Cardiologist visit Jan. 13, 2023 - New Med added (amlodipine)

Finally decided to go see a cardiologist, Brigette and Dr. Woods had been saying I should go as my BP is not under control.  Been having chest, front of shoulder, and shoulder blade (all left side) has been having a dull ache so I've been concerned.  Dr. Bagheri says its not the heart, most likely the popped rib.  But it's been hurting more lately, and occasionally I get a sharp pain (2-3 seconds).  They run an EKG, all looks normal.  HCTZ can caused triglycerides and A1C to rise so lowering dose by half.  But adding back a low-dose Amlodipine to take at night which should prevent some of the side effects, the other two meds take in the morning.  Returning on Feb 16 do to a ECHO.  

• An echocardiogram may be done for further evaluation of signs or symptoms that may suggest:

• Atherosclerosis. A gradual clogging of the arteries by fatty materials and other substances in the blood stream. It can lead to problems in the wall motion or pumping function of your heart.

• Cardiomyopathy. An enlargement of the heart due to thick or weak heart muscle

• Congenital heart disease. Defects in one or more heart structures that occur during formation of the fetus, such as a ventricular septal defect (hole in the wall between the 2 lower chambers of the heart).

• Heart failure. A condition in which the heart muscle has become weakened or stiff during heart relaxation and blood can't be pumped efficiently. This can cause fluid buildup (congestion) in the blood vessels and lungs, and edema (swelling) in the feet, ankles, and other parts of the body.

• Aneurysm. A widening and weakening of a part of the heart muscle or the aorta (the large artery that carries oxygenated blood out of the heart to the rest of the body). The aneurysm may be at risk for rupture. .

• Heart valve disease. Malfunction of one or more of the heart valves that may cause an abnormality of the blood flow within the heart. The valves can become narrowed and prevent blood from flowing through the heart or out to the lungs and body. The valves can also become leaky with blood flow leaking backwards. An echocardiogram can also check for infection of the heart valve tissue.

• Cardiac tumor. A tumor of the heart that may occur on the outside surface of the heart, within one or more chambers of the heart , or within the muscle tissue (myocardium) of the heart.

• Pericarditis. An inflammation or infection of the sac that surrounds the heart.

• Pericardial effusion or tamponade. The sac around the heart can become filled with fluid, blood, or infection. This can compress the heart muscle and prevent it from beating and pumping blood normally. This can cause symptoms of feeling dizzy, lightheaded, or a dangerous drop in blood pressure.

• Atrial or septal wall defects. Irregular channels between the right and left sides of the heart may be present at birth, or may occur form trauma, or after a heart attack. These defects occur in the upper filling chambers (atria) or the lower pumping chambers (ventricles). This may cause heart failure or poor blood flow, or increase your risk for stroke.

• Shunts. Shunts can be seen in atrial and ventricular septal defects but also when irregular blood flow is pushed through the circulation from the lungs and liver.

An echocardiogram may also be done to assess the heart’s overall function and general structure.

Follow-up on March 30 to see how the meds are doing, going in for labwork about 2 weeks prior.  Also at this appointment will be a carotid ultrasound. 

A carotid ultrasound is performed to test for narrowed carotid arteries, which increase the risk of stroke. Carotid arteries are usually narrowed by a buildup of plaque — made up of fat, cholesterol, calcium and other substances that circulate in the bloodstream.

Mammogram - January 2023

  Went into for a routine mammogram.  Results show my tissue is dense (nothing new) but they noticed some calcifications so recommended I get a diagnostic mammogram and ultrasound.  Scheduled for March 16, 2023.  We'll see what it is.  If it is suspicious, then I guess biopsy would be next step after this.   If ends up being a tumor, most likely is Stage 0, if it's only in the milk duct and not in the tissue.  In which case surgery and radiation should take care of it.  Let's hope it's nothing serious. 

EXAM: TOMOSYNTHESIS DIGITAL SCREENING BILATERAL MAMMOGRAPHY

HISTORY: 50-year-old female, routine screening evaluation.

TECHNIQUE: Using a digital tomosynthesis system, tomosynthesis (3-D imaging) bilateral CC and MLO mammograms were performed.

COMPARISON: None available.

FINDINGS:

Tissue Density: The breasts are heterogeneously dense, which may obscure small masses.

Indeterminate asymmetry with associated calcifications is identified in the superior left breast on MLO image 8. No suspicious mass, distortion or calcifications are otherwise identified within either breast.

IMPRESSION: Indeterminate findings in the left breast.

ASSESSMENT: BI-RADS Category 0: Incomplete. Need additional imaging evaluation.

RECOMMENDATION: Additional imaging.

Annual Labwork Dec 2022

 All levels of cholesterol are now out of the normal range:

Total Cholesterol: 207, was 185.  (<200)

HDL: 38, was 39 (>50)

LDL: 126, was 98 (<100)

Triglycerides: 299, was 358 (<150)  (mainly caused by too many calories.  Need to eat less and exercise more)

CHOL/HDLC ratio: 5.4, was 4.7 (<5.0)

NON HDL Cholesterol: 169, was 146 (<130)

Had a respiratory allergy test done also (Class range 1-5, 5 being worst).  Surprised with some of these:

Allergic to dust mites (2 & 3), cats (2), dogs (3!), cockroach (1), Alder and bermuda grass (3), Mtn Cedar (4), Olive tree, walnut tree, Elm, Timothy Grass, Johnson Grass (2), Oak (5), Cottonwood, Common Ragweed, Russian Thistle (1).

Immunoglobulin:  1001 (<114).  Guess I am in a highly allergic state.  Which is odd because I don't really have allergy symptoms right now.  Roshan suggested maybe it's Roscoe and I just got used to it.  Or right now there's medium levels of Alder.  If it's this high now, wonder what it will be when its allergy season. 

Diseases which cause the elevation of serum IgE levels include atopic diseases (asthma, allergic rhinitis, atopic dermatitis, urticaria), parasitic diseases, cutaneous diseases, neoplastic diseases, and immune deficiencies IgE levels can also be high when the body is fighting an infection from a parasite and from some immune system conditions.

Will need to maybe follow-up with an allergist or see if it goes down on the next test.  Maybe I should do every few months?  Or see if they can do a food allergy test or a specific serum IgE test.  Dunno if the allergies are causing my high BP.  Or could be causing my coughing.

Also new was my A1C is now 5.8 (<5.7) which now puts me into a 'pre-diabetes' category.  Diet and exercise important here as well.  

Labwork was done mid-Dec, I hadn't been eating well, it's cold so not much veggies/fruit, just eating more carb-y stuff.  Dr said she thinks I should go on statin.  I don't want to go on statins, so asked if we could re-test in 4-6 months, and see if changes to diet and exercise makes a difference.   So we'll see in a few months. 

At-home sleep study scheduled for Feb 16, 2023. 

Annual Exam 12.8.22

 New doctor at the Health Center.  We chatted and she asked how I felt and I said 'good', dunno if that's why but she didn't really give me an exam. Talked about my stroke history, she said to ask Dr. Bagheri at my next appt if they've ruled out PFO, Patent foramen ovale (PFO) is a hole between the left and right atria (upper chambers) of the heart.  Most chest xrays don't look for this unless it is suspected. But she also thinks Eisenhower would of checked for this when I had the stroke.  But this could cause a stroke.

Had her order me an allergy test and cancer antigen marker on the labwork.  And an order for a mammogram.  

Had her look to see if I have a deviated septum.  I don't but the right nostril is narrower, there's a bump on the inside, which is odd because she asked if I ever broke my nose because there is a bump on the left side on the outside.  Mentioned if this is causing my snoring and she said most likely.  As she looked surprised that I snore.  Said I should go for a sleep study.  

Looking at the last EKG and chest xray, she said my heart is not enlarged.  So I'm guessing it's not big anymore?  So I wonder why Dr. Woods said it was.  Wonder what led him to believe I could have heart failure...  Asked if I still should go see cardiologist, and she said yes. 

She asked why I went off Carvedilol (high HR) and calcium channel blocker (couldn't remember) but she likes those meds.  She thinks the carvedilol affected me because I was coming off the metoprolol and HR tends to go off as body gets rid of it.  She saids it takes at least a month for it to start working.  

Also got a flu shot.  Felt tired around 230p, took an hour nap.  Left arm little sore. 

BP at doctor's 150/100.  

Looking back on notes, Amlodipine is a calcium channel blocker.   At one point the dose was doubled (to be taken twice a day instead of once/day), which started causing burning tongue feeling.  Didn't go away even after returning to one dose.  At this time my meds switched to Metoprolol. 

Was on Amlodipine March 2014 to Feb 2017.  I think it was working at first then gradually started not working.  Same happened to Metoprolol.  Was working at first, then not, dose was doubled, side effects kicked in, meds changed.  On Metroprolol from Feb 2017 to early 2022 (I think).  Then switched to Carvedilol, then Bystolic. 

Will go do labwork and mammogram next week.  Call if I can do sleep study at home.

Just read over notes from when I saw Dr. Woods.  One cause of high BP is dehydration.  I haven't been drinking much water since it's been cold.  Maybe about 4-5 cups of warm water.  That could be it.  

Menopause??? & update

 Last period was mid-September, almost three months ago.  It's a bit weird it just kinda stopped, leading up to it it was pretty regular, even coming early some months but never getting farther and farther away.   Looking back, when I had hot flashes, that was probably the beginning of perimenopause about 5-6 years.  Some other symptoms that may been related to this:  restless leg syndrome, tinnitus (ear ringing), joint pain (right hand mainly), increased forgetfulness, heart palpitations, insomnia, burning mouth (tho I think was medication), bloating/gas, bladder incontinence, vaginal itching, anxiety/depression, breast/nipple tenderness first month of missed period, and high blood pressure (mainly now, even with medication.)  

Average age is 52-53.  I', 50 now.  Since it's menopause when I've officially had no period for 12 months, I'll be 51-52 most likely. 

Been having somewhat more of an urge to go pee lately, can kinda feel bladder getting full and then feel like I gotta go.  Memory def getting worse.  More gray hairs coming in.  Hip pain still about the same, if anything a little better.  Knees seem to be better as well.  LIb got me a standing desk.  I think that's been helping. 

Left underarm/left boob dull ache/sensitivity.  Also along left should blade when pressed.  Not sure if it's related to heart? BP has also been somewhat high so seeing the cardiologist (Dr. Bagheri) in Jan.  

In two days I have annual checkup.  Asking for mammogram along with some other questions.  Will update after appointment. 

Update 9.14.22

BP has been creeping back up to 140-155/90-110.  Pulse in the upper 70s-80s for most part.   BP was doing good couple months ago so started to only take meds every 3 days or so.  Which then turned into I forget to take for at least a week.  BP then started coming back up on some days.  Still have been trying to eat better, less meat and more brown rice.  No dairy, switched to oat milk for my lattes.  Exercise level is still just my daily Roscoe walk.  Been working a lot, lib ladies taking vacation and Chantel got sick and she'll be out till maybe Dec. so been working Anza on Sundays as well.  And seeing Baba when I have a couple days off.  Feeling busy and always on the move.  Miss my four days off.   But car needed radiator and brakes which was about $2300 so I feel like I need to work to pay for that.  Vacation coming up mid-Oct.  

Hip pain was starting to get worse, wake up during night with pain, and pain in the morning.  Usually got better as I got up and walked around but felt I need to do more.  Starting looking in fascia stretches, and other forms of stretching that engage the muscles during the stretch.  Had a breakthrough in my stretching and things are starting to progress.  Forward bend, was stuck at only reaching my first knuckles.  Then was able to get the fist down.  Now I can palm it, tho it is pushing it.  Getting close to doing a pancake stretch and now also working on the front and side splits.  Its nice to actually see progress!  Dunno if eating less meat is making me more flexible?  I knew I have tight calves (only on left), the side with the hip pain and heel pain.  Been working on massaging the calves at night and I think it was been helping.  Today had left pain in hip in the morning.  Also started to wonder why its just the left leg that has problems for the most part.  Maybe related to the stroke? Which was on the right so it affects the left side.  Read it can cause muscle weakness, nerve issues, among other things.  I dunno but that might be one reason why the left is so tight.  

Feeling like I get tired quicker lately.  Feeling more tired after work, going grocery shopping.  Maybe my muscles are getting weaker from just sitting all day at work. Haven't hiked nor rode my bike in months, it's been too hot and now I don't have the time.  Maybe I should put the bike on the trainer again.  That might be good for my hips as well.   

Need to clean the bedroom.  All that stuff around me is slowly getting to me.  Abby moved out so will move her queen down in a couple weeks.  Maybe things will seem roomier.  Finally cleaned the top of my desk, tho basically just moved everything to the floor...  I need to start doing creative things again.  Maybe i'm just depressed from not doing anything for myself in a while.  I'm hoping this being busy won't last too much longer.  Thinking about changing my Baba visits to every three weeks instead of two after our Oct vacation.  It's starting to wear on me a little.   Emi is coming in two months already. Need to get upstairs ready. Then winter. Still need to paint the house and deck.  And fix deck and get new chandelier...   Lots to do. Always.  

Health Update 6.23.22

 BP ranging from 112-150/74-104.  Pulse 66-84 (mostly in the 70s).  Since Baba's cancer diagnosis (June 8), been trying to eat more veggies and not drink everyday.  Donated blood three days ago, cholesterol was 197.  It's in the normal range (125-200) so that's good.  Been foam rolling a little over a month (maybe 2-3 times a week).  At chiropractor two days ago, he didn't have to crack the middle of my upper back.  So I'm guessing the foam rolling is helping.  Hips had been hurting tho, looks like torqued pelvis.  Prolly from sitting all day.  Will need to work on stretching more and sitting up straight.  Joint pain in hand went away after stopping Valsartan.  Still drinking a glass of water upon waking and trying to drink during the day.  Still not at the target 8 cups tho. Maybe 6-7 cups.  Getting better.