Hi all. We had a routine follow-up appt. with hubby's cardiologist today (bad heart attack with damage and 5 bypass surgery 8 years ago). He had a stress cardiolite treadmill earlier in the week. There were no changes that would indicate new blockages - but his ejection fraction (EF - measure of heart's pumping efficiency) had reduced from 45 to 28 since last year. 28 is pretty low (heart transplants are sometimes needed when the reading is in the teens; 60 to 65 would be a normal EF for his age). So the cardiologist did an echo cardiogram to see if that was consistent with the EF obtained from the other test; we'll get that result on Monday or Tuesday. It it is, then he will recommend a cardiac catherization. We can decide we want a catherization procedure even if the EF isn't down on the echo - if we want to be extra cautious (my inclination!).
How this relates to this board...
We told him about the confusion episodes, memory problems, etc. and the battery of tests that seem to have ruled out AD. I asked if it could be TIA's. He said it was possible - but he is inclined to think the adult onset seizure disorder is more likely. He doesn't seem to think the memory/confusion is related to the heart problems.
For those who remember the neuropsych exam results recommending psychiatrist evaluation: that is not scheduled until June. Hubby is looking forward to some "good drugs" after that.
There haven't been too many memory/confusion episodes in the last month or so - so hopefully they are right and it is not AD. I still lurk and read posts and say prayers for you all. When we get the echo and/or cardiac catherization results, I'll let you know.
Thanks for the update - I was wondering too. What, exactly, is the adult onset seizure disorder - and what are the symptoms? Have you researched it and if so, where can I go to do so as well? Thanks for any info on this, it just may be what my hubby and FIL have as well. C
Glad to hear an update, too, and am very glad things seem to be pointing away from AD. That is such good news. I do hope your hubby's heart efficiency improves with medicine or exercise. I'd think a low cardiac output is bound to affect thinking.
Basically, it's adult onset epilepsy. His seizures are what they call "partial complex" - not a grand mal type of seizure that most people associate with epilepsy. You can do research on epilepsy and find a lot of info. The reason they think that is the problem is because in addition to the confusion/memory episodes, hubby also had some episodes that began with him smelling a strong smell (that wasn't there) and then were followed by agitation and feelings of disconnection, etc. They really don't know for sure because his brain wave was normal - but that is not uncommon if the person is not having a seizure concurrent with the test. They put him on anti-seizure meds kind of as a "trial" and because he hasn't had as many confusion episodes, we are guessing it is working... I can't remember what the neurologist said was probably the cause of the epilepsy. Apparently it can relate back to something that happened years ago and is somehow triggered in later years. He had a very serious motorcycle accident as a teen (knocked unconscious, etc.) - as well as years of alcohol abuse - and also the vascular arterial disease. I guess any or all could be related.
I am hoping hubby will decide to get the cardiac catherization regardless of the echo - to be on the super safe side. I just remember him passing his stress treadmills not that long before the heart attack that did all the damage. So I am not that relieved when a stress treadmill doesn't show anything... As his cardiologist said, he would be a pin cushion if we did a cath procedure with every chest pain (he has them all the time) - but I say - we've ignored them and NOT done a cath for 7 years now... I say it's about time to be extra cautious since bypasses often only last about 10 years. It's been 8 for hubby and his eating for most of those years was just as bad as before the heart attack. Anyway, I understand not wanting to overact to every chest pain - but I am really worried that his heart is worse (as the EF from the last test seems to show and as his weakness seems to show) - and I wouldn't be surprised if oxygen deprivation from poor heart function isn't also a part of his cognitive decline.
I guess it's really hard for docs when there are multiple health problems that may or may not inter-relate.
And yes, I thank God that his problems do not appear to be AD. I'm kind of sorry we had the genetic test that showed he does have the genetic markers for AD. That was done because of family history of AD. But, since this doesn't appear to be AD (and his father's was not developed until quite a few years older than hubby), he may be in that percent that have the markers but do not develop AD.
Thanks for your concern. I know these problems are NO COMPARISON to what you are dealing with. You really do have my prayers and sympathy for the losses you are facing while your loved ones are still alive but suffering from a horrible horrible disease. Hubby's father did have AD, but his heart gave out before he got bad. Anyway, you all are in my prayers.
The echo also showed a weakened heart muscle, so they will do a catherization on Thursday May 4th. I can't believe it - but I forgot to ask the cardiologist if he thought heart function problems could be the cause of confusion episodes and memory difficulties.
Don't be shy! Call the cardiologist's office, ask to speak to a nurse, tell the nurse a brief history and then ask your question so the nurse can answer from her experience or ask the doctor if you'd prefer that. They'll call you back with the answer or the doctor will call you. It's a reasonable question and deserves an answer. It seems likely to me that the weak heart muscle could contribute to poor circulation which could contribute to befuddled thinking. Maybe he'd benefit from some Oxygen?
Hubby had cardiac catherization procedure today. Surprisingly - and thankfully - there was basically no change since 99 - and this test did not show a significantly reduced (from last year) pumping efficiency like the others had. The 3 grafts (of 5) that were open in 99 are still open; 2 had failed previous to that. His ejection fraction is about 40 (60 or 65 would be normal). The main problem he found was some dehydration in his "pipes" and low BP. He is making medicine changes related to that. He does not think hubby's confusion is/was related to the heart. He did suggest following up with the neurologist to see if he can reduce some of the newer meds that were added after all his testing. The cardiologist feels they are contributing to his low BP - and that gives very little room for fluctuation without causing the weak/dizziness. Some of the readings during the test were like 86/44, 92/44, etc. So, I guess we'll find out if backing off the anti-seizure meds results in more confusion/fuzzy headed episodes. It will be trial and error with meds for awhile it seems. But thankfully, his heart is no more damaged than before and is basically "stable". And we'll just take the confusion stuff a step at a time if it gets any worse when the meds are adjusted.
On a different note... My dad and step mom came and sat with me while the procedure was being done. I found out that one of my aunts (late 50s or early 60s) is showing definite signs of AD. My grandma on his side had AD. And his older brother (mid 70s) has been diagnosed with "dementia". And my step mother said my dad (early 70s) is getting forgetful too but she thinks it's more from not listening. So I guess when we get together for a family reunion in late May, I may see some differences in my aunts/uncles. We haven't been together as a large group since my grandma died in 1996! I may be referring a few of them to this board for help.
That's my report for anyone who is interested. Thanks for all of your support.
Last edited by needtoescape; 05-04-2006 at 04:16 PM.