. By about 2:20 I was in the preparation and recovery room with the other patients. My nurse was very nice, but unfortunately, I've forgotten her name. After weighing me, I went to my bed and curtain area and changed into the gown. Meg was with me for the start, but was asked to leave while the nurse prepared me. The preparation in included a partial shave on both sides of the groin and then an IV was started in my arm. I was also connected to heart and blood pressure monitor. Meg was invited back into the curtain area to wait with me after all this was done. We watched a video about the procedure and then had a chance to ask questions. The nurses all encouraged me to get an angio-seal. Instead of a clamp, the angio-seal uses a collagen to seal the opening made in the femoral artery near the groin. They said that the bleeding stops much faster and that you may be able to go home within 2 hours. Although I was ready to go by about 3:20, they didn't take me into the procedure room until about 5:00. Before going down to the room, I was given some benadryl in the IV to relax me.
The Procedure
The room is very cold. You get even colder when sterilizing solutions is sprayed on both sides of your groin. After about another 10 minutes Dr. M was about ready to start. They asked if I wanted more general pain relief. Dr. M said I probably wouldn't need it so I declined. He then said I would feel a pop as he set up the puncture of the artery and put in the "introducer sheath" which is a tube through which the catheter can be inserted into the artery. It didn't hurt much at all. Then in just a few seconds the catheter was inserted and it was right up next to my heart. I could watch it on the giant monitor. I could not feel the catheter inside me. Then the catheter was moved into my heart. All of a sudden my heart rate went to 180 on the monitor and I could feel it in my chest. My heart was really racing. Within about 30 seconds I felt much better. The doctor said that was because the catheter was no longer inside my heart. I looked again at the monitor and could see this. Again it was moved into my heart and it started beating faster but not too fast to continue with the test. Die or "contrast agent" was injected through the end of the catheter. The die went all over the chamber, documenting the regurgitation (leak) in my aortic valve. Next I believe the doctor switched catheters, which I did not feel and took only a few seconds. Now Dr. M was trying to get die injected into my coronary arteries to check for heart disease. It took a few tries but eventually he hit it right and the screen showed my entire coronary artery filled with die. This was good news meaning no blockage or any sign of heart disease.
Angio-Seal (AS)
As advised by the nurses, I asked for the AS. Another nurse came in to do the sealing procedure. After being essentially painless since the original puncture, this actually hurt a lot and I began to raise my leg at the knee. They told me to lie flat or they would not be able to do the seal. I got through it, but now regretted my earlier choice to skip the additional pain relief. I was then wheeled out of the procedure room, about a half hour after being wheeled in.
Recovery
For the first hour they ask that you lie very still and not move your legs. In the recovery area I was back in my original curtain area and Meg was with me. Everything went fine for the first hour. The nurse checked my bandage for bleeding and there was none, just some tenderness. I was given a little morphine via IV. After an hour they propped me up in bed and I had something to eat and drink. After that I was asked to get out of bed slowly and walk 30 feet and sit back down. If you can do that three times about 15 minutes apart without having your heart rate crash or faint you can be discharged. I felt a little wobbly getting back into bed and within a few minutes my heart monitor alarm went off, my blood pressure dropped to 80 over 40 and my heart rate dropped below 50. They leaned me all the way back to flat in the bed and slowly I started to feel a little better. In the meantime, a lot more people came into my area because of the alarm. The staff talked to me and said a lot of the young guys faint. I love being called young! The nurses all encouraged me to drink more and urinate. I did all this but it wasn't easy if you know what I mean. Later I tried another walk. Meg thought I looked terrible again after that 30 foot walk. My heart did not decelerate, but I did need to lie back down again. At this point it was moving on toward 9:30 and the heart cath area was closing. My very kind nurses had already stayed past the end of their shift. They arranged for me to be admitted to the hospital for a few more hours of observation.
I ended up with a private room upstairs around 10:00. After about 45 minutes on the 4th floor I started to feel a little better. I made a 25 foot walk and came back to bed feeling okay. Just two more walks and I could go home. By about 11:30 I had completed my walks and was discharged just before midnight.
Recovery at Home
The next day you are tender in the groin area and need to take it easy. No driving that day and I stayed home from work. The next day was Saturday and I was feeling much better, able to walk with no pain, just an awareness of tenderness in the groin area. The bandage came off and it looked fine with no bleeding.
The next day was Sunday and I began a college visiting trip to Southern California with my daughter. We shared the driving and the trip went fine.
My only advice to other patients is to accept more pain relief at the beginning of the procedure, especially if you get the angio-seal.
Preparation
I arrived at the hospital at 2:00. By about 2:20 I was in the preparation and recovery room with the other patients. My nurse was very nice, but unfortunately, I've forgotten her name. After weighing me, I went to my bed and curtain area and changed into the gown. Meg was with me for the start, but was asked to leave while the nurse prepared me. The preparation in included a partial shave on both sides of the groin and then an IV was started in my arm. I was also connected to heart and blood pressure monitor. Meg was invited back into the curtain area to wait with me after all this was done. We watched a video about the procedure and then had a chance to ask questions. The nurses all encouraged me to get an angio-seal. Instead of a clamp, the angio-seal uses a collagen to seal the opening made in the femoral artery near the groin. They said that the bleeding stops much faster and that you may be able to go home within 2 hours. Although I was ready to go by about 3:20, they didn't take me into the procedure room until about 5:00. Before going down to the room, I was given some benadryl in the IV to relax me.
The Procedure
The room is very cold. You get even colder when sterilizing solutions is sprayed on both sides of your groin. After about another 10 minutes Dr. M was about ready to start. They asked if I wanted more general pain relief. Dr. M said I probably wouldn't need it so I declined. He then said I would feel a pop as he set up the puncture of the artery and put in the "introducer sheath" which is a tube through which the catheter can be inserted into the artery. It didn't hurt much at all. Then in just a few seconds the catheter was inserted and it was right up next to my heart. I could watch it on the giant monitor. I could not feel the catheter inside me. Then the catheter was moved into my heart. All of a sudden my heart rate went to 180 on the monitor and I could feel it in my chest. My heart was really racing. Within about 30 seconds I felt much better. The doctor said that was because the catheter was no longer inside my heart. I looked again at the monitor and could see this. Again it was moved into my heart and it started beating faster but not too fast to continue with the test. Die or "contrast agent" was injected through the end of the catheter. The die went all over the chamber, documenting the regurgitation (leak) in my aortic valve. Next I believe the doctor switched catheters, which I did not feel and took only a few seconds. Now Dr. M was trying to get die injected into my coronary arteries to check for heart disease. It took a few tries but eventually he hit it right and the screen showed my entire coronary artery filled with die. This was good news meaning no blockage or any sign of heart disease.
Angio-Seal (AS)
As advised by the nurses, I asked for the AS. Another nurse came in to do the sealing procedure. After being essentially painless since the original puncture, this actually hurt a lot and I began to raise my leg at the knee. They told me to lie flat or they would not be able to do the seal. I got through it, but now regretted my earlier choice to skip the additional pain relief. I was then wheeled out of the procedure room, about a half hour after being wheeled in.
Recovery
For the first hour they ask that you lie very still and not move your legs. In the recovery area I was back in my original curtain area and Meg was with me. Everything went fine for the first hour. The nurse checked my bandage for bleeding and there was none, just some tenderness. I was given a little morphine via IV. After an hour they propped me up in bed and I had something to eat and drink. After that I was asked to get out of bed slowly and walk 30 feet and sit back down. If you can do that three times about 15 minutes apart without having your heart rate crash or faint you can be discharged. I felt a little wobbly getting back into bed and within a few minutes my heart monitor alarm went off, my blood pressure dropped to 80 over 40 and my heart rate dropped below 50. They leaned me all the way back to flat in the bed and slowly I started to feel a little better. In the meantime, a lot more people came into my area because of the alarm. The staff talked to me and said a lot of the young guys faint. I love being called young! The nurses all encouraged me to drink more and urinate. I did all this but it wasn't easy if you know what I mean. Later I tried another walk. Meg thought I looked terrible again after that 30 foot walk. My heart did not decelerate, but I did need to lie back down again. At this point it was moving on toward 9:30 and the heart cath area was closing. My very kind nurses had already stayed past the end of their shift. They arranged for me to be admitted to the hospital for a few more hours of observation.
I ended up with a private room upstairs around 10:00. After about 45 minutes on the 4th floor I started to feel a little better. I made a 25 foot walk and came back to bed feeling okay. Just two more walks and I could go home. By about 11:30 I had completed my walks and was discharged just before midnight.
Recovery at Home
The next day you are tender in the groin area and need to take it easy. No driving that day and I stayed home from work. The next day was Saturday and I was feeling much better, able to walk with no pain, just an awareness of tenderness in the groin area. The bandage came off and it looked fine with no bleeding.
The next day was Sunday and I began a college visiting trip to Southern California with my daughter. We shared the driving and the trip went fine.
My only advice to other patients is to accept more pain relief at the beginning of the procedure, especially if you get the angio-seal.
Saturday, October 24, 2009
Aortic Heart Valve Issues
My diagnosis is that the aneurysm is primary, and due to its expansion, my aortic valve cannot close properly and blood leaks back into my heart (the secondary effect of my condition). Both problems need to be fixed. The aneurysm needs to be repaired to avoid the possibility of rupture or aortic dissection. The valve needs repair because the leak causes the heart to work harder which can eventually lead to an enlarged heart. The aneurysm fix is fairly standard. The damaged portion is surgically replaced with a Dacron tube. The aortic valve must also be repaired or replaced.
Valve Replacement Options
There are two replacement options, each with advantages and disadvantages. The first option is replacement with an artificial valve made out of plastic and metal. Dr. I showed me one of these valves. The advantage of an artificial valve is that it lasts forever. The downside is that you must take blood thinners, such as Coumadin, for the rest of your life. The other option is a tissue based valve from a cow or a pig. This type of valve does not require blood thinning medication. However, in "younger" patients such as myself, the valve will only last 10 to 15 years. For me that would mean another surgery at about age 60.
Valve Repair
A final option is valve repair, or more formally, a valve sparing aortic root replacement. This surgery was developed by Dr. Tirone David (currently with Toronto General Hospital), and the procedure carries his name. It is a complicated operation that adds about an hour and half to the more standard valve replacement approach. The obvious advantage of this approach is avoiding the need for blood thinning medication and hopefully future valve replacement.
Valve Replacement Options
There are two replacement options, each with advantages and disadvantages. The first option is replacement with an artificial valve made out of plastic and metal. Dr. I showed me one of these valves. The advantage of an artificial valve is that it lasts forever. The downside is that you must take blood thinners, such as Coumadin, for the rest of your life. The other option is a tissue based valve from a cow or a pig. This type of valve does not require blood thinning medication. However, in "younger" patients such as myself, the valve will only last 10 to 15 years. For me that would mean another surgery at about age 60.
Valve Repair
A final option is valve repair, or more formally, a valve sparing aortic root replacement. This surgery was developed by Dr. Tirone David (currently with Toronto General Hospital), and the procedure carries his name. It is a complicated operation that adds about an hour and half to the more standard valve replacement approach. The obvious advantage of this approach is avoiding the need for blood thinning medication and hopefully future valve replacement.
Confirmation and CT Scan
To confirm and measure the aneurysm a Chest CT was scheduled for Monday July 12 at Radiological Associates of Sacramento. The test is relatively simple. First you have an IV placed in your arm. Then you lie down, and an arch-shaped machine passes over you for the scan. During the scan you are asked to hold your breath for about 18 seconds. During one of the scans, die is injected through the IV line. They warn you that the die will make you feel warm and flushed, perhaps like you have wet yourself. This is a good description of what it feels like and the feeling passes quickly. After about 5 minutes you are done with the entire scan.
I met with Dr. M on July 16. He said my aneurysm was about 5 cm in diameter (normal would be 2 or 2.5 cm). As I understand it, ascending aortic aneurysms over 5.5 should be repaired surgically ASAP, due to the risk of a "catastrophic event." For aneurysms between 5 and 5.5, surgery is needed but not immediately. (The numbers are different for descending aneurysms and I am no expert on any of this.) Dr. M got me an appointment with a surgeon, Dr. I, the very next day. Dr. I suggested scheduling surgery at my convenience sometime over the next six months. He advised me to exercise minimally--walking and maybe swimming a 100 yards. Prior to surgery, I would need an angiogram also known as a heart catheterization or heart cath.
I met with Dr. M on July 16. He said my aneurysm was about 5 cm in diameter (normal would be 2 or 2.5 cm). As I understand it, ascending aortic aneurysms over 5.5 should be repaired surgically ASAP, due to the risk of a "catastrophic event." For aneurysms between 5 and 5.5, surgery is needed but not immediately. (The numbers are different for descending aneurysms and I am no expert on any of this.) Dr. M got me an appointment with a surgeon, Dr. I, the very next day. Dr. I suggested scheduling surgery at my convenience sometime over the next six months. He advised me to exercise minimally--walking and maybe swimming a 100 yards. Prior to surgery, I would need an angiogram also known as a heart catheterization or heart cath.
Friday, October 23, 2009
Tests and Diagnosis
Late June 2009
So, I have a heart murmur. Lots of people have heart murmurs. I really wasn't very concerned and continued with training for Vineman 70.3 (a 1/2 iron distance triathlon) scheduled on July 19th. On June 13th I did my longest training run for 2009, 10 miles in 1 hour 33 minutes. That's a pace of about one mile every 9 minutes and 20 seconds. I was pleased, not quite thrilled with my time. At the end of the workout my heart rate was 156, fairly typical for me for this type of workout. On June 17th I visited my primary care physician who confirmed that I had a heart murmur and gave me a referral into cardiology. My doctor said I could continue to exercise. Sutter Cardiology scheduled me for an appointment on July 5. On July 3, I did my longest brick (that's a bike/run combination workout). I cycled for just under 3 hours (about 47 miles) and then ran 7.5 miles in 1 hour and 7 minutes. I was very pleased with my run time which was faster than earlier long runs.
Seeing the Cardiologist
On July 5, I saw my cardiologist, Dr. M. After listening with his stethoscope, he said that he could hear either "substantial" or "significant" regurgitation (I can't remember his exact words, but it was one or the other). Essentially, regurgitation is blood flowing backwards within the heart that results in turbulence which can be heard via the stethoscope. Just from listening he believed that there was a significant leak in my aortic valve (blood leaking backward from the aorta into the left ventricle). He also said that I might need valve replacement surgery, probably sooner rather than later. I was stunned. I was training hard and feeling good. I was only 47. Everyone in the waiting room was much older!!! This made no sense to me. Dr. M said the next step was an echocardiogram (essentially a sonogram of the heart) to confirm his diagnosis. I asked if I could continue to train. He said yes, but to listen to my body. If my heart started to race or felt odd, I should stop the training. Still not really believing this was happening, I worked with the very helpful cardiology scheduler who got me in the next day for an echocardiogram after learning of a cancellation. This test takes about a half hour. The practitioner puts some lubricant on your chest and moves the wand over your chest at different angles. They take lots of measurements on the viewing screen. It's painless and easy.
The News
On July 7 I did my usual swim of 1300 yards at the gym, followed by a spin class workout of about 45 minutes. On July 8 I ran five miles in the morning before work. At 9:00 I received a call from Dr. M's nurse. She said that I had an ascending aortic aneurysm and that I should stop triathlon training. Again, I was stunned. I did a lot of googling that morning trying to figure out what all that meant. In a nutshell, the aorta is main artery leaving the heart from the left ventricle and bringing blood to the rest of the body. The aorta heads upward at first (the ascending aorta) and then makes a u turn (the aortic arch) and then heads down toward the legs (the descending aorta). My aneurysm was in the ascending portion just after leaving the heart. An aneurysm is a dilation of any blood vessel caused by disease or weakening of the vessel wall. Fortunately I had an appointment the very next day with Dr. M to go over these results.
So, I have a heart murmur. Lots of people have heart murmurs. I really wasn't very concerned and continued with training for Vineman 70.3 (a 1/2 iron distance triathlon) scheduled on July 19th. On June 13th I did my longest training run for 2009, 10 miles in 1 hour 33 minutes. That's a pace of about one mile every 9 minutes and 20 seconds. I was pleased, not quite thrilled with my time. At the end of the workout my heart rate was 156, fairly typical for me for this type of workout. On June 17th I visited my primary care physician who confirmed that I had a heart murmur and gave me a referral into cardiology. My doctor said I could continue to exercise. Sutter Cardiology scheduled me for an appointment on July 5. On July 3, I did my longest brick (that's a bike/run combination workout). I cycled for just under 3 hours (about 47 miles) and then ran 7.5 miles in 1 hour and 7 minutes. I was very pleased with my run time which was faster than earlier long runs.
Seeing the Cardiologist
On July 5, I saw my cardiologist, Dr. M. After listening with his stethoscope, he said that he could hear either "substantial" or "significant" regurgitation (I can't remember his exact words, but it was one or the other). Essentially, regurgitation is blood flowing backwards within the heart that results in turbulence which can be heard via the stethoscope. Just from listening he believed that there was a significant leak in my aortic valve (blood leaking backward from the aorta into the left ventricle). He also said that I might need valve replacement surgery, probably sooner rather than later. I was stunned. I was training hard and feeling good. I was only 47. Everyone in the waiting room was much older!!! This made no sense to me. Dr. M said the next step was an echocardiogram (essentially a sonogram of the heart) to confirm his diagnosis. I asked if I could continue to train. He said yes, but to listen to my body. If my heart started to race or felt odd, I should stop the training. Still not really believing this was happening, I worked with the very helpful cardiology scheduler who got me in the next day for an echocardiogram after learning of a cancellation. This test takes about a half hour. The practitioner puts some lubricant on your chest and moves the wand over your chest at different angles. They take lots of measurements on the viewing screen. It's painless and easy.
The News
On July 7 I did my usual swim of 1300 yards at the gym, followed by a spin class workout of about 45 minutes. On July 8 I ran five miles in the morning before work. At 9:00 I received a call from Dr. M's nurse. She said that I had an ascending aortic aneurysm and that I should stop triathlon training. Again, I was stunned. I did a lot of googling that morning trying to figure out what all that meant. In a nutshell, the aorta is main artery leaving the heart from the left ventricle and bringing blood to the rest of the body. The aorta heads upward at first (the ascending aorta) and then makes a u turn (the aortic arch) and then heads down toward the legs (the descending aorta). My aneurysm was in the ascending portion just after leaving the heart. An aneurysm is a dilation of any blood vessel caused by disease or weakening of the vessel wall. Fortunately I had an appointment the very next day with Dr. M to go over these results.
Where to begin? How about my (benign) brain tumor?
As the title indicates, this blog is mostly about my diagnosis, surgery, and recovery from an ascending aortic aneurysm. This first post is written exactly two weeks before my scheduled surgery at Stanford Hospital. The purpose is to explain how I got here. So where do I begin? With an unrelated health problem.
June 2008
One day at my office I became dizzy and nauseous. I ended up vomiting in the bathroom and unable to stand. After about an hour of turning down help from my concerned co-workers, a nurse from the Capitol was called, and later an ambulance took me to the emergency room. There I was given anti-nausea medication and a series of tests. A head CT showed a small mass just inside my left ear. I was released with some anti-nausea medication and told to follow-up on the unknown mass with neurology. I saw my own personal physician that day and an MRI was scheduled. I felt fine the next two days. However, on Friday of the same week, I had the same thing happen all over again. Dizziness, unable to walk, vomiting, yuck. I had forgotten to bring my medication, darn!!
My wife was very concerned and pressed my physician to move up my MRI to the very next day. I had another similar episode the following Tuesday but this time the medication limited the spell to dizziness and nausea with no vomiting. Following the MRI, I had an assessment with Dr. C. (a neurosurgeon). He concluded that the mass was benign, most likely an epidermoid cyst or a fatty lipoma. It may or may not have contributed to the dizziness. Absent any more symptoms, his recommendation was do nothing and have another MRI a year later. I did have a hearing test which documented some hearing loss in my left ear.
June 2009
After the three episodes in June 2008, I had no recurrence. In July 2008, I completed the Vineman 70.3 half-iron distance triathlon in 6 hours and 20 minutes. As suggested, I had another MRI in June 2009 and met again with Dr. C. He concluded that the cyst had not grown or moved and he was not at all concerned about it. He did suggest another follow-up MRI in 1 more year. Before leaving he did a very brief physical exam. Just before finishing he put his stethoscope on my chest and said "anyone ever talk to you about that heart murmur?" I replied "no." He then said in a somewhat self-deprecating manner, "Well if the brain doctor can hear it, anyone could." This marked the beginning of my time as a heart patient.
June 2008
One day at my office I became dizzy and nauseous. I ended up vomiting in the bathroom and unable to stand. After about an hour of turning down help from my concerned co-workers, a nurse from the Capitol was called, and later an ambulance took me to the emergency room. There I was given anti-nausea medication and a series of tests. A head CT showed a small mass just inside my left ear. I was released with some anti-nausea medication and told to follow-up on the unknown mass with neurology. I saw my own personal physician that day and an MRI was scheduled. I felt fine the next two days. However, on Friday of the same week, I had the same thing happen all over again. Dizziness, unable to walk, vomiting, yuck. I had forgotten to bring my medication, darn!!
My wife was very concerned and pressed my physician to move up my MRI to the very next day. I had another similar episode the following Tuesday but this time the medication limited the spell to dizziness and nausea with no vomiting. Following the MRI, I had an assessment with Dr. C. (a neurosurgeon). He concluded that the mass was benign, most likely an epidermoid cyst or a fatty lipoma. It may or may not have contributed to the dizziness. Absent any more symptoms, his recommendation was do nothing and have another MRI a year later. I did have a hearing test which documented some hearing loss in my left ear.
June 2009
After the three episodes in June 2008, I had no recurrence. In July 2008, I completed the Vineman 70.3 half-iron distance triathlon in 6 hours and 20 minutes. As suggested, I had another MRI in June 2009 and met again with Dr. C. He concluded that the cyst had not grown or moved and he was not at all concerned about it. He did suggest another follow-up MRI in 1 more year. Before leaving he did a very brief physical exam. Just before finishing he put his stethoscope on my chest and said "anyone ever talk to you about that heart murmur?" I replied "no." He then said in a somewhat self-deprecating manner, "Well if the brain doctor can hear it, anyone could." This marked the beginning of my time as a heart patient.
Subscribe to:
Posts (Atom)