Tests scheduled and rescheduled - Day 66

I made the last of 4 phone calls to various medical agencies by 8:40 this morning and all but one had called back before 9:30.

The colonoscopy scheduled for July 21 at UIHC is rescheduled for Oct. 27

The heart (cardiac) catherization (also called a coronary angiogram) at St. Luke's Hospital is scheduled for Thursday, July 23

What is a heart catherization?
According to WebMD,  it is an invasive imaging procedure that allows the doctor to "see" how well the heart is supplied by blood vessels. A long, narrow tube, called a catheter, is inserted into a blood vessel in your arm or groin and guided to your heart with the aide of a special X-ray machine. Contrast dye is injected through the catheter so that X-ray videos of your valves, coronary arteries and heart chambers can be created.
(I was born with a congenital heart murmur and had this procedure done when I was 12 years old. The catheter was inserted into my right arm.)

What is purpose of a heart catherization? 

• To evaluate or confirm the presence of heart disease, such as coronary artery disease, heart valve disease or disease of the aorta
• To evaluate heart muscle function
• To determine the need for further treatment, such as interventional procedure (stent placement) or bypass surgery.

Dr. Butler's office is to call and let us know when to stop and restart the coumadin before the upcoming heart cath procedure.  PCI Cardiology said usually you stop the coumadin 3 to 4 days before.  Dr. Butler's office did not call, so we decided to go with the recommended stop time.

Instructions from PCI Cardiology ...
Jim is to start taking baby aspirin today.  Labs to be done Monday afternoon,  July 20.  He is not to eat or drink anything after midnight Wednesday, July 22, except for morning meds with a sip of water.  We need to be at the hospital at 8:30 a.m.,  2 hours before the procedure.

PCI Cardiology also said the abnormal results of the stress test reveal a large reversible defect.  It could be related to the left anterior fascicular block showing abnormal on the EKG taken July 1 at UIHC.  When Joan, the nurse coordinator for Dr. Parekh (Jim's thoracic surgeon),  returned my call, she said it is doubtful this new heart problem is related to the May 12 surgery,  because Jim was monitored throughout and there were no problems.

My writings today ...

Stop!
Listen!
You are Mine
yet you withdraw from My Presence
presuming yourself
more knowing
than anything
I have to say

You are weak
and you will remain weak
until you put your selfishness
behind you
and settle your focus
on Me

You live in the world
yet the world is not your answer
You run toward it
eager for something new
yet the world does not provide
what you need

I AM the Answer
I AM what you need

When will you return to Me
When will you stop running away

I have given you what you need
Why do you fail to believe
you have the best
There is nothing better
than to sit at the feet of My Son,
Jesus

Be filled with My Presence
Open your heart
to all and every blessing
I have set before you

See the good around you
instead of every wrong.
(c) Cathy Orrick Luders

New dilemmas - Day 65

I made two calls this morning - one to Jim's primary care physician, Dr. Butler, and another to the Center for Digestive Diseases at UIHC.  It was too bad the nurse from UIHC didn't call first, because now I've had to call Dr. Butler's office a second time.

Jim is scheduled to have a colonoscopy next Tuesday, July 21, per orders from Dr. Parekh, his thoracic surgeon.  We didn't have prep instructions, thus requiring a call.

We have plans to attend the Cedar Falls Bible Conference July 26-31 (reservations were made and paid earlier this year), but now I question the reality of those plans.

So the nurse from the Center for Digestive Diseases called back late morning.

This colonoscopy is not your typical procedure, with prep being done the day before.

Prep begins:

•  today - no corn, popcorn, iron or multivitamin. No Problem!
• Friday (4 days before procedure) - he is to stop taking Coumadin - unless of course the doctor managing this med thinks otherwise.  Hence, my second call to Dr. Butler's office to find out if indeed he is to stop 4 days ahead, when he is to restart, and what to do about the INR  re-check currently scheduled for July 24. 
• Sunday, July 19 - after supper, he takes the bottle of clear magnesium citrate.  Nothing red.  No jello.  Begins clear liquids and continues on that through Monday.
• Monday, July 20 - between 3 and 4 p.m., drink the jug of lovely tasting stuff (not!) - Nothing after midnight

And then we received a call before 1 p.m. from PCI Cardiology - Dr. Li's office,with results of the stress test Jim took on Monday and Tuesday of this week.  The nurse said it was abnormal.  She didn't say what specifically was abnormal, only that it was.  She asked if Jim had had any chest pain and he said no.  A cardiac catherization aka angiogram is to be scheduled, and she hoped to have called us back today with a date and time, but that didn't happen.

If there is blockage, a stent will be put in.  The nurse said if there is no blockage,  the procedure would last 30 minutes;  otherwise, it could take up to 1 1/2 hours.  He would need to be at the hospital two hours before.

Then I called the nurse coordinator for Dr. Parekh at UIHC because we thought it a good idea if he received the stress test result report and any other information.  I wondered if the surgery could have caused this problem.  We haven't received a call back from her either.

So I stayed home and worked, waiting for return phone calls.  Tomorrow morning we will have to get up earlier and make phone calls earlier as well.

Jim and I went grocery shopping after supper and we were talking about things Dr. Parekh said during our 4-week clinic visit with him July 1.  When we got home, I started looking through previous notes.  At that clinic visit Jim had an EKG and results showed normal sinus rhythm but abnormal left anterior fascicular block.  Nobody seemed to know what the latter meant, but results were to be sent to Dr. Li,  Jim's cardiologist.

So I did a google search on Left Anterior Fascicular Block.  I found the following of interest:

• It is a medical name indicative of scarring or other blockage that causes portions of the heart's left ventricle to shrink or constrict. 
• Lifestyle choices and genetics may have much to do with why the blockage happens
• Chest pain is not always present
• Dizziness can be a symptom of a defect in cardiac function.  Unconsciousness may occur.
• Stay away from refined carbohydrates

Dizziness ... has been bothering Jim since taking Coumadin, which can lower blood pressure,  and Jim's BP is definitely dropping. 

Refined carbs ... we have one doctor who tells him to eat whatever you want, need to add fat.  And we have another doctor who tells him to avoid foods high in carbs and starch. 

I talked to Jim's sister, Dianne, the RN.  She suggested we call Dr. Gerke's office in the morning and reschedule the colonoscopy. Take care of the heart first. Also to call the cardiologist and find out exactly what was abnormal about the stress test. 

I know the Lord is in control.
I know He will take care of us.
He is taking us down paths for His purpose.
He will bring us through it.
We must stay strong in Him,
because without Him, we are so weak.
Sometimes our weakness overwhelms us
We seek His guidance.
We seek the prayers of His followers across the seas.
We seek a place of quiet refuge
to be comforted by the One
who knows us so well.
(c) Cathy Orrick Luders