Wednesday, July 15, 2015

Appointment of Highs and Lows

Tehilla sauntered into the cardiology department and showed her "polish" off to everyone. She gave hi-fives and waved hi to all of the nurses and doctors. She made friends with all of the other patients and hammed it up for everyone. Our nurse, Yifat, came to see us and couldn't get enough of Tehilla.

We went in for the echo. Tehilla lay down and looked pretty unsure whether she was going to cooperate. In the end, watching Fisher-Price videos won out, and she was calm for all of it except when they needed to do her neck. It's very uncomfortable and Tehilla freaked out a bit, but eventually calmed down and let them finish.

"I am feeling really happy!" is what Dr. Golander said while looking at the echo. Tehilla's heart function is really good. However, when he looked her vitals, he was not happy with her blood pressure. It's still too high.

Here's the way it works- Her blood pressure is very high. The increased pressure from her blood is what weakened her heart muscles in the first place. Which caused her to be in heart failure. We started giving her Digoxin to force her heart to squeeze harder, despite the pressure. We also have been giving her Enalapril and Carvedilol to lower her blood pressure, which is the root of the problem. So, clearly the Digoxin is working and giving her great heart function- but we haven't really fixed the underlying issue which is her blood pressure. We've basically put a band-aid on it.

So, we have raised the dose on Enalapril and Carvedilol to the maximum dosage and we are adding a new medication called Clonidine. It is a medication that is used for a few different things, one of them is high blood pressure. It will have a relaxing effect on Tehilla for the first while until her body adjusts to the medication. Let's hope that this finally lowers her blood pressure.

We will see Dr. Golander again in 3 months.

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