Monthly Archives: October 2016

Echocardiogram Images 

I thought it would be cool to share my final echocardiogram results from my recent hospital stay. I took some video of the echo screen. My cardiologist points out the clot, which is small enough here to allow me to be discharged.

Also, notice my mechanical aortic valve shape. My doctor points to it in the 2nd video. It is near the middle of the screen. It is a circle, with a straight line that goes from its 12 o’clock to its 6 o’clock. That line will appear and disappear, which are the bi-leaflets closing. Use the picture of a St. Jude’s mechanical valve below to help identify it in the echo. regent-2

 

 

In screen shot below, I have circled the clot.  It appears as a little white smudge. It was larger when it was first detected last Friday. Try to look for that little smudge in the videos above.

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Discharged 

I’m being discharged! The events of today went as follows:

1. Blood work, including INR test. Result: 2.4

2. Cardiologist came in and discussed Coumadin and issues involving it. 

3. My primary cardiologist performed an echocardiogram, discovered that the clot is much smaller than Friday, and discharged me. He felt that even though I’m having trouble getting my INR up to 3.0, that I’m on the right track and I can finish getting to my new range at home. My new INR range is 3.0-3.5

Going home!

Just keep thinning

This is my third night after being admitted for non-obstructive prosthetic valve thrombosis. It has been emotional and frankly pretty scary. Each day I wait as my INR is being raised. While that is happening, heparin, a different anticoagulant is constantly dripping intravenously. 

My girlfriend Michelle has been by my side, and I truly would be lost without her. We are of course looking forward to my INR raising soon, and keeping it above 3.0 consistently. 

The next step, is hoping that the clot is naturally absorbed by the bloodstream. I’m not sure whether or not my Doctor will be checking via echocardiogram for the presence of these clots in the near future. I’ll be asking that question tomorrow. 

If you are reading this, and also find yourself in a similar situation, or you’re concerned about it because you also have a prosthetic valve, I found the following study to be very informative:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1861363/#!po=19.1667

narcopiggy says, “make blood thin!”

Clot

On Wednesday October 12, while driving to work, the vision in my left eye slowly began to black out. It seemed as though dark clouds were forming around the center of my view. I pulled over and within 3 minutes of when it started, my vision was almost all gone in that eye, with a small pinhole in the center. Then, it started to get better and in a total of 5 minutes, my vision was completely back.
After consulting my nurse friends, I excused myself from work and drove myself to the ER, which was absolutely useless. Loma Linda ER is a trauma center, and during the 13 hours I spent there, it took 8 hours to get a bed, 10 hours to see a doctor, and the only tests they did was blood tests and an eye exam. They did not feel that it was necessary to look at my heart. This is the 2nd time in my life that the Loma Linda University Emergency Room overlooked my condition. The first time was back in 2014 when they were unable to notice that my newly implanted valve was infected and falling off. This time, if they were able to simply perform an echo on me, then they would have noticed what is going on currently.

Today I went in for an echocardiogram with my cardiologist. I was an emotional wreck. My biggest fear was that I had endocarditis again. It turns out that I have some tiny fibrous blood clots on my mechanical aortic valve. One of these tiny clots dislodged and briefly clogged the blood flow to my eye. The condition is called Amaurosis Fugax.
My anticoagulation therapy is Coumadin. Without the Coumadin, clots form on the rigid edges of my mechanical valve. My INR (how ‘thin’ my blood is) was supposed to be between 2.0-2.5. A normal person who isn’t on anticoagulation therapy will have an INR of 1.0. The day of my episode, my INR was 1.8. This means that clots were more likely to form. I missed a dose of Coumadin on Monday, which means my INR was probably below 1.8 then. These clots could have formed then. There’s no way to know though.

Endocarditis can cause Amaurosis Fugax, as can blood clots. Luckily, the clots are very tiny. Even if the clots that are currently in my heart were to dislodge, they would not cause serious damage, such as a stroke. The goal is to keep them from getting larger.

I was just admitted to the cardiac unit at the hospital. I will stay here for a few days to be given heparin while my Coumadin dose is increased. Heparin will keep the clots from getting larger and stop new clots from forming. My INR will be increased to 3.0 and I will now try to maintain that level at home from now on.

They are doing a blood culture to be 100% certain that it’s not an infection again (Endocarditis). They said that bacterial vegetations don’t normally form on the valve leaflets like how it appears in my echo, but since I’m here, and because of my history of endocarditis, they want to be sure. At this point I’m not worried.

I will hopefully be discharged this weekend. I am super disappointed that I will be missing two amazing concerts that I was planning on going to this weekend. As my friend told me,

“There’s a lot of magical stuff goin on in the world. Concerts and Music festivals are like condensed reminders of the beauty, engagement, and interconnectedness that is possible for humanity.”

Check them out the artists that I was going to see this weekend below:

How To Dress Well and Moses Sumney.