Sunday, July 6, 2014

Mr. Sprocket Update - Getting Better Every Day

I'm sorry I haven't updated everyone on how Mr. Sprocket is doing for some time.

When I last wrote, Mr. Sprocket was doing great on his morning walks and had just finished a service call for one of his contract clients.

Tuesday, June 24
we took an even longer walk in the morning than the day before. Then Mr. Sprocket got a call from the Bakery. The two door freezer was not working.

Instead of calling his friend, Mr. Sprocket thought he could figure out what was wrong and fix it with my help. He suspected it was the defrost timer.  Luckily, he had a spare on his truck. He loaded up the trunk of the car with tools and parts and we headed to the Bakery.  The evening baking shift didn't start until 6 PM so he could take his time.

This was the first time Mr. Sprocket stood on a ladder.  He did fine.

And when he got tired, he improvised.

Although the new defrost timer was a tight fit on the old box, I handed him tools and he was able to get the new timer installed.  He did start to feel weak at one point, but after a while he realized it was because we had missed lunch. His blood sugar was just low, not anything to do with his heart. We stopped work and went to get something to eat.

Wednesday, June 25, 9:30 AM

This was his first appointment with his cardiologist, but it wasn't an appointment like what we were expecting.  After the initial assessment of him, (about five minutes), we were directed to a room with many other people. We were supposed to bring all of Mr. Sprocket's medications. We didn't know that, but I brought his medication list he was given from Providence St. Joseph's when he was discharged.

We listened to an RN give a lecture on "Managing Your Heart Failure."  Mr. Sprocket really didn't end up in the hospital from congestive heart failure. He had a heart attack. After the lecture, a dietitian explained to the audience how to read a food label and figure out if the food you are eating is high in sodium or not.

It was basic, general information, 95% of which we already knew. After the lecture, the cardiologist and the registered nurse practitioner came around to each person, looked over their medications and had a few words with each person.  And that was it. There was information on how to get your medications refilled, and not to wait until they had run out.

Mr. Sprocket was not impressed with the female cardiologist at all. She took his pulse for about 30 seconds, told him his heart rate was too high (74 or 75) and doubled his beta blocker medication. (It was quite low to begin with.)  She had very little information about his case from Providence St. Josephs. She did not have his prior echo cardiograms or the results of any blood tests, but I guess she thought she had enough information about him to assess him.

She did agree (after pressing into his shins) that he did not need the diuretic so she discontinued that medication.  And that was it. The cardiologist was with him about a minute or two at the most. The nurse spent more time with him.  The nurse did agree that he could get into a cardiac rehab program.  They scheduled an echo cardiogram for August 25. Mr. Sprocket pressed for another echo cardiogram that day. The nurse said she would try to slot him in. They might have an opening in the afternoon.

We brought our lunch and ate in the cafeteria. After lunch, we tried to register for the cardiac rehab program, which is in the physical therapy department. We stopped in, but they needed time to asses him. However, he also had to get to his first appointment with his primary care doctor.  We thought that we might be able to come back later.

The primary doctor was a young Asian intern. That was an interesting appointment where he took a long medical history. Mr. Sprocket was able to get him to prescribe a sleep aid, just not the one he wanted.  He also agreed to test his kidney and thyroid function numbers again. After that appointment, Mr. Sprocket got the call from Cardiology that he could get an echo at 3 PM.  He races up there while I want for 35 minutes for the nurses to get his orders for the labs printed out.

I then head to Cardiology.

I ask the front desk how soon he will be done with the echo, since the Physical Therapy department closes at 4:00 PM.  At 3:20 PM, they assure me he will be out in a few minutes.  He's not done with the echo until 4:00 PM so we miss getting him on the schedule.

I'm way too tired from being at the hospital all day. I'd had it. I told Mr. Sprocket we were going home and he could get his blood drawn for the thyroid and kidney tests another day.

Thursday, June 26
We got a good walk in in the morning. Mr. Sprocket stopped by the Bakery to check on the freezer. It was fine. He also received a down payment to order a door seal on another freezer that the health inspector required.  I had a big sewing order due on Saturday so I spent the day sewing and Mr. Sprocket spent the day cooking.  I was up late into the night, making progress on several Market Line bags.

Friday, June 27

Mr. Sprocket went to court with me and helped cover the Cameron Brown hearing. (I still have my notes to write up on the Brown and Michael Gargiulo hearings. From the little I saw of the Brown hearing, it didn't appear Judge Lomeli was very happy.)  After court we headed to the hospital so Mr. Sprocket could register for physical therapy and get his blood drawn.

In the physical therapy department, he was given some simple exercises. It was then he realized that his right leg (the one that had the Impella up the right femoral artery, and is his dominant leg) is quite weak. He had difficulty just lifting his right foot off the ground from a sitting position. It was a little wake up moment as to how much conditioning he has lost.

So now he knows what he needs to concentrate on. Rebuilding leg and arm muscle!  He will get physical therapy once a week starting July 30. That was the first available appointment/time. If he misses two appointments, he is rejected from physical therapy.

After the PT department, we stopped into the Cardiology department to see if he could get the ejection fraction results of his echo cardiogram and also to see if he could drive.  When he left Providence St. Joseph's, Cardiologist #1 (who saved his life) told him he couldn't drive for a month.

The cardiologist and nurse practitioner were very busy but they did send a note out to the front desk that his echo cardiogram was "normal."  His ejection fraction was 50-55.  This was fantastic news.  Normal hearts have ejection fractions ranging from 55-70. Mr. Sprocket was given a note that he was cleared to drive and that there were "no restrictions" on him.

The only issue that Mr. Sprocket has been having has been the insomnia. Mr. Sprocket has a terror about not being able to sleep and one of the main side effects of beta blockers is insomnia.  Insomnia can raise your heart rate. Mr. Sprocket's beta blocker that was prescribed by the #1 cardiologist, a generic for Coreg, is not only a beta blocker but also an alpha blocker, which also causes insomnia.

The medication worked great, caused him virtually no problems, except that sleep was elusive.  Sometimes the sleep aid would work, and sometimes it wouldn't. Sometimes he tried relying on the Benadryl, but that didn't always work and when it did, it left him quite groggy in the morning.

Saturday, June 28th

It was a marathon day of last minute sewing and driving. Mr. Sprocket met up with his friend who took over his accounts while he was hospitalized. He needed to get his door keys back for several of Mr. Sprocket's contracted clients.  Mr. Sprocket drove me crazy, being a back seat driver while he was on the phone most of the time.

I dropped off my sewing order and Mr. Sprocket got to speak to my friend who runs a cardiac rehab program at a different hospital network. Their partner is a pharmacist. They were very patient and answered a ton of questions my husband had. They both thought Mr. Sprocket's recovery so far was "amazing" considering where he was just a month prior, and the fact that he was only on a single heart medication. (In addition to the heart medication, Mr. Sprocket is on aspirin, a blood thinner, a cholesterol lowering med and a thyroid medication.)

Sunday June 29
Mr. Sprocket worked from 1 PM to 8 PM at the Bakery, fixing a problem with the huge, ten tray rotary oven. I helped by handing him tools. This time, he made sure to break early for lunch.

Sunday night, he had another night of virtually no sleep. Mr. Sprocket spent time on the Internet searching his medications and seeing if he could do an alternative to the generic for Coreg.

Monday, June 30
We took a 2.4 mile walk. Mr. Sprocket can now keep up with me. He downloaded several heart monitor apps onto his phone and monitors his heart rate when he walks.  He had a second night of not great sleep.

Tuesday - Thursday, July 1-3
We took a 2.7 mile walk and Mr. Sprocket had to take a rest half way. He was having difficulty and most likely dehydrated. After we got home, Mr. Sprocket got on the phone to the Cardiology department, hoping to get his beta blocker changed.  He was able to speak to the nurse practitioner and the doctor agrees to change his medication. He will now have just a beta blocker and have nitroglycerin pills only if he gets pain. He starts on the new medication that evening. He is able to get a decent night's sleep on the new med.

The next day, Mr. Sprocket notices that the new medication makes him real dizzy. The medication also makes his heart rate somewhat irregular, to the point that it's difficult to get a consistent reading of his heart rate on the heart rate apps. He becomes even more discouraged. That morning, he doesn't feel he can drive on this medication.

On Thursday, we go back to the hospital. I stay in the lobby while Mr. Sprocket heads to the Cardiology department. He sees the nurse practitioner and asks to speak to her. He gets a very short meeting with the cardiologist and the nurse practitioner.  He was asking about options for another medication. There is some discussion about how much time they are having to devote to him. They mention that his heart function is normal. (I don't know since I didn't speak to them, but maybe they see him as not a high risk patient at this point, that doesn't need the attention they are having to give him.) They recommended that he cut his current medication in half, or even discontinue the new medication to see if his symptoms go away.  He cut his medication back to half.

Friday - Sunday, July 4-6
We had an okay 4th of July, watching the fireworks show down at Marina del Rey.  We took a few walks to look at the boats. Mr. Sprocket had a bit of trouble getting to sleep that night.

Saturday morning, Mr. Sprocket walked by himself since I had a client.  He stayed on our street, close to home, going back and forth around a loop. Mr. Sprocket stopped the new beta blocker to see if his dizzy symptoms disappeared. However, his heart rate went a bit high. He had quite a bit of anxiety about that. Searching the Internet he found out that you're not supposed to quit a beta blocker cold turkey, because it can cause your heart rate to jump. Neither the cardiologist nor the nurse practitioner mentioned anything about stepping down gradually off the beta blocker.  Mr. Sprocket talks about changing doctors, since he's totally disappointed in his care. That evening, he went back on 1/2 the new medication. He had to take melatonin and a benadryl to get to sleep.

And that brings us to Sunday. Mr. Sprocket took 1/2 the beta blocker medication. He did okay during our two mile walk and didn't get dizzy. He didn't measure his heart rate too much during this walk. Later in the day, he worked at the Bakery again, putting in a new door gasket on a freezer.  After he was there for a few hours, he asked me to stop by to help him with the gasket.  He takes a late lunch with me then goes back to work.  His heart rate after eating was still pretty high. We left about 6 PM.  On the way home, he stops at one of his regular, monthly clients and talks to the building manager. I ask him to measure his heart rate. It's 101, still too high. He rationalizes that it's high because he was driving. I tell him that is too high for driving. He realizes that at 1/2 the dose, he's not having any dizziness but the medication is not keeping his heart rate down after some relatively easy work and driving.

Overall, Mr. Sprocket is doing remarkably well. It might take a bit more tweaking of his meds to limit the side effects and to keep his heart rate down.  We've decided that he needs help reducing stress so we've ordered a good supply of Dr. D'Adamo's Catechol, made specifically for Type O's and AB's. You can listen to a short lecture about the product at the link.

Mr. Sprocket is also realizing that it will take some time for him to build his strength back up again to where it was before the heart attack.

Thank you everyone, for all your positive thoughts and prayers.


Kathy said...

Thank you for the detailed update. I'm so happy to hear Mr. Sprocket is on the mend.

Love the improvisation.

God bless and take care.

Kathie Berry said...

Betsy, I am so glad to read how things are going. I have been down and out pretty much and made up my mind today to come here and see how you both were. I was so afraid that he wouldn't be with us anymore and thrilled to see he was and how well he is doing. No small part of that credited to his lovely wife I am sure. And his tenacity! My thanks and prayers wing on high and love you tons!

Kathie Berry

Kathie Berry said...

Betsy, I am so glad to read how things are going. I have been down and out pretty much and made up my mind today to come here and see how you both were. I was so afraid that he wouldn't be with us anymore and thrilled to see he was and how well he is doing. No small part of that credited to his lovely wife I am sure. And his tenacity! My thanks and prayers wing on high and love you tons!

Kathie Berry

Anonymous said...

I'm a long-time reader. I had a major heart attack about four years ago. Much of the cardiac rehab shtick is nonsense or worse. Building up to a good level of consistent physical activity is helpful, as is staying well-hydrated and well-rested.

Your family continues to be in my prayers.

cereusle said...

I thank you for the updates on Mr. Sprocket's progress. It's heartening to know that you are both doing well and that what could have been a dire situation has mostly passed. Life may never be the same as it was before, but it will be better in many ways. Your husband is a smart man to take his health seriously and make efforts to improve.