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  • Writer's pictureAnupam Gupta

Stories of the heart.. from the heart

So that red blob with white streaks and the greenish spots on the right - that's my heart as seen through a CT machine - beautiful isn't it? Why did I get into a CT machine to do what and when etc - may be the questions popping up eh? Read on.. Disclaimer - Any information or thoughts or interpretations presented in this writeup are mine and not of a qualified medical practitioner - I don't have any education in medicine or any theoretical wisdom at all of the human anatomy. So read at your own risk, draw inferences if you may but it's just a rookie writeup, coming from a runner/cyclist/fitness enthusiast who is in his 40th year on this planet earning a living doing a usual (I think) IT job spending hours on the laptop. This writeup does not equate or replace nor intends to replace any expert medical opinion or advice.

Okay so now that we've got the much needed disclaimer done, let's jump in -

What the hell is all this heart stuff?

Following the much preached regime of getting vitals checked every 6 months, I got the recent tests done in early October this year from a local path lab. Most things were in range except - platelets count (95,000 vs 1,50,000 - 4,10,000), Differential Leucocyte Count (DLC) was unproportionate, TSH (14.01 vs 0.35 - 5.50), LDL cholesterol calculated (150 vs <100)..

What made me bit worried was the platelets count of 95,000. And the realization that I had had few episodes of dizziness in the past week or so - I suddenly connected the dots. I knew I had been careless with my hypothyroid medicine so knew what I needed to fix that (begin having my meds regularly!). I didn't understand the DLC stuff and been reading LDL being high is not a worry - so well. A good physician in the neighborhood when consulted said the platelets aren't dangerously low but could be because of ITP - Immune Thrombocytopenic Purpura - a blood disorder characterized by a decrease in the number of platelets in the blood. Platelets are those cells in the blood that help stop bleeding. A decrease in platelets can cause easy bruising, bleeding gums, and internal bleeding. And boom - the second realization - I had been getting unexplained small bruises (like big pimples) on both my arms and they sprouted blood droplets at times! All ignored so far and brushed aside as just some skin allergy. The physician gave me some multi-vitamins and asked me to see him with few tests done in 6 weeks. Now my worry level had increased. Mixed with news of some known and allegedly fit people succumbing to a cardiac arrest or some unknown/unexplained incidents - almost every few days - I was sitting on the edge of my chair most times. Took a deep breath and decided I need to dig deeper than a physician's advice - Almost 20 days after the reports were in, I decided I need to consult a cardiologist - more for my peace of mind than anything else.

The heart & the blood doctors and Google!

The cardiologist gave me a 'do not waste my time' kind of a look when I went to him and said I was worried with these reports. Per him there was nothing to worry and all was pretty much fine. My asks on if there are 'safe' or 'recommended' ranges of resting heart rate or maximum heart rate were just rubbished as nonsensical questions. Took me a while to convince him to take me seriously.. and when I reminded him of my family's history with cardiac stuff, he wore his reading glasses properly. Looking at my LDL levels and my past reports of the same made him recommend me a statin to bring it down. But again I wasn't convinced it that was really a worry. To put my mind to peace which he understood was the need - he said if I wanted - I can go in for a CT angiography - to really just see if there's anything going inside those arteries at all or it's just nothing. Plus a consultation with a hematologist to see those platelets stuff. Felt logical and that's what I did. The hematologist suspected ITP (just like the physician I had consulted earlier) but proposed few more tests to be sure. Another test tube full of blood was sucked out of me to test for Rheumatoid Factor, platelet count (repeat), some ANA-IFA with Titre test, Viral marker and well Lipid profile (this time not calculated but actual) again.

To my relief and to the hematologist's too - the tests were all negative for the suspicion plus the platelets were now 1,18,000. All she said was - eat well, enjoy life, don't worry and see me in 3 months just to keep your mind at peace :). She concluded though there may be a very mild ITP but that's really a no worry or concern for her so shouldn't be for me too. The repeat LDL was again high per standards and for that she wasn't too worried again.

Relieved I was now waiting for my CT angiography to begin. 30 minutes around & in the gizmo machine and a few days later got my report. Like most of us, I tried making sense of all the colorful images from the docket - of course they just looked colorful nothing else. Tried making sense of the report and read thrice to see if I could decipher anything. With some effort I realized it was mostly termed 'normal' with a note of 'eccentric mixed plaque seen causing approx10%-15% stenosis in LAD (left anterior descending artery)' and another saying 'calcium score - 15'. The key word was 'stenosis' and what did I do - google search! Google made me infer that the big pipe that gets blood to the left side of the heart had hardened a little possibly due to some minor plaque caused from possibly cholesterol. It also told me it was nothing to worry about. The calcium level of 15 possibly meant mild levels of plaque detected with certainty (minimal narrowing of heart arteries likely).

Wondering what it all meant I was told my wait is over and the cardiologist will now see me. I was relieved that he again reiterated there's nothing to worry, but he also reiterated that he wanted me lower my LDL to below 100 to in turn reduce chances of more plaque formation by 30%. Since my LDL been historically high and with this very minimal stenosis, he stuck to his earlier recommendation of taking statin. Though I've been reading and hearing how and why LDL may not be a bad thing & why statins may be avoided, but of course plaque in the arteries was definitely not the best news however minimal it was. I've been advised to focus on quality of food I take in (means just no junk etc) and also keep my workouts in moderation - continue running/cycling/sports etc but - in moderation. On my ask what that meant - was told to not just go to my extreme insane limits - in hypothesis just avoid feeling like my eyes will pop out or my lungs will explode or go absurdly breathless. Like an idiot I asked - So then it should be all fine and dandy.. to which he said - there are no guarantees and no risk avoidance.. there's only precaution and risk reduction. If we could produce guarantees, we'd be all immortal beings. He greeted me off saying not to visit him again before possibly 18-24 months with repeat lipid profile test done and with reemphasis on moderation in workouts and to stop thinking and googling too much :-)

My take away The heart wants to go faster, stronger, quicker, further, lift heavier n all... but for it's own sake guess need play along with caution - exercise in moderation (intensity), know thy body, know what is nibbled and what it does to the inside, get preventive checkups done possibly every 6-12 months (a lipid profile and CBC), not to skip my regular meds (the one for hypothyroid for sure). I guess the continued focus in zone 2 of HR or power workouts will be key - that is what I understand by moderation. Maybe a marathon or ultra cycling is now twice a year versus almost every 3 months. And it's for sure endurance runs and rides most times versus speed workouts. I'm still not fully convinced on statin intake but have started them for sure as advised. I'll aim at correcting my food habits further, get a repeat Lipid profile test done in 6 months maybe and see if I can think of stopping them, till then I've got a pill to pop post dinner daily. So well, I guess I'll shrug off any worries I had for now but also just go a little slow, a little easy than before.



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