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Good News! made it back into cardio rehab.


MikeO

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Well done @MikeO- that's really good news, fingers crossed it continues!

It's funny how experimenting with the time of meds can make such a difference.  I was told to take low-dose Trazadone at bedtime to help with my insomnia but I only started to feel sleepy in the early hours of the morning so I decided to start taking it earlier - taking it between 6-7pm works much better for me.

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I did get the results back from my stress test and it does look promising. I have really worked on getting my heart working well and it shows. down side my bp's for whatever reason changed to being high but has responded diastolic wise to the Amdialol not so much on the systolic blood pressures. More to the story coming.

After resting images were acquired, the patient exercised on a treadmill for a few minutes as part of the pharmacologic stress protocol.  While walking, the patient received an intravenous bolus administration of 0.4mg 5mL of Regadenoson. After Regadenoson administration, the patient received the stress dose of technetium-99m sestamibi intravenously and SPECT myocardial perfusion images were acquired using standard SPECT/CT technique. A low-dose noncontrast CT scan was performed for attenuation correction. It should be noted that this low-dose noncontrast CT scan is not sufficient for diagnostic purposes.
      
      
     PROCEDURE RESULTS:
     Analysis of the static and gated stress and rest images was performed. The low dose noncontrast CT images were reviewed. Coronary calcifications are present. On review of the rotating raw images, there is no abnormal extracardiac activity.
      
     Myocardial Perfusion:
     Stress and rest non-attenuation corrected images demonstrate a fixed, moderate-sized area of mildly-reduced uptake in the basal to apical inferior segments. This defect normalizes on attenuation corrected images, consistent with attenuation artifact.  
      
     The remaining myocardial segments show normal uptake. No evidence of myocardial ischemia, infarction, or scar.
      
     No evidence of transient ischemic dilatation.
      
     Left Ventricular Function:
     Gated images post-stress demonstrate normal myocardial wall motion and thickening. LV systolic function was quantified using QGS/QPS software. Left ventricular ejection fraction (LVEF) post stress attenuation corrected is 62% and is visually normal without regional wall motion abnormalities.  The post-stress left ventricular end systolic volume (ESV) is 29 mL.
      
      
     As the teaching physician, I personally examined the radiologic study, reviewed the findings with Dr. Peter J Haigh and arrived at this interpretation.
      
     This report was generated using voice recognition software. All reasonable efforts were made to ensure accuracy. However, to assist in our continuous quality improvement, if you require further clarification or feel there has been an error in this report please contact the Department of Radiology at radinfo@uwhealth.org.
   
   
   
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Well stress test for the most part went well. BP's not so well so an order was put in for a 24hr ambulatory blood pressure monitoring test. I did make some headway on the diastolic side but the systolic is still high.

What gets me is that the providers in north eastern wisconsin do not offer and the nurses are unaware of the test.

I am sure there's a reason for the spikes in blood pressure but have a feeling it is not vascular related as it is neurogenic. I did tank at cardio rehab.   

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  • 3 weeks later...

Well took a bit but Cardiology has a BP med plan. They are not on board with upping the Carvedilol i have little room to work with hr wise so they are not willing to make a beta-blocker change. We did discuss the use of pyridostigmine and have to reach out to Tania to discuss. What we are going to try is increasing the Amlodipine by 2.5 mg so yes ( i will have to split pills ) but they are taking a conservative approach. Big concern is my liable vitals. 

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  • 2 weeks later...

Well starting to see the benefits from my recent med changes and sticking with the cardio rehab program. I do have to say that this is the most stable i have seen my blood pressures in years. No longer hitting those 180/190 systolic readings and my diastolic pressures have improved as well..

I do still have episodes with my bp tanking which is a concern. I suspect i will have to just live with that and get better at recognizing the precursor symptoms.

For now we are staying the course with meds as my average blood pressure is just under the goal of 140.

 664410806_11-4-21thru11-17-21bloodpressures.jpg.f0699afdd8f7ff1bd660254d35eb16d6.jpg

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  • 2 weeks later...

Well graduated from Cardio Rehab yesterday. I do have to say this is a worthwhile program. I did have a bit of a rough start but it only got better as i progressed. 

At the start i could only tolerate walking 2 minutes on the treadmill before having to stop to making it all the way for 42 minutes (and nothing bad happened).

As part of the process we did figure out that my meds were not working for me so my Cardiologist completely changed them out. Now my bp is a bit more stable (not perfect but better) i have less fatigue and seem to tolerate exercise much better.

I just hope i can maintain this going forward. 

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As I started to recover from my first (2005) and second (2012) relapses, I started to go to the YMCA for their exercise classes for elderly patients. They looked at me funny and asked me why a young man (I was young once) was coming to these classes. It was just the right amount of rehab for my situation. Let me tell you, some of those older adults were running circles around "the young man." Lol!

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