Sunday, Feb 1
Finally, we got the blog out at 1:00 a.m. today, for the 5th and last week of January.
I got up at 6:00 a.m., took some meds, one a diuretic, and went back to bed until 9:30. Guess I was wiped out from the past couple day’s activities.
No CPAP report today; only oximetry, as yesterday.
Oximetry showed I am benefiting from the SpO2 control, with dips into the 80s, more often than with the machine (but it still happens occasionally with it on). This may just be sensor thing as I move, as it doesn’t last.
Weather today started with spitting snow that has changed to drizzle. John managed all the feeding and exercising dogs.
Lunch today is leftovers for each of us. John is having meatloaf, and I’m having the rest of my chicken salad I fixed yesterday. I had a late breakfast of an apple fritter covered with plum preserves (made by my friend, Gloria, from our plums we shared), so my lunch will be later than usual.
I’ve been working on the last (I think) edits of the report for my friend, and now am trying to organize receipts for taxes, and medical records to prepare for my Tuesday appointment. I have to report on my medical data from CPAP and Oximetry for my cardiologist. I completed our volunteer hours for the month of January. I found the missing TurboTax receipt for my refund at Costco.
Tomorrow, I will stay home again to complete projects.
Listened to some of the Super Bowl. Not a nice ending for Seahawk fans. John read there was less than 13 minutes of play and just over one hour of commercials. The rest of the remaining 33 hours was just stuff. Friday night high school football should be more entertaining, especially considering the cost.
Monday, Feb 2
CPAP report. Reported figures. 8 hrs 46 min with AHI = 0.11
EVENTS: 1 H, No major mask leaks (max=19 L/min)
I managed to take off the pictures from last Friday’s celebration at the senior center and send to the folks who put it on.
I worked a lot on my report and questions to give to my cardiologist.
Our dinner was 5-ounce filet of Copper River Salmon (source of Vit D), nicely seasoned, butternut squash with pecans & brown sugar, and a 1/2 of an orange. Photo below was taken after some of the food was consumed.
Tuesday, Feb 3
CPAP report. Reported figures. 7 hrs 54 min with AHI = 0.13
EVENTS: 1 H No major mask leaks (max=13 L/min)
I never got around to describing my Tuesday visits to the Yakima Heart Center (YHC). I will try to do it now, four days later.
Our very long day started, leaving the house at 9:25 a.m., and going to the first visit at the Imaging section of the YHC. The purpose was to get my implantable cardioverter-defibrillator (ICD) checked. I have been on a program of regular checking (a company study) every 3 months, since it was installed June 1, 2010. I’m at the end of that research, so the only need for reading now is to look for irregularities and test its battery life. Every night, the vitals of the device are checked over my landline. It actually can be read by the YHC via their website for the imaging, monthly, and I don’t have to make a trip down except every 4 months. My battery has 15% usable life (about 10 months) before I have to be set up for a replacement surgery to implant a new one. It will be a surgery lasting from start to finish, about 3 hours. Mine may require a little more prep time because of my severe allergy to Heparin (usual blood thinner used in operations and also used to clean IVs). As well, some of my heart medications will have to be stopped or changed before the surgery. The only one I know for sure is Coumadin, but I will have to go in for a complete physical and “work up” once my battery gets low enough to send the alert for replacement. The nice thing is that I can continue to be monitored every night and the technician can check my device through the web, monthly, to alert them to start the planning phase for the operation.
It will occur in Yakima Memorial Hospital, and I know my surgeon, Dr. Pham, whom I have seen previously for other decisions about my ICD. The nice thing is that the technology has improved in the 5 years since, the size is smaller, and the weight lighter than mine now.
{click image to see detail}
Above is a schematic of a single-wired ICD, as I now have.
One of the things that will be considered is making the single wire (lead into the heart), now in the right ventricle, considered a single chamber ICD, into a dual chamber ICD, with two leads, (one as before, and additionally one into the right atrium). The weakness of my heart and my low ejection fraction has prompted my primary cardiologist (Dr. Kim), to request consideration of the second wire. Last year Dr. Pham determined I was not a candidate for the surgery. However, my guess is that I will be now, because the unit is going to be replaced this year and Dr. Kim believes the dual lead will be good for my heart. The second wire will be pushed through a vein to the other part of my heart. My appointment with him is March 10, to make this determination. He is a nuclear cardiologist and performs all the ICD and pacemaker operations. My surgeon, for the current ICD, retired.
From that first appointment, we went to the waiting room for my appointment with Dr. Kim, at 11:15. I was called in fairly rapidly, but his assistant took care of many initial things while we awaited my doctor (with another patient). He is so generous with his time and attention that I never complain about waiting. First, she took care of my meds reporting, took my blood pressure and pulse, and then performed an ECG for the doctor to view when he arrived. That’s always his procedure, even if there is a previous ECG just 2 weeks old. I also had had a fasting blood draw a week previously, and that was to be reviewed this visit. I requested a copy from the assistant, and it was provided as I checked out.
Dr. Kim arrived about 12:30 p.m. and reviewed his notes, the lab results from last week, the ECG earlier today, and fielded my questions, from the last visit. Concerns for this visit were with my changes in medications, and the results, since the changes occurred at my last visit, Nov 14, 2014. Here are a few highlights.
My BNP (one of the most sensitive ways to assess how well a damaged heart is doing on treatment) was 178 last week, better than previously at 188. Read about BNP here.
That’s a change in the right direction but still not great. We’ll check back in a month to see my progress overall. My potassium was high, so while I had started it with the diuretic, he stopped me on it for now. My Creatinine (measuring kidney function) was a little high up to 1.62 from 1.29, but he said it could have been a slight dehydration from the fasting blood draw, and we’d look in a month. He reviewed my progress on Telmisartan (Micardis, generic), and upped my dosage to 20mg from 10mg. We also discussed my change in Magnesium dosage. In the lab test previously, the reading was 1.8, and now is 2.0 (Range desired is 2.2-2.5). No change, okay to stay on 750mg.
I don’t think the Vitamin D test was in this lab, because I’m continuing until April on the large dose of D2, once a week. I asked the difference between D2 and D3, which I had been on and will go back to at the end of the 25 weeks of the high dosage. I found on the web that D2 was obtained from plants, and D3 was from the body’s interaction with the sun. However, his explanation was that it was pharmaceutical; they could “squeeze” more of D2 into the capsule, so you have fewer to take. Web articles suggest this used to be the case but now D3 is available in greater strengths. It won’t matter much because by the time I get it figured out I will be off of the high weekly dose. At the moment this remains one of medicine’s little mysteries.
We went over my twice-daily readings of my blood pressure the week preceding the appointment. I wore my oximeter and added those SpO2 percentages to the chart. He was pleased with the systolic being higher than in November, but not very clear if the new medicine was possibly responsible. Guess we will review in a month, when he wants me to return. He would like a higher blood pressure and faster beat to provide “reserve” in case something bad should start to happen. There are no symptoms at the level I am not at now. He then examined me on the table, and continued dictating his findings and conclusions into the tape recorder about our visit. He also took time to answer more of our questions about the requirements of the reports on medical condition to the government and for insurance purposes (Medicare & Group Health Insurance). Forms appear on his computer screen as he works and he has to type in his assessment from a list. This is why, sometimes, the report I finally get seems a bit odd, and perhaps even contradictory.
From there we went (at 2:05) to my Medical Supply place for the CPAP equipment to check out my recently acquired face mask, which I thought was not fitting me properly, and causing nose chafing from the tight fit of the nasal pillow. I had my mask with me to show them. We fiddled with it some, and realized there were no adjustments able to be made to the headgear that I hadn’t tried, and there was only one size fits all so I couldn’t replace with a different-sized headgear. They did offer and I tried a medium nasal piece, but it was too big. Then they suggested looking at another mask. I did, and the other one had more chances for resizing, and also it had larger more comfortable nasal pieces. However, once we actually got it all assembled, I decided it was too confining for my likes. Phillips Respironics, the maker of my CPAP machine, made that last tried mask, but I decided to stay with the AirFit 10 by ResMed (for her), I had, and just work with getting it correctly fitted. Don’t I look wonderful? This one seems to put pressure on my nose and pushes it up more than I’d prefer.
On to Costco. It was getting late, 2:40 I think and we had not had breakfast or lunch. I stood in line to return my Turbo Tax software, while John went to get our food. I requested a Chicken Salad (Grilled chicken slices, grape tomatoes, grated parmesan, lettuce, croutons, and a ranch/Caesar type dressing). John had a full polish sausage with the limited fixings he likes – onions and relish and mustard. We shared a frozen yogurt very berry sundae (strawberries).
We stopped by a friend’s in Ellensburg to deliver some low dose aspirin we purchased for them, and she returned 2 dozen eggs. Nice. We were very late getting home. It was going on 6:00 p.m., long day. John had all the evening chores with horses, dogs, and cats, and I fixed the food for the inside (and outside) cats.
I brought home a good half of the chicken chef salad and added some good stuff to it to cover both our dinners. Because we had eaten such a late lunch, it worked fine, and then we added a dessert.
Wednesday, Feb 4
CPAP report. Reported figures. 8 hrs 1 min with AHI = 0.00
EVENTS: none, No major mask leaks (max=6 L/min)
Another busy day. I had many email chores to do before I left at 11:00 a.m. for the Food Bank Soup Kitchen music. I started by visiting with one of the patrons I had not seen since the other building burned down. I was so happy to see her because I had been concerned she was sick.
Today, we had a full contingent of three instruments (& we all sing), plus two extra singers from the staff. Next week we will have 3 staff singing. It’s getting to be quite a presentation on Wednesdays. The servers still get in on the action keeping time to the music, or singing. Lunch served today was a pasta dish and salad, and a great peach/plum dessert. On my way out, I got some bread – whole-wheat crescent rolls (we have never had) and a loaf of French bread in a large cannister shape. Here is a link with the shape but not the French part. Bread from a can.
SAIL (exercise) class had a very high number of people today. I did not even count, but there were people in rows behind the pool table and the central circle. I met the lady who knits stuff for us, and gave her a big hug. She’s recently gotten the news that her cancer surgery was successful in getting it all out.
After loading some boxes in the back of my car from Gloria, I went by to get some ice cream to replenish the bucket we finished 3 days ago. The dogs and cat get nightly treats (tablespoon size) and they have been very demanding since we ran out Sunday.
We left early tonight for a lecture at CWU, first going by Pizza Hut for a pizza and carrying our own Pepsi. We took a container along to put in 3 pieces, 2 for John, and got our places on the front row, getting there 1/2 hr early. We enjoyed our dinner. The lecture started at 7:00, and went until 8:30 (longer than usual, but no one left early). It was presented by Wendy Bohrson (we’ve known her for the past 20 years, as a member of the Geology faculty). She was presenting at the Ice Age Floods monthly meeting, and while her topic was not on IAF material, it was very well received. It was on the Mt. Mazama eruption (that formed the Crater Lake caldera) and also she covered the Cascade Volcanoes. The presentation was very interesting, complete with a volcano demonstration from H2O2 (two different strengths, largest was 35%), yeast, food color, and water, in two differently shaped vessels. The demonstration was directly in front of us and performed by two of her students. When they were setting up, John asked if we needed safety glasses.
Thursday, Feb 5
CPAP report. Reported figures. 7 hrs 12 min with AHI = 0.00
EVENTS: none, very quiet. No major mask leaks (max=6 L/min)
Today we went on separate trips to town, with John going to Super 1 to take advantage of a really good sale (case pricing) on several types of canned beans, and tomatoes. We can make chili without so much salt, as well as using them in other dishes. They all have ‘best by’ dates of 2017. It does not claim the stuff is irradiated but it seems to keep forever.
I went for our music at a nursing home, but got confused, and first went to the wrong one (where I had spent so much time in 2010). When I got there and didn’t see a familiar truck of one of our guitar players who ALWAYS arrives early, I rethought it, and realized I was supposed to be at Royal Vista this week, instead. If this were a big city I might have been 20 miles off track. In EBRG, not so much. So, I fast retraced 2.5 miles NE and made it in time to help organize. We had a nice turnout with Gerald, Charlie, Jeanne, Maury, Bob, Nancy, Ellen, Manord, and Minerva.
I rushed out to get to a meeting starting at 3:00 p.m. at CWU I was invited to, happening in the old class (Intermediate GIS), I taught from 1988 until 2009, for a presentation by two former students. It went until after 5:00, when we went upstairs for pizza and pop (a total surprise for me). After we ate, we shared stories about students’ career plans. It was very interesting, and I believe helpful for everyone participating. The department head even joined us. One of my former students did most of the classroom presentation, but the other did a nice job leading the discussion about the students’ future plans. I did not get to my car to come home until 6:43, but I had taken my violin inside with me so it did not get too cold. Stringed instruments are temperamental things in temperature changing situations.
Friday, Feb 6
CPAP report. Reported figures. 7 hrs 50 min with AHI = 0.51
Events: 4 h No major mask leaks (max=8 L/min)
I had to go to my neighbor’s with my oximeter to check her pulse and O2 blood saturation level. Her son went too, and we helped for an hour taking blood pressure with two different units and the oximeter, and manually. We were concerned with her high pulse rate. Finally, we left when we found she had not taken her Digoxin (that lowers it), but later in the afternoon, he checked on her, and she was not in good shape, so he took her to ER, where they found pneumonia and dehydration. She’s doing better on Saturday.
John fixed a chef’s delight today. He made a special grilled sandwich of bacon, egg, cheese, and mushrooms. Really tasty, and different.
In mid-morning John started a beef-roast with tomatoes, red onions and several spices. Then late in the afternoon he added carrots, celery, and mushrooms. This was done in the oven. We had some of the whole-wheat crescent rolls, sprinkled with grated Parmesan, and then broiled. It was probably the best beef “stew” I have had in my life.
The west side of WA has had lots of rain with some flooding and related problems. Soil gets saturated with water, winds come up, trees and power lines go down. The flooded houses this week are on a low spot next to the Duckabush River. Here is the spot using Google Earth if you want to see where: 47.652493, -122.937434
Who couldn’t see that coming?
Saturday, Feb 7
CPAP report. Reported figures. 7 hrs 21 min with AHI = 0.41
EVENTS: 3H No major mask leaks (max=7 L/min)
Today was filled with watching the weather change from sunshine to rain and back again several times. John would go out during the sunshine to prune the very long-thorned blackberry plants he’s been working on, off and on. Today he finished. Now he has a small patch of yellow raspberries to do.
I spent the day mostly on the blog, but also on some paperwork I’ve skipped over the past week. John brought me the mail today with more to do, and I haven’t even gone through mail arriving earlier this week.
Hope your week was fine.
Nancy and John
Still on the Naneum Fan