Three Months from OHS and One Month of Praluent

All the things I have to watch now ... The good things:
 
I met with my cardiologist yesterday, for a 3 month post-op and for going over my latest blood tests and echo. I'll try to summarize the whole visit. There were some good things and some ... so-and-so things. And here they are:
- well, I am alive, right? That's the best one; :-)
- he thinks I am doing well, and gaining strength and looking good (but we all know we don't always look how we feel, right?!);
- the cholesterol (the only culprit for ALL my heart problems, as far as we know) is going down fast as a result of Praluent,  but it's not where he wanted to see it after a month of treatment; (more below)
- according to the surgeon, and the cardiologist agrees now, there is no scare about a repeat surgery: my valve is leaking, but that leakage is normal and not too heavy (he qualified it as "mild" and both the surgeon and the cardiologist agree that it should not get any worse, given the nature of my artificial valve;
- the left atrium is "borderline" enlarged, by some people, but not by most books/ guidelines. He is not worried about it at all.
- my systolic (first number) pressure is back to normal, or even slightly high - it's way better than 100, at 120-130. This is why I am no longer dizzy;
- I can start working this coming week, but at a limited schedule (4 hour days), not full time, for a month maybe two;
- (not sure if this is a good thing, but it is for me, so I am listing this here :-)): he gave me a handicap sticker for the car. I cannot carry any weight, still, so I bought a dolly for my huge purse, computer bag, lunch bag. I can park in designated spots at work and roll my dolly in the office a short distance, rather than having to trek across 2-3 parking lots (since I go in later all the close spots will be taken) with 15-20 lbs of stuff. 

The borderline good/ so-and-so thing - not sure where to list it:
- my INR tanked yet again. I swear, I try, but there is no getting this right yet. It dropped from 2.4 (which was in range) to 1.8. However, after 3 months from surgery, which is where I am now, the new range for the On-X valve is 1.5 to 2. So, I am luckily in (the new) range, although out of the one that was acceptable before yesterday. So, they didn't adjust the dose this time. Will check back in 10 days to see if it holds. 

The so-and-so things:
- he is not happy that the cholesterol is not at normal values; he said he always sees the numbers in the normal range after treatment with just 2 shots (this is one month of treatment), which is what I have done so far. Mine are significantly lower then before the Praluent (below), but he was hoping it'd be more around 170, instead of 230; so, he doubled up the dose from 75 mg/ every 2 weeks to 150 mg/ every 2 weeks; so far, I have tolerated the Praluent well - liver tests are within normal ranges, and I have no visible side effects. I hope nothing bad is hiding in the shadows of this, though. All I have is hope for this, as there is limited research so far.

 

These are the numbers in: March (before I started Praluent), through April, after one dose, and then after 2 doses, just this week (May). Notice the increase in the HDL and the drop in the ratio

 
- my diastolic (the second blood pressure number) pressure is still very low - it was 40 yesterday. He has no explanation for it, and he is worried about it. The only thing he can do at this point is watch it and I must take is SLOW. No running, no heavy lifting, no stress, just don't overwork the heart. I need to exercise, but slowly, without rushing the heart. He will meet with the surgeon again about this and try to figure out what other cause can it be. He said leaky valves bring the diastolic down, but not this much down. It could all be just part of the healing process after OHS and heart attack, and it will bounce back up, but we'll see in time. For now, he is mystified.
- my pulse is very high, even at rest, so he increased the beta blocker some more, only slightly, by 12.5 mg/ day. He can't do more than this because he is afraid it will also bring down the diastolic, which is already too low. 

So, all in all a good, informative visit, and I am so lucky and excited that I get to go back to work, even part time (4 hour days for at least a month, maybe two). I hope it will all go well and I'll feel good doing this. 

This week (my last week off), I tried to do a little more each day, and I took a couple of day trips around our area. I felt OK, but extremely tired when I got back. I also had a day of rest in between the trip days. My chest gets very sore and stiff in the car, so with a 30-45 minute commute (one way), we'll see ... 

For now, I am still, three months later, trying to find my new normal. Between checking blood pressure and pulse every day, watching the atenolol daily, and coumadin weekly, and feeling literally different every single day, I can say I am pretty busy. And life and now work has to fit in there somewhere. Easy does it, I guess. We'll keep plugging in and hoping for the best while learning this body of mine once more, once anew. 

Much health to everyone and a good Sunday and week!