Thursday, April 25, 2024

last night's walk, tomorrow's appointment

Last night, I walked from work to the Han River, then home—same route I'd walked the other day. I'd planned to include some creekside staircase work, but as the walk started out, I began experiencing some minor chest pains, and that was enough to warn me away from the stairs. After about ten or twenty minutes of walking, though, the chest pains disappeared, and the rest of the walk went fine. I recall feeling resentful, as if the hospital had done something to me, making my recovery this time slower than it had been after my stroke. Honestly, I'm still not quite sure of the nature of what afflicts me. Simply saying "heart failure" doesn't tell me much; the term is just a label covering a spectrum of symptoms and conditions.

I think part of my resentment had to do with the fact that the chest pains' appearance and disappearance followed the same pattern as from before I'd been hospitalized. I'd thought the hospital treatment and the new meds might do something to break the pattern, but apparently not. So I'm stuck in some sort of medical samsara.

Today's a fasting day: my first follow-up appointment at the hospital is tomorrow, and my paperwork says I have to fast for at least nine hours before arriving. To my delight, I saw that my weight had gone down when I weighed myself this morning: I'd dropped from 115.5 kg to 114 kg. That's undoubtedly thanks to walking yesterday. Since I'm fasting and walking today, I expect to drop another kilo. It's all liquid weight, of course, but as long as the trend keeps going down, then I don't mind. My only worry is that I might get woozy tomorrow if I go too long without food, and the appointment is at 4:50 p.m. I can say that taking meds at night has been a good strategy thus far: when I wake up in the morning, I'm not woozy at all. Then again, I do have a diet smoothie for breakfast after waking up and recording my numbers. Tomorrow, my worry is there will be no breaking of the fast until much later in the day. I guess we'll see how it goes.

Here's hoping for a chest-pain-free walk tonight. And maybe some stair work.

UPDATE: the message with my QR code finally arrived. I was getting worried.



3 comments:

John Mac said...

I hope you get some good news and clarity from the docs today. I'm glad you had a good walk, but those continuing chest pains would freak me out. It sounds like you are doing what needs to be done to heal, but maybe you can get some feedback on the meds, symptoms, and a what next course of action.

Good luck!

Daniel said...

"I recall feeling resentful, as if the hospital had done something to me, making my recovery this time slower than it had been after my stroke. Honestly, I'm still not quite sure of the nature of what afflicts me. Simply saying "heart failure" doesn't tell me much; the term is just a label covering a spectrum of symptoms and conditions."

This is a very philosophical observation and I feel compelled to comment to help make sense of those feelings.

From what little I know about cardiovascular disease and decompensated heart failure, I would credit the hospital with saving your life (albeit by pumping you full of drugs that may have been overkill to some extent, especially concerning BP) this time around. The recovery 'feels' slower because while modern medicine can reverse the effects of an ischemic stroke (I'm guessing yours wasn't hemorrhagic?) if treated quickly, it is much less adept at treating heart failure, which involves a complex and gradual downward spiral of the pumping mechanism and not the piping mechanism (which is what a heart attack would spring from).

Think of it this way, if a pipe is blocked due to soft plaque that has somehow broken free from a plaque deposit due to inflammation, etc. a variety of meds and surgical procedures can force the blood to flow somewhat smoothly again if treated in due time.

If the pump itself is failing (i.e., heart failure), however, things become much trickier. Now, without a science or medical background, I can't comment on what goes wrong with the actual pumping mechanism, but the abstracts of papers I've read on heart failure make it clear that there's no easy way to reverse the process.

What's important is that you *can* improve symptoms and drastically cut mortality (by 40%+) by taking a range of different meds (SGLT2 inhibitors and ACEIs/ARBs, among others) and alleviate symptoms through dietary and lifestyle changes.

At your appointment today, I would ask the docs if there's anything else they can prescribe for heart failure. Metformin and insulin sound like decidedly old school antiquated treatments, especially when a literal revolution has taken place in the last decade in terms of heart failure treatment. Definitely something to consider...

Kevin Kim said...

If the pump itself is failing (i.e., heart failure), however, things become much trickier. Now, without a science or medical background, I can't comment on what goes wrong with the actual pumping mechanism, but the abstracts of papers I've read on heart failure make it clear that there's no easy way to reverse the process.

It might happen after my lifetime, but maybe someone will find a stem-cell solution to repairing damaged heart muscle. Or it may already be happening.