Thursday, February 5, 2015

And the Diagnosis Is...

First, a picture. That should set the stage for this post.


A lovely Riesling from Mosel, Germany called Urban, I might add. Now, for the rest of the story...

It all started about this time last week, when Mr. T was trying to shake a head cold and cough. Then Thursday night, he noticed this golf ball-sized knot on his neck, left side, just below his jawline. He called our doctor's office first thing Friday morning and was able to get an appointment with the nurse practitioner in about fifteen minutes. So far, so good.

When he got to the office, they started taking his vitals and making notes about the reason for the visit. Only...the nurse kept coming back to his heart rate, which was bouncing around, up to a high in the 160's. They did not one, but two EKGs...and then they called the ambulance. Mr. T called me from the office to give me some brief background info and to ask that I meet him at the Emergency Room at High Point Regional. And off I went.

Several EKGs later, a CT scan (for the knot on his neck), plus two IVs, one of which was inserted by the EMT on the bumpy drive to the ER, followed by a couple of medications, and the ER doctor gave us a diagnosis: atrial fibrillation or A-fib. By mid-afternoon, the doc was confident the meds were working and that Mr. T was stable enough to go home. He wrote two prescriptions and advised a follow up with a cardiologist, sooner rather than later.

Easier said than done, apparently. Our family practice doctor is a member of a multi-discipline group that includes a cardiologist group, so that is who the referral went to. When Mr. T talked to them on Monday, he was told the first available appointment was February 25th. Over three weeks away. Really?

Plan B. We live a heartbeat away from one of the premier cardiac care centers in the USA, located at Wake Forest Baptist in Winston-Salem. We looked up cardiologists on our insurance website and located several in the Wake Forest Baptist Heart and Vascular Center; called the number; and had an appointment for Thursday (today). Excellent! Of course, there's always a little catch...this one involved having to fax 28 pages of testing documentation and background information (when we stay within our group, that isn't necessary since all the docs share records). Ah well, small price to pay for some peace of mind. 

We were further surprised this afternoon (in a good way!) when we met the cardiologist, Dr. Stacey. I'm not sure what I expected, but he is the nicest, kindest, most caring specialist I've met in a long, long time...maybe in forever! He took Mr. T's newest EKG printout (which the tech did today as he was checking in) and compared it to one of the ones from last Friday. He drew pictures to illustrate his points (oh yeah...right down T's alley there!) And he answered all of our questions without rushing us through the visit. 

And, based on the hills and valleys (or as T called them: divots) on the printout, he gave Mr. T a different diagnosis: atrial FLUTTER.  Here's what the Mayo Clinic says:

"Atrial flutter is a type of heart rhythm disorder (arrhythmia) caused by problems in (the) heart's electrical system."

Bottom line: FLUTTER seems to be easier to resolve than FIB. The next steps are finishing the course of antibiotics (prescribed by the ER doctor), increasing the new heart med, getting an ultrasound (next Friday)...and if all is okay, then scheduling with the electrophysiologist (or as Mr. T calls him...the electrician) for a procedure called an ablation (which won't be a walk in the park...but a bit easier than the procedure done for A-fib). And then...if all goes well...that should be it! Dr. S says the success rate for the flutter ablation is 90+%...and if it works as designed, then there shouldn't be a need for drug therapy (as there potentially would have been with A-fib). Best news we have had in a week!

So, we celebrated in great relief with a visit to the nearby fave New Town Bistro and Wine Bar (click here to go there: http://www.newtownbistro.com). Hence, that photo of the wine glass above.

Oh, and about that lump that started this ball rolling? It was diagnosed as an infected salivary gland and is responding to the antibiotic. And I have never been so thankful for a health problem in my life. For, if Mr. T hadn't gone to the doctor when he did, he might not have known about his heart problem (which was not showing any symptoms yet) until much more damage had been done...or he had suffered a stroke (which is the main danger with this type of heart irregularity).

So I'm raising my glass to good fortune...and better diagnoses!

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