THE ISSUE WITH MY PHYSICAL HEART

I saw my cardiologist here in Williamsburg on February 9th.  Perhaps you may be wondering, “But if she has cancer, why is she seeing a cardiologist?”

Since 2010 I have had a history of heart failure.  I believe that my heart failure was medication induced since immediately after I discontinued these specific medications, my heart rate substantially improved.  However, damage had been done and my ejection fraction percentage (EF%) had gone down to about 25%.  (Note that normal EF% is about 50% to 75% and not ever a 100%.)  EF% identifies how well the heart is functioning by measuring its pumping efficiency.  It is used to classify heart failure types and to indicate the severity of heart failure.  Thank you, Google.

For many years, I had to take Metoprolol to improve my heart function.  However, in 2020, I needed to discontinue this medication since my blood pressure kept dropping too low.  Despite the need to discontinue the Metoprolol, my EF% had improved.  In August 2022, my EF% was up to 45-50%.

Because of the suspicion that the many spots on my lungs may have been a sign of infection, the doctors at Johns Hopkins had ordered an echocardiogram (echo) back in December 2022.  The report showed no sign of infection in the heart, but that my EF% had dropped to 37%.

Okay.  I wish that I could say that I was very spiritual and reading that report did not “floor” me.  I don’t know what it is about the heart.  I guess I think when one dies of cancer, it is a long and drawn-out process.  When it comes to the heart, I tend to panic.  “Your heart goes then you go!”  Also, in fall of 2009, one of my co-workers had died due to her heart failing. She had told me that her EF% was down to 10% and a few months later, she died!  I went right back to the same place emotionally that I was when I first found out about my heart failure.  “What? Lord this TOO!  You have got to be kidding!  Please not my heart!”  I guess I see dying of heart failure a little more sudden than dying of cancer.

The confusing part too is that since November 2022, I have had shortness of breath (SOB), chest pains, a persistent cough with pink blood-tinged mucus, fatigue, and weakness.  I even noted some swelling in my legs on the way up to Baltimore.  All of these are signs of heart failure.  

Chest pains are scary because yes, my mind goes there.  No, I must tell myself, I cannot be having a heart attack because I am still conscious.  All these symptoms have improved quite a bit since the radiation treatment, but I still had wondered about my heart, especially since I was still having chest pains.

Moreover, heart failure is listed as one of the serious side effects of Tagrisso, which is the medication that I am taking to slowdown the growth of the cancer cells.  Because it may cause heart problems that may lead to death, the company recommends that your healthcare provider check your heart function before starting and during treatment as needed. They also recommend reporting to your healthcare provider any of these signs and symptoms: feeling like your heart is pounding or racing, shortness of breath, swelling of your ankles and feet, feeling lightheaded.

Needless to say, it was very good to see my cardiologist.  He reassured me that my chest pain was not because of my heart.  He also elaborated more on when the symptoms are more concerning, such as SOB without much effort and swelling in the legs that do not go down all the way with elevation.  My EKG reading was the same at the appointment as it was when it was checked at the ER in November 2022.  Medication is still not an option for me to treat my heart failure currently since most of the time my blood pressure measures on the low side.  Our plan is just to continue with monitoring my heart function with another echo scheduled in May.

Certainly, as a Christian, I believe that with my death, I will be reunited with God and we will walk together in the Garden as he, Adam, and Eve did before the fall of man, etc. etc.  Though this is very true for me, it is the process of getting there--the dying part--that poses to be the challenge.

These days with the diagnosis of stage 4 cancer, I find myself dealing with thoughts of death many times.  It can be quite overwhelming with a paralyzing affect when I find myself focused on the uncertainties surrounding my death (in that it is final, and it is the first time that I have ever died so I wonder how it would “feel”) and on wondering how I will die (will it be sudden or long and drawn-out).  I must admit in the past, I would just ignore it.  (Oh right, there was that time before my first hip surgery, where I made a “video” will.  Also, during my mental breakdown in 2019, my mind was riddled constantly with disturbing thoughts of death, but these were more a product of my extreme anxiety.)

The fact is that all of us one day will die, and unlike Jesus we will not know how nor when we will die.  The only difference between my current stage of life and yours is that I have been told that more than likely I will “soon” die of cancer.  Any one of us though could die in a car accident or get hit by a meteor tomorrow.  As James 4:13-14 says none of us are guaranteed tomorrow, but most of us are not at all prepared for facing our deaths.  Most of us would, as I tended to do, prefer to ignore this inevitable fact of life or procrastinate until it is too late.  I think that this is why I have heard so much about loved ones scrambling to figure out funeral arrangements once a person unexpectedly passes.

Let me tell you, it has been a very emotional process for me in making these various arrangements.  I cried for about a week trying to work out my advanced care directive plans.  I spent a whole day researching the processes of donating my body to science upon my death and then another week before I sent off the paperwork because I was playing out so many of the different scenarios in my mind.  What if… Ugh.  Sheesh!  Like I am in control of that.

When I get out of that crazy mindset of trying to control everything, I find comfort in knowing that God is the one who is in control, and he provides me with exactly what I need at the time I need it. He has perfectly mapped out all the days of my life as it says in Psalm 139:16 (NIV)Your eyes saw my unformed body; all the days ordained for me were written in your book before one of the came to be.  He even knows what my struggles are even before I have them as it says in the first part of Psalm 139:1-4 (NIV):

1 You have searched me, Lord, and you know me.

2 You know when I sit and when I rise; you perceive my thoughts from afar.

3 You discern my going out and my lying down; you are familiar with all my ways.

4 Before a word is on my tongue you, Lord, know it completely. You know everything I do.

The only thing that I can do is to continue to live as God has commanded and decide every day, every moment of the day that Jesus is my Lord.  And to help me do this, I continue to pray and meditate, hanging onto different scriptures such as:

2 Corinthians 9:8 (NIV)

8 And God is able to bless you abundantly, so that in all things at all times, having all that you need, you will abound in every good work.

Philippians 1:6 (NIV) 

6 being confident of this, that he who began a good work in you will carry it on to completion until the day of Christ Jesus. 

I must continually remind myself to just trust that God HAS GOT THIS and that his love for me is so immeasurably more than I could ever imagine.  God will give me every possible thing that I need to overcome my fears and all that burdens me.  Jeri, my younger sister, would say to me: “Just take the collar off and let it go.”  Tammie, my good sister friend would say: “FROG it”. (Forever rely on God.)

So vast is God’s love:

Romans 8:38-39 (NIV)

38 For I am convinced that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers, 39 neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus our Lord. 

So vast is his power, which is at work within me to give God all his glory:

Ephesians 3:20-21 (NIV)

20 Now to him who is able to do immeasurably more than all we ask or imagine, according to his power that is at work within us, 21 to him be glory in the church and in Christ Jesus throughout all generations, for ever and ever! Amen. 

He is continuously helping me to be as ready as I can be when I will finally see him.  To God be the glory! AMEN!

COMMENTS WHEN BLOG WAS FIRST POSTED ON CARING BRIDGE SITE:

Vicki Sandiford: Hi dear sister, Thank you for being so REAL!! All the highs and lows are very relatable and by sharing them you are helping all of us be prepared for whatever scenario our future holds. Will be praying about your physical heart! I want it to keep pumping for a very long time. Recently, I have been focused on getting my spiritual heart "pumping" again as it should, for according to Proverbs 4:23, its condition dictates the quality of all that you do. "Above all else, guard your heart, for everything you do flows from it." I think this is a good scripture for us both and applies to both physical and spiritual hearts! Love and peace to you!

GREG FAWCETT: Kim, your relentless faith and hope in our Lord Jesus is so inspiring. I pray that God will bless and multiply your days left and use you for His glory. We all have an expiration date and agree that we all need to be ready at any moment to meet our Lord and Savior face-to-face as He welcomes us into everlasting! Blessings to you!

Pam Franz: My brother Gary had a widow maker heart attack at the age of 46 in 1999. He had 5 way bypass surgery & then threw multiple blood clots to the lungs and heart. They did an emergency surgery placing a vena cava filter to try to stop any more. Gary was so scared after all of this he would not go back to any doctor for over 20 years. His EF range has been in the 20% range and remains there. He is on no heart meds. His cardiologist at Norfolk Heart Hospital told him that some people can function well with an EF of 20% which has been Gary’s experience. Two years ago on a routine exam, his doctor had him scanned as Gary is a former smoker. The doc’s suspicions were correct in that they found the very silent and almost always fatal, aortic aneurysm quietly sitting there waiting to burst. Gary had to go for over 16 months until it grew from 5.2 cm to 5.8 cm. Norfolk Heart Hospital did the aortic aneurysm repair and within three weeks, Gary developed blood clots again, and threw two huge ones into his heart and several into his lungs. All of them should have killed him. God has touched Gary for some reason and has allowed him to continue to walk this earth. Gary says when God calls him home, he will be ready, but every day he gets up he gives thanks. He has had a very hard road physically. Then of course you know that in March 2019 his wife Pam was diagnosed with stage four lung cancer and that’s when we took her to Johns Hopkins and she was treated by Dr. Hales. I do not pretend to know why some people have the burden of health issues, such as heart problems and cancer and others seem to sail through life with not a care in the world. Gary has planned and paid for both his and Pam‘s funerals and I have written their obituaries. That is very very sobering but it is something that we will all have to have done in some manner either ourselves or someone on our behalf. Kim know that God has you in the palm of His hand like my brother and He has a plan unique for you. I know you love and trust the Lord Almighty so never let go of that faith. Gary turns 70 this summer & not a day goes by that as his sister I don’t thank God for every single moment. Kim, you know you have my family’s love and support. We continue to keep you in our prayers. I cannot know what you are experiencing but if I could help carry your burden, even for a day, I would. Be strong my sister in Christ. Love, Pam.