Nancy and I went to Yakima today for a visit with the cardiologist. He reviewed her history and records from the time she entered Yakima Regional Hospital with an on-going heart attack on the Friday morning after Thanksgiving. This was interesting – his view – but it was not new material. He reviewed all the medications and recent tests and suggested some adjustments and a substitution. He also made a referral to another doctor in the practice, this one is an implantable device specialist.
One med problem is that the desired action of Coumadin (Warfarin) as an anticoagulant isn’t being maintained with the 2.5 unit dose and creeps up with the 5 unit dose. Thus, until there is a 3 unit dose we are back to taking the larger dose about every third day.
He is recommending stopping the Lisinopril and substituting Telmisartan at its lowest dose. These meds are to help maintain blood pressure in an appropriate range and one advantage of the new med is that it lasts longer in the body than the other. Deciphering all the other differences of these types of drugs will involve more reading than I want to do tonight, so no more about them now.
The referral to the implantable device specialist is to get an opinion on whether or not one of the modern gadgets would work for Nancy in controlling heart functions. There may be benefits with some implanted device but there is also the problem of her reaction to heparin such that any procedure would be more problematic. That appointment (about 2 weeks off) has yet to be scheduled, so again, there is not much more to be said tonight.