Right, having spent the afternoon at Arrow Park Hospital’s cardiology dept, the result is that I do, incontrovertibly, have heart failure. But there’s a mystery – it’s not the normal heart failure associated with aortic valve calcification.
Yes, for once I got a good doctor, one prepared to listen – which always makes a change. A nice guy, too, but like all doctors he had a tendency towards bullshit. Only a little bit, and it’s probably excusable as he doesn’t yet know how much I know (which, as it turned out, is, anyway, a hell of a lot more than he expected – he’s also given me a research tip!). He agreed, too, that given my symptoms, NOT having heart failure just wasn’t a possibility – which I’ve been saying for just a couple of weeks short of a year!
So, the normal type of heart failure associated with aortic valve calcification – in which the left ventricle retains some blood it should have been pumped – is absent, for now at least, but as the valve narrows (it is already slightly narrow), that’ll happen – it’s inevitable. That’s where the BS came in – he at first said the valve wasn’t narrowed (stenotic), but when I pointed out that it could hardly not be, he conceded that yes, it is narrowed a little. But, hey, it’s a rare doctor, at any level, that will concede a point to a patient about anything. My only question is how much is a little?
Then what sort of heart failure is it? Cor Pulmonale would be my guess, as I was diagnosed with the early stages of it about 10 years ago so it’s bound to be worse now, but with COPD that’s just so obvious I don’t know how he could miss it.
He was blue-skying about badly-connected coronary arteries, which might actually be a possibility given that when I had an angiogram in 1996, they had trouble locating the entrance to one of my coronary arteries which wasn’t where it should have been, apparently. He also floated the possibility of a hole in my heart – which I think can be discounted unless holes spontaneously appear, which I’m pretty sure they don’t. From my teens to my 41st birthday – when it all went belly up – I was extremely active – within the limits of my respiratory problems – more active, in fact, than many perfectly fit people. If I had a hole in my heart, that wouldn’t – couldn’t – have happened.
So assuming he’s being honest about the aortic valve calcification and narrowing being fairly minor – and I have to believe him on that – he’s lined up a double-catheter angiogram which will reveal if he’s having me on, so I trust him.
I had a bunch of blood tests, an extensive spirometry test and an ECG, plus I was given a large plastic bottle in which to collect 24 hours worth of pee. Oh joy!
And when I left he was busy lining up a whole raft of further tests. He says I shouldn’t be as disabled as I am, but he’s in for a disappointment if he thinks he can fix it – most of what ails me predate my heart problems. The heart problem isn’t fixable either – you can’t cure heart failure – so I’m not yet sure where he thinks he’s going with this, but I’ll go along with it unless I feel that some tests are dangerous – that is the risks outweigh any potential benefits.
And so, Doctor Abdelmouti, at St Catherine’s Hospital, Birkenhead, perhaps next time a patient points out that all the symptoms of heart failure actually do point to, er, heart failure, you won’t laugh idiotically and deny it just because it doesn’t fit your narrow world view, as you did also when I asked, given that I had the symptoms of heart failure, what else could it be? You didn’t know and – worse, you didn’t fucking care!
You might like to bear in mind for future reference that if it looks like a duck, walks like a duck, and quacks like a duck then it’s a good idea to accept that it’s a bloody duck!
And to round off a pretty good day, I got a huge smile from a very young, extremely blonde and gorgeous doctor. No idea why, but it sure as hell cheered me up.