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Saw Dr. Lever at Cleveland last week. After reviewing things with him and his nurse practitioner I set out on a day of testing. Xrays, EKG, Echo, Stess Echo, and interogation of my new ICD so the stress test didn't set it off. Interestingly they found that in the time I had it put in (one week) I had 2 episodes of nonsustatained v-tach. The ICD is set to monitor at 145 BPM, fire at 165 BPM, and again at 185 BPM. The v-tach got up to 160 BPM. I met with Dr. Lever after all the test result came back, he recommended no myectomy. My HCM is of the Apical variety with the lower half of my ventricular chamber obliterating (muscle banging into muscle with no lower chamber remaining)with each beat. He felt any surgery would be of minimal value at best since there is not obstruction per se. After seeing my echo tape and discussing in detail with Dr. Lever I am satisfied it is the correct course of action for me at this time, although I'm still not sure why I have a 59mm/Hg gradient. (Dr. Lever felt it was the way my previous tests were measuring it with the obliteration...does that make sense??) He was positive about the recent ICD implant and encouraged me to be active to the level I can tolerate. More walking, general exercise etc. no heavy lifting or strenuous activities, now that I have the safeguard of the ICD. He is changing my meds to a mix of verapamil (which I was already taking 600mg/day) and Toprol XL. He lowered the verapamil after raising his eyebrows at the daily dosage to 240mg/day and added the 50mg/day of Toprol. My wife felt the visit was well worth the journey. She learned more yet about HCM and gave her a sense of reassurance and comfort things are under control for now. Of course getting from Delaware to Cleveland was no small feat. For those of you not on the east coast it has been bitterly cold here, and LOTS of various forms of precipitation last week. We hit them all on the way. Sleet, freezing rain, snow etc. etc. Made for quite a journey.
Steve.
Steve.
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