What time was my appointment?

What time is that appointment? 10:15 am. But I do not have that on paper anywhere so I assume I could be wrong and go in at 10. Plus that is me, always wanting to be just a little bit early to any appointment. Why do I do that to myself? I think I learned from the people I grew up with, my friends, who were almost always late. I did not like that.

Regardless I am there and waiting, and waiting and …. well why is there a desolate desert wall mural on the wall I have been staring at for 1.5 hours? There is not a drop of water in site, no sign of redemption, no second chance here with the lizards, cactus and sidewinder snakes. Why does this take up the whole wall of this office? A heart hospital of all places.

I digress. Finally at noon I am called back. I had already discovered that my appointment was at 10:45 so that was my bad anyhow. And then I get my 10 minutes with Dr. Malik.

At the TEE he gave his initial findings – nothing – knowing full well that I would have no freaking memory of that. Knowing that the drugs would have made my mind mush but he always does that. I remembered enough to know that he found nothing and not to take the meds for the following week surgery. Then he takes the results back and has a couple of weeks to make sure nothing was missed (I am sure his interns do this).

This in depth study found – nothing. Was that a surprise? To me it was not. There are no holes that are of normal or abnormal size. There is evidence that there is a hole but that is not supported by there actually being one there. Thus I fall into the less than 1% of the people with a hole in their heart whose hole is wholly confounding the field of medicine by not being a whole hole that can be found by normal means. Rather my hole is masquerading as a heart.

“Why are you looking frustrated?” “Well a hole could have been wholly closed and this whole nightmare could have had a resolution with my heart being whole again.” “But this is good news!” “Why?” “Well we do not have to do the surgery and with medication you should be OK.”

Notice the “should be” OK. So we discussed that. In all reality I may have another stroke. If I take my medicine, lose weight, control blood pressure, exercise and live healthy there is a huge possibility I may not have another one. But if I do? Well at that point I would need to go to Dr. Malik right away and the book would be thrown aside for this … and a right-sided cardiac catheterization would be performed.

Definition:

Cardiac catheterization (also called heart catheterization) is a diagnostic procedure which does a comprehensive examination of how the heart and its blood vessels function. One or more catheters is inserted through a peripheral blood vessel in the arm (antecubital artery or vein) or leg (femoral artery or vein) with x-ray guidance. This procedure gathers information such as adequacy of blood supply through the coronary arteries, blood pressures, blood flow throughout chambers of the heart, collection of blood samples, and x rays of the heart's ventricles or arteries.

A test that can be performed on either side of the heart, cardiac catheterization checks for different functions in both the left and right sides. When testing the heart's right side, tricuspid and pulmonary valve function are evaluated, in addition to measuring pressures of and collecting blood samples from the right atrium, ventricle, and pulmonary artery.

What is key to me here is this:

1. Cardiac catheterization is categorized as an "invasive" procedure which involves the heart, its valves, and coronary arteries.
2. Dr. Malik has done this procedure once (1) yes once. He would actually be looking at the wall of my heart on the right side and testing it, probing it, looking for this elusive hole.

This pretty much makes the decision a clean cut one for me. Thus I followed up with two questions:

1. What else did the TEE show? -- Nothing abnormal. He could actually see everything and I have a normal heart.
2. Last time I was here you said the following “it is not a matter of if you have another stroke but when” --That was when he was working off of the assumption that led him to believe there was a large (respectively speaking) hole in my heart. With the findings it is now, in his opinion, “if you have another stroke”.

So I think and ask a question that was not on my list but I have been thinking about.

This is all with the assumption that I take this Aggrenox every day for the rest of my life – correct? Well what are the long term affects on other parts of my body?

The answer to this is that it is something I will always have to be aware of – internal bleeding in events of extreme trauma, that it will take longer for wounds to stop bleeding and I need to avoid bleeding ulcers.

So that about sums this visit up. I have to go to my neurologist next month and see what he says. I have an appointment with Dr. Malik a year from now and I trudge merrily along making myself right again in the sometimes surreal world that has become mine.