The Road To Transplant


Long Term Side Effects No Longer Matter -  That’s what my cardiologist told Denise and I today when we went to see him, because my heart failure has seemingly worsened. Last week, I was hard hit with right-sided heart failure symptoms. My abdomen was distended and clearly retaining fluid, my skin color was a pale shade of grey, and my diaphragm was working against me, which made breathing difficult.

The doctor contributes the problem to a couple things. Foremost, I have a messed up heart. I wish I could sugarcoat this, folks, but sometimes blunt and to the point is the best way. I have the biventricular pacemaker and defibrillator, and they work beautifully. They’ve brought my heart’s EF—Ejection Fraction—up to about 20%. However, I am still producing too many PVC— Premature Ventricular Contractions—which would be best explained if you think of them as out of step heartbeats that always come too soon. They come one at a time, two at a time, and in runs of three or more. Having PVC limits the effectiveness of the pacemaker; each time I have a PVC, my pacemaker gets confused. Too many signals are coming to my heart, and consequently, nothing moves, not even my blood. If the pacemaker is to be therapeutic, that’s to say ‘effective,’ it must work at least 92% of the time.

My pacemaker is working at about an 80% effectiveness rate. That is not good enough to sustain my life. The doctors think if they can control the PVC, they can increase the effectiveness of the pacemaker, thereby reducing the frequency of my heart failure.

Do you remember in my original memoir, when I discussed the drug called amiodarone? It’s a generic of the drug Nexterone, which I have been offered several times through the years and always dismissed. I dismissed it because the long-term side effects are liver damage, eye damage, skin problems, and kidney failure, to name a few. When the doctor told Denise and I that they want to add amiodarone, I brought up the side effects issue.

He said, “Brian, you are in end-stage heart failure. You are not likely to live five more years. We have a drug we think might make you more comfortable, for now. We are past the point of worrying about long-term side effects. Brian, Denise…do you understand? You will not be alive long enough to worry about long-term side effects.”

As my wife sat there…stunned, I agreed with the doctor.

Road at Sunset

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