Fighting Genetics

So I like to say that one of my goals in life is to fight genetics.  Clearly I lost that battle on the eye front.  Thanks Dad for the detached retina.  But fortunately modern medicine was able to correct that problem for me.

Throughout my life I have had an obsession with my blood pressure and my heart health.  Heart disease has been a recurring theme in my family history.  I remember my mother having blood pressure issues from a relatively young age and I became determined that I would not have a similar fate.  I can’t say I’ve done anything in particular but decide that I will not have blood pressure issues and have monitored it over the years.  My blood pressure definitely gets high now but it is not consistent and so far no doctor has seemed concerned about it.

Now in reality I am an actuary’s dream or so I was told when I was in my 20’s.  My grandmothers lived to be 94 and 96.  My father lived to be 84.  Even my great great grandfather who was born in 1838 lived to be 84.  Pretty impressive for that time period.  Those genetics I would like to have and even improve upon.  My husband has a goal to live to be 115.  That really isn’t out of reach in this age of modern medicine and health. Add to that the idea that each generation lives longer than the previous.  My father lived 15 years longer than his father.  That’s a pretty good increase. I have always assumed I would have a nice healthy long life so I’m not sure why I have been so obsessed with my cardiovascular health.  I don’t think any of my ancestors were and they did ok.  I guess I just want to be sure that I take control and have some positive effect on my future if that is possible.  I am afraid of dementia.  I saw my grandmother and father deal with this in later years and so far dad’s genes seem fairly strong.

So why I am rambling on about this genetics thing?  My mother was diagnosed with a lot of heart issues a couple of years ago.  I was at my PA’s office for some sort of routine check up and discussing my concerns about heart health with her.  In women there is apparently a stronger possibility of heart disease when it exists on your maternal side.  I told her that I had done a good job so far of avoiding high blood pressure and high cholesterol and I intended to continue along that path.  She told me “you can’t fight genetics.”  That is when I decided to make it my life’s mission to do exactly that (but I still want the longevity!).

So my husband and I are preparing to hike the Inca Trail and I am turning 50 this year.  For some reason these two events combined with my family’s heart health history has caused a little concern for my health in some of my family members.  It seemed reasonable that I should go have a check up and blood work.  I found a new doctor’s office since my former physician’s assistant is no longer practicing in town and managed to end up with a very thorough nurse practitioner.  She did a full physical with labs and an EKG.  Everything looked great.  My cholesterol was mildly elevated but nothing that needed medication. It was pointed out that most people get a cardiology evaluation sometime in their fifties and with my family history and upcoming trip it just made sense to go ahead and get it done.  So being an obedient little patient off I went to see my mother’s cardiologist for screening, certain this was just to appease my family.

The cardiologist’s office seemed to question why I was there.  I explained it was due to my family history and the fact that I would soon be hiking at close to 14,000 feet.  So another EKG was done and an exam and I was pronounced healthy but just to be complete we should do a stress test and echo.  Well I expected that.  I left with follow up appointments and my biggest concern being that I had three months to work on my cholesterol as I will be having a very detailed panel done in a few months that breaks cholesterol down into smaller parts and may burst my bubble that I may not be as healthy as I think I am.

I was nervous about the stress test because I am not a runner and I don’t like treadmills.  I was assured I could stop at any time if my shins or back started to hurt so I thought ok this won’t be so bad.  And honestly the test was a breeze.  My technicians were talking to me the whole time and telling me I was above average.  We even decided to have a little fun seeing just how far I could go as they told me I had already reached a diagnostic test much earlier.  I left feeling like a cardiac lab super star.  I’ll see everybody next week, I proclaimed as I left more than ready from my echocardiogram the following week. I was quite surprised to get a phone call from the doctor the day before my echo.  I hadn’t planned to hear anything until after that test. I was at work surrounded by noise and distractions and with a less than stellar cell phone reception when I answered the call.  It became evident that I should sit down.  So yes, something did show up at the end of my stress test.  My first concern was for my upcoming trip to Peru.  Then the idea of having heart surgery hit me.  I was so surprised that I couldn’t even think about the questions I should be asking but that was ok because the doctor said she would be calling the next day after she read my echo so I could ask those questions then.  What I did know is that my heart had thrown some “weird” beats at the end of the stress test on cool down and she had consulted with an electro physiologist.  It appeared my heart might have an electrical bypass is how she described it.  It is easily treated with a heart catheterization and they just close the bypass.  Ok.  Wow I have to have heart surgery and I’m only 49.  That is what I took from this call.  I think she just told me I will have to have an ablation.  My mother had an ablation and it took a while to recover from.  Oh no, we may not get to go on our trip that we have been training so hard for.  Why can’t we catch a break in the medical department? And why do I have to be such an overachiever.  I was much younger than my dad was when my retina detached and now I’m beating my mother on the heart surgery front.

The next morning I headed in for my echocardiogram.  I was nowhere close to as happy and confident as I had been the week before.  On this day my blood pressure was an amazingly beautiful 120/80 as I waited for my turn on the table.  I spent the rest of the day anxiously waiting for my call from the doctor armed with my now coherent questions.  Of course no call came.  I called the office the next morning asking for results from my test and begging to have two questions answered.  Because of course I had by now spent time on the internet and decided this bypass must be due to Wolff Parkinson White syndrome.   Quick Google search defines WPW this way – “The extra electrical pathway in Wolff-Parkinson-White syndrome appears between the heart’s upper and lower chambers and is present at birth.

Symptoms most often appear between the ages of 11 and 50 and include a rapid pounding heartbeat, dizziness, and lightheadedness.”

We were going into a holiday weekend and my anxiety had kicked into high gear so I really needed to hear that my echo was good.  Of course the doctor was out of the office and the nurse couldn’t answer my questions so I began a long weekend of anxiety.

Since my retinal detachment on February 1, 2013 it seems my family has had more than its fair share of medical problems.  Thursday is my day off and it is a rare Thursday that does not have one or more doctor appointments scheduled.  I was starting to see some weeks free of those dreaded appointments though and was hoping we were nearing the end of health issues for a while.  One daughter had hip surgery in March and we actually had some success.  We knew we would have a break until she has the other hip done next year.  Unfortunately my other daughter has recently been diagnosed with an autoimmune disease so we get to meet a new specialist next month for her to find out what we are actually dealing with but we thought maybe it would explain so many other issues she has had the last couple of years.  Then on that Friday my husband told me that he needed an abdominal ultrasound done due to some findings on routine blood tests .  Well now anxiety just skyrocketed.  Jeff and I made a lot of jokes over the weekend but it was clear we were both worried.  I just couldn’t enjoy shopping for our trip because I still didn’t believe I would get to do the hike.

I was a good patient on Tuesday and didn’t call the doctor’s office the day after a holiday still hoping I would hear from her.  On Wednesday I called and left a message begging for a call back and the ability to get my referral made.  I did receive a call from the new doctor’s office with an appointment time for the following Monday.  Ok, at least now I knew I would have answers soon.

Finally a week after my echo my doctor called me.  Good news, my echo was perfectly normal.  I was able to ask my questions.  She assured me this “condition” might not be a problem.  She would not confirm Wolff Parkinson White syndrome but said it would be similar to that and that there are hundreds of possible electrical bypasses that exist in the heart. The specialist she was sending me to sees these conditions as routine and will be able to take care of it easily. She told me it was nothing short of a miracle that he agreed to see me so quickly since it usually takes months to get an appointment with this type of specialist.

I arrived at the new doctor’s office prepared to have my questions answered.  I felt like they were asking me why I was there more often than they should.  Another EKG and then I met the doctor.  He told me that I had been sent because of an arrhythmia that showed up on my stress test.  He said it is quite possible that this is a normal arrhythmia.  Apparently lots of people throw irregular heartbeats that don’t require any treatment.  His attitude left me feeling this is what he expects to be the case for me.  What is this arrhythmia, I asked.  Is it WPW?  Well that is what we need to find out he told me.  If it is WPW we need to treat it.  Treatment is an ablation.  Of course here is my question – will I still be able to hike the Inca Trail in September?  He seemed surprised that I would think I wouldn’t recover in that time.  We have six or seven weeks, that is plenty of time to recover.  But it would keep me from training for 4 to 5 days. I had to admit to him that the heat and humidity was keeping me from training now.  I was so confused because my mom was told she would have a three to six month recovery from her ablation.  I was quickly led to understand that my heart is in far better shape than hers was.  I was surprised that I would not be fitted with a holter monitor but would go straight to an electrophysiological study.  So no matter what I get to have a heart catheterization done.  Recovery will be the same with or without the ablation.

So there is lots of good news.  My husband’s test came back ok.  If I have WPW I’ve had it my whole life and it’s curable.  I think I may be more nervous if I don’t have WPW.  I mean on the one hand it means I have a normal heart but on the other it means I had to have a surgery I didn’t need and why do I throw weird beats?  Now am I going to worry about that?  But either way I am still planning a long healthy life choosing to fight genetics when needed to enhance the good parts.  After all I have a lot of good genetics to embrace.  And I still get to hike the Inca Trail in a few weeks!  Talk about the wonders of modern medicine.  Who would have thought that you could have surgery on your heart and then be hiking at almost 14,000 feet a mere six weeks later?  Let’s get this thing done.  I’m ready to buy sleeping bag liners!