jm's Adventure with Multiple Myeloma: Cardiology Consult for Right Atrial Thrombus - March 23 2012

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Friday, March 23, 2012

Cardiology Consult for Right Atrial Thrombus - March 23 2012

Jan Martin drove me to UCH for my Cardiology Consult with Eugene Wolfel, MD, Cardiology at UCH. Short history: On Day 40 after my 13 September 2011 autologous stem cell transplant, I had an echocardiogram where a large right atrial thrombus (blood clot) was discovered in my heart. At the time, I had both a Trifusion Hickman catheter in my left chest and a Bard Power Port in my right chest. The following day, 3 November 2011, I had an MRI of my Heart which confirmed the right atrial thrombus. I was put on daily Fragmin injections 12,500 units and had both the Trifusion Hickman catheter and the Bard Power Port Removed.

I have been followed with monthly echocardiograms and the right atrial thrombus has decreased some in size, but PERSISTS. 

Concern now as I had a PICC Line placed on 16 March 2012 for my VDT-PACE treatments and it terminates at the right atrium of my heart. Hence, the consult to Dr. Wolfel at UCH.

Jan and I waited for our visit, but not too long.

Dr. Wolfel came in and was well aware of my neutropenic (low white blood cell count) state. He told me that he works with heart transplant patients. Dr. Wolfel was especially kind and was genuinely concerned for my well-being. 
I shared with him my history and I had copies of all my cardiac tests which was a good thing since they did not have a copy of my MRI of the Heart Results.

Dr. Wolfel examined me and listened carefully to my heart. I have a slight systolic murmur.
He wants me to get another echocardiogram and then he will evaluate if I can have pulmonary function tests (part of the pre-autologous stem cell transplant authorization process). I am not a candidate for a trans-esophageal echocardiogram because of my low white count and MRI of the Heart is LONG (2 hours) test that was very hard on me the first time.

I need to continue on Fragmin even though my platelets are low because I still have the potential of clotting even with almost no platelets. He had me sign a release of information so he could get my pre-transplant echocardiograms from Poudre Valley Hospital in Ft. Collins for a baseline done 23 June 2011 and 9 August 2011.

All in all, it was a very good appointment and I trust that Dr. Wolfel will have my best interests at heart.




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