Opdivo Day At UT

Today, was Opdivo day...  with a 7:30 am arrival time that forced me to leave home no later than 6:30 am and an alarm setting of 5:50 am which to me is no different than 6:00 am but those extra 10 minutes gives me an opportunity not to feel like I m rushed and make a cup of coffee before I leave.

I see the Oncologist every other month and this appointment was set with the doctor so he could review the results of my CT scan that I had on Monday.  My results were good however there were a couple of spots that around a millimeter of growth which is almost insignificant...  but, for me, growth is growth.

My Oncologist did not appear to be too worried with the results and said that we were going to proceed as we have in the past....  in other words, there will be no changes in my treatments.

However, when I asked about the discoloring on both of my forearms and if that was caused by the treatment, he first comment was, "they aren't bruises?", to which I replied NO.  So, after examining them further, he was concerned about why there was blood just under the skin and wanted me to see a Dermatologist.

After 13 years of treatment and going into my 14th year in 2022, I am grateful that my recent test results are extremely positive and hope that this positive rhythm will follow me forward.

Heart Cath Procedure

On the 28th of this month, I will be having a heart catherization procedure to further explore the results of my nuclear stress test that indicated my LAD was displaying a limitation of air flow...  however, while there was an abnormal reading, I was able to achieve my target hearf rate for my age...  which typically does not happen if there is a restriction of air flow especially inside the LAD...  so, this procedure will provide results that will confirm either there is a problem or there is not or the problem does not warrant anything to be done about it at this time...

In other words:

• do nothing
• insert more stents
• have a bypass

Now...  depending upon the result...  I will make two different decisions...  either stay with UT Medical Center - Cardiology or asked to be referred to Vanderbilt Cardiology.  And, my reasoning?  I believe Vanderbilt has more experienced cardia surgeons.  For example, UT has only been putting in stents for the last 5 years and I just have the mentality that experience makes for a better surgeon, espeecially when one is dealing with the heart.

Twelve years ago when I had my 5 stents put in at NYC Presbyterian Hospital, I knew that stents were more often than not a temporary fix...  more than likely I would end up having a bypass at sometime down the road...  maybe now is that time...  or maybe not...

What I do know is that bypass surgery is commonplace and that it takes a good 12-18 months before the bypass patient is back to normal.  And, while I am still fairly young, my recovery will be a llittle longer that it might have been 12 years ago and it will be even longer if I get to wait another 12 years...

Nuclear Stress Test Results

 

A few days ago, I had a nuclear stress test and while I achieved my target heart rate, I felt light-headed and soon after the test was halted.  Yesterday, I received a call from my Cardiologist who informed me that my test yielded an abnormal result...  meaning there is a blockage and that blockage revolves around the LAD...  called the "widow maker".

My Cardiologist indicated that the next step was to have a heart cath procedure that will actually take a closer look so that heart surgeons can determine if additional stents should be inserted, or if a bypass should be performed, or if maintaining the status quo is appropriate...

In 2009/2010 five (5) stents were inserted into my heart arteries, 3 in the LAD and 2 were inserted into other arteries on the left side.  After 10 years, it is normal and typical for these stents to no longer perform as they were originally intended to perform.

My concern folds around the idea that for the last decade I have only eaten heart healthy foods to prevent something like this from happening...  Exercise may have helped reduce plaque build-up but diet is the preferred way to go...  I did both but concentrated more on diet than on exercise.

These days instead of entering the artery in the inside upper thigh in the groin to travel to the heart, the surgeon enters into another artery in the wrist around the area of the thumb.  This approach is less invasive and just as effective with the recovery time being greater.  I am waiting to hear back on the dates for this procedure...  but what I do know is that it will start at 7:30 am and I am to report 90 minutes before that.

That procedure will determine that next steps that I will be taking.A few days ago, I had a nuclear stress test and while I achieved my target heart rate, I felt light-headed and soon after the test was halted.  Yesterday, I received a call from my Cardiologist who informed me that my test yielded an abnormal result...  meaning there is a blockage and that blockage revolves around the LAD...  called the "widow maker".

My Cardiologist indicated that the next step was to have a heart cath procedure that will actually take a closer look so that heart surgeons can determine if additional stents should be inserted, or if a bypass should be performed, or if maintaining the status quo is appropriate...

In 2009/2010 five (5) stents were inserted into my heart arteries, 3 in the LAD and 2 were inserted into other arteries on the left side.  After 10 years, it is normal and typical for these stents to no longer perform as they were originally intended to perform.

My concern folds around the idea that for the last decade I have only eaten heart healthy foods to prevent something like this from happening...  Exercise may have helped reduce plaque build-up but diet is the preferred way to go...  I did both but concentrated more on diet than on exercise.

These days instead of entering the artery in the inside upper thigh in the groin to travel to the heart, the surgeon enters into another artery in the wrist around the area of the thumb.  This approach is less invasive and just as effective with the recovery time being greater.  I am waiting to hear back on the dates for this procedure...  but what I do know is that it will start at 7:30 am and I am to report 90 minutes before that.

That procedure will determine that next steps that I will be taking.

My Stress Test Today

I arrived at the Heart & Lung Building of UT Medical Center in Knoxville at 6:45 am as requested and signed in a the front desk.  Five minutes later, I was escorted back to a patient waiting area with 5 other patients and all of us had IV's put into our arms by techicians who also explained the procedure to us.

One by one, we were taken in to have the radioactive isotope pushed into our IV and after wating 30 minutes, we had a 15 minute CT scan of our heart and its blood flow at rest.

Shortly after that we were taken in one by one to the treadmill area heart monitor connections were attached to our upper body, a blood pressure cuff was attacked to our left arm and we got onto a treadmill and began walking flat for a minute or so.

My nurse told me that my target heart rate was 125 becasuse of my age.  

A minute or so later the treadmill's speed and incline were increased and I began to breath more deeply and my knees began to ache.

A minute or so later the treadmill's speed and incline were increased and the incline had to be 30 degrees or better, and another technician  entered the room to administer another nuclear dosage once I reached my target heartrate.

By now I was really get hard to breathe and my chest hurt a little and I felt faint but no dizziness or room spinning.  As I leaned on the bars because of feeling faint, I reach my target level, the dye was pushed into my IV.

The speed of the treadmill was lowered a bit but not the incline and I needed to walk another 90 seconds.  I managed to find the energy to do that and when the treadmill was stopped, a chair was placed behind me and I sat down...  with a plop!

It took about 2 minutes for me to begin breathing normal again but the nurse wanted me to sit for a full 5 minutes because I had felt faint.

I was taken back to the  waiting area and told to eat non-healthy cheese and crackers which would assist in making the second scan turn out better.

Ten minutes later, I was in the CT scan machine and 15 minutes after that, I was walking out the door, and heading downstairs to my car.  I pulled out of my parking slot at 10:00 am.

I am assuming that someone from my Cardiologist's office will call me with the results in the next few days.