Posts by brightgull95

restlesscobra13 said:Listen, folks,

I dropped my first post here a few days ago.
Over the last week, I’ve been dealing with these brutal joint pains—some of them are actually swollen—and this weird ache in my shins, almost like I’ve smeared cold gel all over them.

My blood work shows:
...

ASO antistreptolysin titer 709 (normal range 0-200)
...

What I really need to know is: could strep be causing these joint pains? This has been going on for a week now and I am at my wit's end. My shins hurt and they feel like they're radiating this intense coldness. On top of all that, I’m dealing with chronic tonsillitis and vasomotor rhinitis, according to my ENT.

Look, strep in general—or even a specific strain of it likeA—Group A, if you want to get technical—isn't the direct cause itself, but rather the antibodies produced by your body as a standard inflammatory response to them—yes, that's it.

There are specific criteria—primary and secondary—used to diagnose this, but from what you've told me, you haven't met enough of them yet. You've only mentioned one thing: arthritis(?). You need to go see a rheumatologist and a cardiologist immediately. The rheumatologist will be able to tell you if this is actually the strep issue you're freaking out about, and the cardiologist can too. They look for involvement in a second organ, which would satisfy one of the primary diagnostic criteria.

Walter Robinson5 said:Hey everyone,

My dad just ended up in the hospital. He’s fighting COVID-19 along with severe bilateral pneumonia, plus he deals with chronic high blood pressure. He’s been on oxygen in the ICU for about four or five days now, pulling 9–10 liters a day, and his oxygen saturation is sitting at 89%. Since the doctors aren't really giving us much of an update, does anyone here know if he's heading toward a ventilator? How critical is this stage, really? Is there a realistic chance of recovery? His blood pressure is being managed with meds, and for the last few days, things have just stayed stagnant—not getting better, but not getting worse either. I'm looking for some insight. Is he close to needing a ventilator or what?

Is that 89% while on standard oxygen, high-flow nasal cannula, or non-invasive ventilation? And does your dad have some underlying lung disease that would make an 89% saturation look "normal" even when he isn't acutely sick?

Look, whether someone needs invasive ventilation (meaning a ventilator, yes) or not doesn't depend solely on saturation levels—regardless of whether we're talking about your father or anyone else. It depends on pH levels and other metabolic markers (like BE and HCO3-), the partial pressure of oxygen and CO2 in the arterial blood, lactate levels, mental status, agitation, and respiratory rate.

As for how critical your dad actually is... honestly, I could brew a pot of coffee, look at the grounds left in the filter, and probably get a more useful answer than just being told his saturation is 89% on whatever kind of oxygen he's breathing.

Moderators, please move this to a different thread if one already exists.

Joshua Cruz48 said:Hey everyone,

I've been battling gut issues for two years now. My symptoms look a lot like Crohn's, but they've told me it isn't Crohn's. Colonoscopy came back clear, but my liver enzymes are high, there's elevated copper in my urine, high creatinine levels, and edema in the small intestine. You can actually see the thickening and inflammation in the small bowel, but according to the docs, it's not Crohn's. They're basically saying it's some kind of inflammation, but they have no clue what's causing it or how to treat it. Has anyone dealt with anything similar? I'm at a total loss on what to do next.

Which one exactly? Some specific degeneration or something else? 😬
The extra "n" in your term is unnecessary; in your case, it's just edema. 😉

Honestly, I haven't the slightest clue what this could be. If they are absolutely, positively certain that it isn't Crohn's—meaning the inflammation was confirmed via gastroscopy in the proximal small intestine or some other method—then there are very few possibilities left. The only thing that jumps to mind is celiac disease (gluten enteropathy). You really need to find an IBD specialist; they’ll be familiar with the rarer conditions and might actually have some useful differential diagnoses for you.

wiredmaker10 said:So, I finally got my heart MRI results back, but honestly? It’s just a massive wall of data. For someone like me who isn't exactly a medical expert, it’s incredibly frustrating. There are all these specific values and numbers—most of which look pretty much the same as my previous tests—but there’s no clear-cut conclusion or actual diagnosis staring me in the face. Just endless metrics without the "so what?" factor.
Basically, here’s what the report says:

The results are in, and frankly, they’re a mess. We’re looking at significant dilation of the right atrium, along with dilation of the left atrium—we're talking a diameter of 50mm and an area of 27cm². On top of that, there's dilation of the left ventricle, hitting widths of up to 60mm during diastole. To be clear, while the wall thickness appears normal and the myocardial signal intensity looks fine, the structural enlargement is definitely there. It's a lot to process.
The scan came back clean—no signs of any intracardiac tumors, and there's absolutely no pericardial effusion to worry about.
The Cine mode shows normal myocardial contractility, though there's some mild mitral regurgitation present. No signs of a shunt.
The resting myocardial perfusion test came back completely normal. Everything looks clear.
On the delayed sequences following the fourth application of the contrast agent, the myocardial signal intensity looks completely normal.

The echocardiogram results just came back, and I’m staring at these numbers like they’re written in some cryptic code. Let's look at the left ventricular volume and function metrics: the EF is sitting at 46.1%. That’s it. That’s the number. I can already hear the doctors starting their usual dance—trying to soften the blow or downplaying it with clinical jargon—but let’s be real about what this actually means. We aren't talking about a perfectly pumping heart here. It’s not exactly "optimal," is it? It’s hovering right in that frustrating gray area where you know something isn't quite right, but it hasn't completely bottomed out yet either. It’s enough to make anyone feel incredibly anxious about what comes next.

Thanks for laying everything out and providing those explanations. Honestly, I was spinning my wheels for a bit, but thanks to you, I finally managed to untangle some of the contradictions and clear up the confusion I was dealing with.

Look, the heart is definitely feeling the strain, but it hasn't sustained catastrophic damage yet. If they haven't explicitly used the term "cardiomyopathy" in the reports, then we’re likely looking at the fallout from atrial fibrillation (AFib), or potentially a messy combination of AFib and athlete's heart. It's a distinction that matters.

wiredmaker10 said:I was fully expecting my MRI results to finally give me some real answers regarding the extent of my LA fibrosis—you know, the specific details my doctor actually requested in the referral. I wanted hard data on how much scarring we're dealing with, actual concrete information! But instead? This whole thing was a complete waste of time. It’s just more of the same vague, useless fluff I already got from my ultrasound. What a joke.

You were expecting a bit too much here. Look, scars show up on an MRI, sure—but they aren’t always obvious. More importantly, the real issue is whether those scars are sitting right there in the atrium. If they aren't present in the chamber itself, then honestly, what happens in the atria doesn't change a thing in this specific scenario. To actually map that out, they’d likely need to run a specialized protocol. You can't just tack that onto a standard cardiac MRI without either making the whole procedure impossible to coordinate or turning a routine scan into a marathon session. Besides, before anyone even thinks about pulmonary vein ablation, they’re absolutely going to confirm whether you have the substrate—the actual scarring—in the left atrium or not. It's a necessary step.

You’re wrong—you actually got way more information than that. There isn't even a hint of structural heart disease here, and you definitely didn't "walk off" a myocardial infarction. As for everything else? That depends entirely on what exactly was written on your referral.

wiredmaker10 I can't even begin to process what they're saying here. It’s just... wow. Honestly? I am absolutely floored by this level of sheer, unadulterated nonsense. They claim that—and I quote—"..." Are you kidding me right now?! Is this some kind of joke? Because if it is, it isn't funny. It’s infuriating! You sit there, you type out these absolute delusions, and you actually expect anyone with half a brain cell to take you seriously? It’s insulting. Truly. It’s an insult to the intelligence of everyone reading this thread. It's one thing to have a differing opinion, but it's an entirely different matter to spout this kind of baseless, unfounded garbage as if it were gospel. It’s reckless. It’s sloppy. And frankly, it’s exhausting to even engage with. We are trying to have a coherent discussion here, and then someone comes along and throws a wrench into the entire works with this level of incompetence. I am beyond frustrated. Just... beyond.
I completely blanked on mentioning my physical stats earlier—I’m a pretty big guy (6'4", 231 lbs), so when you factor in my BSA of 2.39m², that 70mm left atrial diameter I mentioned before actually works out to 29.3 mm/m². That puts me well below the critical threshold.

Look, let’s get one thing straight: a 70 mm measurement means a dilated heart, period. It doesn't matter how tall you are or what your body type is. You can't just ignore that. People need to understand that indexing is absolutely critical when you're talking about heart volume. If you want to know where you actually stand, you have to look at the numbers relative to your body mass. For instance, once that left atrial volume at end-diastole hits anything over 97 mL/m², you're looking at serious dilation. Anything over 75 mL/m² is where that initial dilation starts kicking in. I believe there's another threshold around 86 mL/m² as well. So, if the report actually bothered to include the volumes and not just the raw measurements, you should really take a second to see exactly where your heart falls on that scale. Don't just gloss over it.

Kimberly Ward said:I'm just trying to wrap my head around this (for what it's worth, I'm actually on a waiting list for surgery myself).

Look, if the situation with the valve—I'm assuming we're talking mitral here—is such that an elective procedure is even on the table, then the JPMorgan Chase numbers are completely irrelevant. What matters is the actual state of that valve and just how severe the issue really is.

E.O.D.

Kimberly Ward said:Operation Heartfelt Passion

Look, you wait exactly as long as the attending physician tells you to. Not a second less, and certainly not a second more. If there’s any confusion beyond that, go talk to the doctor in charge and get your answers there.

Kimberly Ward said:How long can you wait for surgery?

😕
I’m sorry, but I still don't follow you at all. If JPMorgan Chase dropped from 2000 down to 500 (whatever units we're talking about here), what on earth does that have to do with waiting for some kind of surgery? What surgery are we even discussing?

Kimberly Ward said:I have a question: if the BNP levels are over 2000 and then they drop down to about 500 with treatment...

So, what exactly is the question here?

wiredmaker10 said:Here’s some actual data to work with, since I find it a bit hard to draw my own conclusions when the doctors are still being vague and leaving everything open to interpretation.

proBNP was 741 at first, dropped to 583 after starting the ACE inhibitor therapy.

Look, the heart is failing. ACE inhibitors don't touch the BNP numbers directly—it's the other meds (if you were actually prescribed them) that do the heavy lifting.

wiredmaker10 said:LAD 46, LVIDd 70, EF LV 51%, TSH slightly above range, rose to 9 after ACE therapy combined with Cordarone.

Alright, an LVIDd of 70 mm is definitely on the large side, but you have to factor in body habitus. Calculate your body surface area (BSA) and divide that 70 mm by it. If the result is under 31 mm/m², then it's actually still within an acceptable range.

Nothing unusual regarding the amiodarone, though you aren't going to be on that stuff indefinitely anyway.

wiredmaker10 said:They haven't done an MRI, a coronary angiogram, or a perfusion scan yet. So far, it's just blood work, an echo, and that's it.

In that case, you can safely ignore any talk about part of your heart muscle having died for now.

wiredmaker10 said:The good news is I'm getting the MRI next Thursday, and I managed to snag an earlier appointment for the ablation at the Mayo Clinic late this November. Since the reports suggest doing the ablation as soon as possible to maximize the chances of restoring rhythm, I'm glad I got in early.

Pulmonary vein isolation works every single time—meaning they *will* restore sinus rhythm. Staying in that rhythm long-term is a different story entirely. It's obviously better to get it done sooner rather than later, but honestly, waiting an extra 3 or 4 months isn't make-or-break; there's zero evidence to support that urgency. On the bright side, your left atrium doesn't look massively enlarged, at least based on the diameter (46 mm).

wiredmaker10 said:I’m 40 years old, a father to two kids still in elementary school, and I just hit a massive wall. Three months ago, I went in for a routine physical required by my employer, and they ran an EKG. Turns out, they caught atrial fibrillation—an arrhythmia with rapid heartbeats. It’s a lot to process.

This isn't the first time, and it certainly won't be the last—I've seen this exact same pattern play out time and time again. It’s becoming an exhausting cycle.

wiredmaker10 said:It’s honestly bizarre. For the longest time, I felt perfectly fine—I mean, really okay. Sure, looking back, there were those stretches about six months before this checkup where I was getting winded a little easier or just felt like physical exertion was hitting me harder than it used to. But I didn't think twice about it! I just chalked it up to hitting middle age and being a bit more sedentary lately. You know how it goes; you assume it's just part of getting older and slowing down, so you don't even question it until it's too late.

It’s not atypical at all—everyone is an individual, and we all process illness through a completely different lens. No two people react to the same sickness in quite the same way.

wiredmaker10 said:It’s the exact same story every single time. You go through all that chaos—the endless searches, the frantic pacing in the ER waiting room—only to come out the other side with an X-ray showing nothing wrong with your lungs or your heart, and blood work that’s more or less fine. It’s maddening.

Did they actually bother to test for NT-proBNP in the lab, or did they just skip over it entirely? If they did run it, was the level elevated? And if it was high—I mean, how much higher than the normal range are we talking about exactly?

wiredmaker10 said:The echocardiogram is a mess. It’s showing eccentric left ventricular hypertrophy and dilation of the left atrium, plus a borderline dilated right side, all while my systolic function is sitting right on the edge of being functional. The bottom line? Dilated cardiomyopathy. Since we couldn't pin down exactly when this AFib started, I was put on anticoagulants, but after three weeks, the cardioversion failed miserably. So, they tweaked the meds, only for the next round of cardiotherapy to fail again after six weeks. Looking at my bloodwork, there's a strong possibility that I fought off a Coxsackie virus sometime in the past—maybe six months ago, maybe even six years—and that might be the smoking gun behind all of this.

If they didn't run an MRI on the heart or perform a coronary angiography, then questioning that diagnosis of dilated cardiomyopathy isn't just fair—it's necessary. You can't just jump to conclusions like that. For all we know, this could strictly be tachycardiomyopathy caused by some issues with the FCC.

wiredmaker10 said:I've been scheduled for RF ablation (pulmonary vein isolation) in six months.

That’s great news.

wiredmaker10 said:my discharge papers list a diagnosis of chronic heart failure with atrial fibrillation. My doctor told me she doesn't think ablation will actually save anything because the AFib has gone on too long and part of my heart is practically dead.,

Was it an MRI? Or maybe a perfusion scan? Honestly, whatever it was, the main thing is having some kind of imaging evidence regarding myocardial vitality. If they haven't done one of those, I'd be skeptical. But if they have, and DCM is confirmed—regardless of whether it was triggered by genetics or inflammation (like a Coxsackie virus)—then FCC is going to be the least of your worries down the road. At that point, you could argue the AFib just developed as part of the DCM.

The success rate of an AFib ablation depends primarily on the arrhythmic substrate in the left atrium; the more extensive that substrate is, the lower the chances of long-term success. On top of that, things like weight, untreated hypertension, intense athletics (think marathons or triathlons), and ultimately genetics all play a role in triggering (and recurring) AFib.

wiredmaker10 said:so I'm wondering what I can realistically expect for my future quality of life, work capacity, and physical activity levels, as well as my actual life expectancy given my age and the fact that I feel okay right now.

Expect to die eventually.

First off, if your JPMorgan Chase levels weren't elevated, you weren't decompensated. Second, there is a massive gap between being "extremely weak" and needing a heart transplant. With all the meds we have now, including Entresto, then moving to CRT-D/P, and finally an LVAD, we've had several years of progress. Third, your LVEF was borderline—maybe around 45-50% depending on who wrote the report—which means you are still nowhere near the danger zone of 35% or lower.