Tuesday, September 19, 2023

Katharine's HCM Advances, Adds New Drugs

 Katharine saw the cardiologist 9/13/23 and her heart has increased in left atrial from 1.50 September 2022 to 1.76 a year later. If it continues to progress, she'll be at 2 or over 2 by April, and more potential issues might develop. For comparison, Myrna in her first year had a left atrial of 1.83, then 1.69 after a few weeks using COQ10 (see later paragraphs.) It would decrease again to 1.52 the next year and remain low until the disease took over in 2013 (almost four years into the disease) and the left atrial increased to 2.12. At this point, she began to develop a series of serious issues. In 2013 she had a heart attack; in 2014-15 she had increased serious CHF issues. And then she died in 2015 (I can't find what size was her left atrium in order to compare to Katharine but it was 2.20-2.30.)

She had two cases of possible CHF this summer after major storms-late July and late August. I had given her small doses of diuretics which worked almost immediately although she needed two more doses in August. With the heart size increasing, more CHF might occur if I do not stay on top of it and fight it immediately with furosemide (lasix.) She may need a daily dose to ward off CHF. I will continue to monitor and discuss it later with the cardiologist if more CHF occurs.

The cardiologist put her on Plavix-1/4 once a day; and an ACE inhibitor Benazepril-1/4 BID. She is also on Atenolol 1/4 once a day.

Myrna was on Enalapril for an ACE inhibitor. I don't know why Katharine is not. The cardiologist said something about it has a different approach given Katharine's early issues. ACE inhibitors stop the ACE process-the angiotesin converting enzyme-which shuts down the bodies' veins, constricts veins in the case of a heart attack or accident that causes the body to lose blood. When you inhibit the ACE process, you allow veins to be wide opened and fully functioning. This helps lower blood pressure, and increases the flow of oxygen to the blood and therefore to the heart. The ACE process also increases SALT so by stopping the ACE process using an inhibitor, the body's ability to retain salt is reduced, thereby lowering fluid due to less salt, and therefore reducing blood pressure.

I also bought from CHEWY, a bottle of Rx Vitamins 30# COQ10, a supplement that we used with Myrna that improved her heart condition for a few years. Each capsule has 30mg. With Myrna, I'm not sure pet formula COQ10 existed because I bought Nature Made and squirted each capsule into her food. She received 200mg per day. Then later, I put it into the goop mixture I devised of this and other supplements and vitamins to improve her kidney function when the amount of diuretics increased and the load on her kidneys was too much, and her kidney values declined. This pet specific COQ10 is small enough that she can swallow it. I will give it to her daily. It's a lesser amount that what Myrna was taking but then Myrna's heart was far worse at 8 months old than Katharine at 14 years old. 

So, if Katharine's heart is nearing 2.0 this next year, and Myrna had severe issues at 2.12, we must work hard to try to improve Katharine's heart function, keep her overall health stable, and monitor closely for CHF; and be aware that there is a chance we might lose her in the next two years. Given her age at 14 and a half, she has lived a long life and we have had her a very long time. I'm grateful that her other health issues-seizures, IBD-are under control and hopefully remain so. That leaves me time to concentrate on taking care of her heart. But I refuse to make any concessions, to give in the inevitable, and to treat her condition as a given. And I refuse to give up. I cannot plan for how I want her life to end or when. But I will help her fight; I will help her body stay strong in order to fight. 

Please read more at the blog's tabs: Myrna's Story, Meds, About HCM; and do a word and category search for further information.


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