A drs demeanor has a huge impact on the patient. The reason why I am relating from the beginning instead of jumping directly onto serious news.
These are the finer details some drs do not consider when handling a patient. Lol I don’t mean to sound like some kind of a boss.. My intention is to highlight the effect of a drs mannerisms on a patient.
I was accustomed to being examined hurriedly with my concerns not being addressed.
[ MAY 2017 ]
This time it was a different experience! Dad & I walked into the practice, filled in forms.. Had the first necessary EKG done, then sat awaiting drs arrival.
Dr walks in at his own stride.. calmly.. takes his seat. Calls us in.
“Hi Muhammad! Is that you?”
He asks dad. Takes off his spectacles & places it onto the table. Pushes his chair back & relaxes. The pair then have a long hearty chat regarding school, studies friends, work, retirement, families etc.
Taken aback.. i listened immediately feeling relaxed. Taking things slow, he is going to give me undivided attention, I knew for sure.
After catching up on each other’s lives, he pushes his chair front, spectacles back on & reads carefully through the concerns I wrote down including the results of the Esteck screening scan. Attaching a brief medical history as well.
To double check, he goes through everything, asking many questions, clarifying, noting down all the information.
**This is where experience comes in**
“Im quite sure of what I’m going to find, if it will be fine to say I know exactly what I’m going to find”
“Let’s get you into the echocardiogram room & see…”
Dr says.
Explaining each part as we go through the Echo.
There are 4 valves in the heart.. These valves facilitate a one way blood flow.
✅ Pulmonic valve fine.
✅ Tricuspid valve fine.
✅ Aortic valve fine.
“There’s it!!!”
❌ Mitral valve – is prolapsed ⚠
I will try to make this explanation simple as possible. As they say ; you know you’re chronically ill when you have to come up with summarized versions of your illness 😂 lol.
The Mitral valve is situated in the upper chamber – left side of the heart. It is a valve which has 2 leaflets – posterior & anterior that opens & closes like a smile.
Usually after incoming blood flows through, it shuts allowing the blood to flow one way out.
When it is prolapsed, the valve does not shut fully – leaving a gap – permitting a 2 way flow of blood. Blood backwashes (regurgitates) through the valve.
Amount depends on the severity of the prolapse. This can reduce the hearts pumping power & over a period time, cause disastrous consequences. When backflow is severe it causes a volume overload resulting in left sided heart failure.
This is abbreviated as MVPS (Mitral Valve Prolapse Syndrome)
MVPS is usually A-symptometic. Meaning a person does not experience symptoms. However, each case varies. symptoms also depend according to intensity of the prolapse.
Mild – no medications are prescribed, a routine echo is conducted.
Moderate – Medications are prescribed to manage symptoms.
Severe – Valve repair or replacement is required. Successful most of the time, again reports vary.
On an echocardiogram this is 1 part of how it looks…
Some experience no symptoms & others experience a host of symptoms.
Some experience symptoms only under pressure or stress & others experience it any time. Circumstances are not a trigger for us. Rather stressful circumstances intensify symptoms normally experienced daily.
There are many causes of MVPS – genetics play a role in some cases, Ehlers-Danlos Syndrome & a list of factors.
If lack of excercise is the cause, the valve will last a lifetime if symptoms are mild / moderate & lifestyle changes are made.
Some cardiologists do not understand the causes too well because their speciality involves the heart alone. I had one who told me my heart is weakening because I’m not excercising. Whereas I excercised almost every single day of my life until I fell ill.
My day began walking, jogging etc etc. If not, I’d feel a bit sluggish.
Some with Dysautonomia still manage to excercise & play certain types of sports managing symptoms with specific treatment plans. For some, treatment plans work well & for others most fails.
One disease, individual cases differ. Those for whom treatment works are really fortunate.
If one has a heart that’s already going into failure, excercise intolerance is a symptom. I tried light weight excercises which were shown to me by a very good physiotherapist specializing in neuro muscular conditions, however it only worsened matters. Gyming will not strengthen the heart if the cause is Dysautonomia.
Now, the Mitral Valve & the function of the coronary arteries are under the control of the autonomic nervous system. In my case the cause of MVP is obviously Dysautonomia.
There are 3 coronary arteries in the heart. 2-3 mm in length the size of a spaghetti. MVP can trigger these arteries causing them to spasm the width of a cotton string.
There is muscle in the walls of these arteries which shut down the arteries creating vasovagal constriction.
The vasovagal constriction in turn creates back pressure onto the lungs causing a suffocated, tightness, restricted & claustrophobic feeling. These are the symptoms of moderate constriction.
Severe constriction causes chest pain. I feel the pain shooting through spot on the MV location (area around circled above) dr showed me.
Each time a person experiences chest pain, does not mean it’s a heart attack & that one should rush to the ER. However from my personal experiences I caution saying;
The severity of chest pain occuring with other symptoms need to be monitored because coronary artery spasms (referred to as angina pain) can result in either of 4 serious results:
1) Heart arrythmias.
2) Heart attacks.. To be posted in upcoming ones.
3) Cardiac arrest.
4) Death.
Nitrolingual spray was prescribed. It is a spray used as a backup to dilate the arteries. Ordered to keep with me on hand wherever I am, in the event of emergency case’s when breathing is stopped. But it causes horrendous dizziness & headaches / migraines as well.
There is a difference between plaque in the arteries & artery spasms. Some suggested I take the famous artery unblock mixture.. Suggestion much appreciated but mine’s is not a problem of plaque.
Symptom management
Beta-blockers slow down heart rate but could not be prescribed due to low blood pressure issue, so a calcium channel blocker called Diltiazem was prescribed daily to lessen constriction & prevent irregular heart rhythms. This did not work either.
After searching for another option, my pharmacist found a capsule that works wonders in keeping the heart rhythm stable, decreases constriction & assists the heart in pumping a bit stronger for me to manage basic, daily activities.
Three weeks ago I missed 2 days waiting for a new bottle to come & ended up…… Almost dead I thought. That day was terrifying but 2 very good people came to my rescue immediately.
Thank you very much Aunty Zarina & Yumnaa.
You were a means of saving my life 💖💙💝
My heart’s pumping & contracting power is completely dependent on the Tasly Danshen Plus Capsule.
Those few hours were a tug of life & death. Each moment intensifying.
Normal rhythm vanished, my heart struggled, pulse rate accelerated causing severe angina spasms & constriction. Breathing became heavier, infact breathlessness took over to such an extent – at full rest I could NOT utter 1 word.
I sat on the couch… Huffing, puffing & panting.
“Hhhhhhh hhhhhhh hhhhhhh hhhhhhhhhhh”
Became disorientated, unable to focus & about to fall unconscious.
The capsule has an immediate effect so once taken, instantly I felt my symptoms being relieved & gradually my heart felt more at ease & happier. Although, it took about 6 days to resume back to it’s “normal” level.
More information regarding the medicine in chapter
https://kayborninmay.wordpress.com/2019/04/01/136-my-daily-pharmacy/
While conducting the echo..
Dr presses the button for us to hear..
The sounds play loud..
I stare & listen in fascination.
Blood flows – in, “click“, out. In, “click“, out. In, “click click”, out. In, “click”, out. In, “click click….” Continouing in such a fashion.
*Pointing onto the screen – see that line*
“That is where the blood flows backwards creating clicking sounds (mitral regurgitation)”
Dr says.
I see the blood escaping with my own 2 eyes lol… WOW!!! It’s a different feeling seeing & hearing your heart pump on that echo, apart from seeing the tracings of an EKG.
Swish, swish, swish
Swirl, swirl, swirl
There we have positive proof of the blood escaping! It’s not in your mind! I never believed so.
The heart muscle is already on the onset of failure beginning to develop more muscle mass, pumping stronger & faster, Initially.
This fails later.
Parents were shocked, faith held them together.. But inside I saw the pieces crumbling.
Siblings & close friends.. Who’s worlds fell apart..
Hey mahn! No one died. I am here, very much alive, now be happy & smile. I told them.
A tongue can lie but the eyes reveal deepest truths.
Concerns mirrored itself through their eyes. I read a story of worry & fear.
What does the future hold?
Strong faith.
Hope.
Trust.
Reliance.
Do not worry about what lies ahead, today is your present. Cherish it. Grab hold of it. Your Lord knows what he is doing. He never errs or falters! Trust in this planning.
I coached myself.
“Are you sure he said its MVP?
“Wheres the report?”
“Mmm.. Ok. As far as I know MVPS is A-symptomatic”
I read the report but I wonder… We must verify.”
Stated all the young drs I came across. No exegeration. Many doubted me.
The reason I continue to reiterate & emphasize – please consult with experienced drs if you’re dealing with a rare case. The older the better. No offence intended to anyone. My current neurologist is middle aged but his knowledge in the electro-physiological field is vast!!!
Very few young ones, infact none have an understanding of MVPs connection to Autonomic dysfunction. Most are baffled beyond words.
Normal explanations regarding it are found anywhere on the internet. However, the part where dr digressed at great length regarding MVP’s connection to the arteries & how 1 affects another…. Is an explanation I haven’t read on the internet.
When it comes to Dysautonomia, kindly remember:
There is far more involved here than “just” the prolapse of a Mitral Valve. More cases of people whos MVP was thought a condition of its own alone, in reality Dysautonomia was discovered to be the root culprit.
To read further regarding MVP kindly click the link. https://www.mayoclinic.org/diseases-conditions/mitral-valve-prolapse/symptoms-causes/syc-20355446
To read further regarding Coronary Artery Spasms, kindly click the link. https://www.healthline.com/health/coronary-artery-spasm
Watching a few videos provide a full understanding.. Many more can be found on YouTube. This is a basic one. Mitral Valve Prolapse and Regurgitation, Animation: http://youtu.be/Q84DwBABbY0
This time I felt waves of relieve wash over to receive answers, but of course a definite shock..
Somehow seeing the results create a bigger shock than only hearing & I guess that’s the reason why, hearing the Esteck screening did not affect me as the echocardiogram itself.
How can we be glad to receive proof of my illnesses?
Why would we be glad to know something is wrong?
Sounds quite insane??
Nahh…
I choose faith, hope & move ahead to overcome higher tides setting in.
This was only the beginning……
Allah sent us with your meds that day & Allah will send u a cure too, inshallah soon😘
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Aameen!!!! 😊😊😘 You & mum will definitely be rewarded abundantly for all the help.
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