Pandemic: Part 2 - 2021

As I said in a previous post, I started de-isolating myself after the Great Lockdown in the fall of 2020. I started seeing my primary care physician for office visits in October and December of 2020. After these visits, he referred me to the cardiologist at KU and also to the endocrinology department at KU for my diabetes. I also saw him in March, May, September and November for regular check-ups.

So . . . In February of 2021, I had my first office visit with a new cardiologist. This would result in an eleven visits directly related to heart problems during the year. On February 19, I had the first appointment with the cardiologist at KU. At this appointment, the cardiologist just went over my medical history.

I started having Telehealth visits with a physician’s assistant in the endocrinology department every few months starting in March 2021, with one visit in person to check for diabetic neuropathy in my feet. I also had my annual eye exam in August for vision and diabetic retinopathy. I also have cataracts that have remained small for five years, so they are not yet at the point that they need to be removed.

On March 22, I had an echocardiogram. It was at this point that there was some concern about my heart function. I had been concerned about being tired much of the time and becoming out of breath after walking just two or three blocks. Because of the low ejection fraction, the cardiologist ordered several other tests during the month of April. These included cardiac catheterization, MRI, nuclear stress test, and treadmill stress test. I had a visitation with one of the cardiology nurses after one of these visits in which she cross-examined me about my how I was feeling, how I was living, etc. I guess the cardiologist felt that she was a health sleuth that could probe me for answers better than he could. And that time, they decided to test some of the blood they had collected for anemia and for iron absorption. Not really sure which of the symptoms I described led them to prescribe those tests, but it was just a few days before my next visit with another cardiologist in the practice on June 4, who specialized in implanting defibrillators. He gave me all the lowdown. Then I asked, “Have you been informed that I’ve been diagnosed with iron deficiency and anemia? I just got those results yesterday.” He hadn’t. The conversation about defibrillator implantation came to a halt!

At this point, the cardiologist called in an order to endoscopy for a complete upper and lower GI. Lovely! I had had a colonoscopy five years earlier so, I get to have another five years early. I’d never had an upper GI before, however, so this would be a new experience. When I called endoscopy the next day, they had received the cardiologist’s order, but their next open appointment was in five months. So I spent the summer months wondering what might be causing the anemia and iron deficiency. In the meantime, I started taking iron supplements and Vitamin C at the suggestion of the cardiologist. I had check-ups with the cardiologist in July and October, at which point he was perturbed that endoscopy could not get me in any sooner than the end of November. He ordered another echocardiogram for November 1 and called to see if I could get my upper/lower GI any sooner.

The November echocardiogram proved hopeful because my ejection fraction was up to what it had been before the Great Lockdown. Actually, it pretty much stayed at that level ever since I was first diagnosed with heart failure ten or so years ago, except for the echocardiogram in March.

On November 11, I had a preliminary visit with the gastroenterologist about what would be happening with the Upper/Lower GI endoscopies. And on November 19, I had the procedure. Fortunately, the results were not entirely conclusive concerning internal bleeding, so I would need another procedure which involved swallowing a mini-camera, a capsule endoscopy. I’ve already posted in the blog about this in the entry for April 6, 2022.

However, because of the disparity between the two echocardiograms, the echocardiograms, the cardiologist ordered a MUGA Scan before the year was out.

Three days before Christmas I had the MUGA Scan. The short story here is that the hopeful news about my heart function from the November echocardiogram was not verified. And this is the reason that in one week I will be having a defibrillator implanted.

The cardiologist also wanted me to lose weight, so he referred me to the weight management clinic at KU. I had one initial visit with the doctor and several periodic visits with a physician’s assistant in the department every couple of months from May 2021 on.

I became concerned because of news that some CPAP machines had been recalled. I have been using a CPAP because of sleep apnea since the fall of 2001. Fortunately, my machine was not one of the ones that was recalled, but now I have established a relationship with a pulmonologist at KU as well as the myriad other specialists I have been seeing. Because of technology, my sleep patterns are monitored year-round and my sleep health seems to be pretty good. My very first CPAP machine in 2001 was much larger and it did not have an SD card to record my sleep patterns to send them to the pulmonologist. Unless something changes drastically, I will only have to see the pulmonologist once a year. I realize that this is not especially interesting reading and that it is full of medical terms which I may or may not have explained accurately, but it was to the best of my understanding. And now it is here in this blog so I don’t have to re-type it every time someone asks, “How are you doing?”