You Gotta Have Heart

Here’s some more specifics about my heart condition and where I’m headed from here. My hospital file has the official diagnosis currently as Congestive Heart Failure. At 45, I’m a bit young for such a lofty diagnosis, but then this particular classification is really just a catch-all for a lot of different issues and doesn’t adequately explain my situation. Sufficed to say, my bid for the summit of Everest is on hold for a while (heck, my bid for the second floor of the house is in question at the moment.)

To really understand my predicament, you have to go back in my history a bit to the late seventies when I underwent ten weeks of mantel radiation for my Hodgkin’s disease. Although radiation therapy had been in use in one form or another for over eighty years at the time, many of the long term effects were still not fully understood – and, to be honest with you, when you’re fighting to rid yourself of cancer, the long term effects are not foremost in you mind. As it turns out, it is not uncommon for radiation patients to later develop a number of medical problems including a hardening of both the pericardium (the sac around the heart,) and the heart muscle itself. As of right now, we know that I have a fairly significant hardening of the pericardium but the extent to which my heart itself has been effected remains to be seen.

What this means is that the heart is able to pump out, but the stiffened pericardium prevents it from adequately expanding to refill. So the blood leaves the heart under sufficient pressure, but the restriction to its expanding means there is a back pressure building on the return side. At the capillary level, the red blood cells are being pushed into the tissues of my organs, but meeting with a backlog of unoxiginated cells waiting for the “pull” of the expanding heart to haul them back to the heart and ultimately the lungs. The tissues don’t get the oxygen they need and begin to degrade. Unchecked and this would no doubt ultimately lead to major organ failure – though I’m a ways from that at the moment. In fact, other than my liver, my other organs seem to be working fine – including my questionable kidneys (knock on wood.)

So the question now is what can be done. Next Tuesday, I’m scheduled for right and left heart catheterizations. They’ll go into the heart with sensors (via the neck for the right side and via the groin for the left side,) and take pressure readings as well as inject dye and watch it on the monitors. This will help determine exactly what’s going on and where the problems are. If it turns out that the pericardium is the primary culprit, then the simplest solution would be to simply cut a slit in the sac and let it open up a bit – thereby allowing the heart to expand normally. As I understand it, it is also possible for them to remove the pericardium completely – though I’m not clear on the particulars as to how and why this procedure would be undertaken. For now, I’m just happy to have a diagnosis that fits all the symptoms and doesn’t involve a return of either of my previous cancers. As soon as I know more, it will be posted here.

Be well.

Chris