Biopsy #6

Yesterday I had my clinic appointment and right heart catheterization with biopsy. Our day began at 8am. The visit with the heart transplant team went well. We reviewed how I'm feeling and I was reassured again that my symptoms are expected and my recovery will take time. I think it's funny because I understand this but they ask how I'm feeling so I tell them. 😂 The team is really incredible and very thorough. We also discussed my referral to cardiac rehabilitation and they agree that I am ready. I know this will help increase my endurance, build back some muscle that I've lost and strengthen my abilities in general. I was informed that I no longer need to check my blood sugar. Thankfully I did not develop diabetes which can happen when you are on steroids. I was so relieved!!

Then I was off to the Cardiac Cath lab for my procedure. It went smoothly, I'm getting very familiar with the process. It helps that I am given some sedation to help me relax during the operation. They let me choose the music this time so we listened to one of my favorites Fleetwood Mac! The right music always calms me. I'm not allowed to eat anything prior to my biopsy so David always gets me a blueberry muffin and a lemonade for the ride home and to take my medications. This week he got me a slice of blueberry cake. It was delicious, I split it with him as I usually do. We headed home at 11:30am. There was a significant accident on the Mass Pike and it took us three hours to get home. We listened to 3 pod casts on the way home. I was having a little difficulty with the ride after the procedure because I was groggy from the sedatives and my neck was hurting more that usually after a biopsy. I'm glad I had some Tylenol in my bag and lemonade in my cup holder.

I received a call from the transplant team this morning but unfortunately I missed it so they sent me a message in the patient portal. My labs are within normal limits. My Tacrolimus level is 7.4 which is lower than last week so I was instructed to increase my morning dose to 3mg and the evening dose will remain the same at 2.5mg. The Pathology was Grade 2/1R. They explained to me that there is no rejection but signs of inflammation. Of course, I have read everything I can find on heart transplant education and biopsy results. I had to question because in my literary search 1R is mild rejection. Grade 1 R, mild – Interstitial and/or perivascular infiltrate with up to one focus of myocyte damage. I had to ask them to explain. This was their response...

"The 2/1R data has been extensively reviewed here and although the pathology report reads "rejection" we know that this is not consistent with rejection but signals there is more inflammation in the heart tissue than a 0R or 1A/1R. It could lead to rejection but not often. We treat 2/1R the same way as a 0R or 1A/1R and continue to lower immunosuppression.

 With the tacrolimus levels running a little lower the past couple weeks, this could contribute to some extra inflammation. "

I'm not sure this explanation actually helps me understand and I feel uneasy with the results but I know that they are monitoring everything very closely. Based on the pathology results they have ordered an echocardiogram to assess my heart's function. This diagnostic test will be done at Cooley Dickinson hopefully in the near future. I will continue with my weekly lab tests. My next clinic appointment is in October and then again in November with another biopsy. I imagine if they were concerned I would be having another biopsy sooner. I will continue to stay positive and work towards a healthy future.

Each 💔 Beat Matters

KellyAnn

Post ❤️ Biopsy