I ain't scared of no MRI!!!

[Candy]

Dear Bryan, It has been a long time since I was able to sit here and catch up on everyone. I came here tonight specifically looking for info on you and that sternum! I, too, hope you get a good result to help you get rid of the pain. I am so sorry it is still going on. I have had a few MRI's with all my dancer injuries. MRI'S were uncomfortable before the heart surgery! I can imagine how sore you must have been. I look forward to hearing about your results.

Take care, Candy

 

[Bryan B]

Thanks Candy! I was just thinking about you yesterday. I was cleaning out my PM's (per Ross's instructions ) and reread the nice PM's you had sent me after my surgery. I hope things are going well for you!

I think things are going to work out fine. I just have to keep an open mind and have some faith that whatever may happen will happen for a good reason.

 

[Candy]

Nice to hear back! I am doing well, and have been teaching alot, too much probably, but the extra stuff winds up tomorrow ( a summer workshop). I am still uncomfortable with the pounding heartbeat. Do you still get that? Sometimes when I am just resting it looks like my heart is going to leap from my chest. I thought that would go away. An when I am exercising or dancing, it pounds away, too. I am not winded when it happens, no pain, and the heart rate is still under 120. It drives me nuts, and makes me nervous. Any feedback?

 

[Bryan B]

Candy,

I haven't had that problem while resting, but I have noticed that recently it seems to take longer for my heart rate to return to a normal rate after exercising (my surgeon gave me the go ahead to start exercising again). I think that's because I went several weeks without any aerobic exercising in an attempt to get my sternum issue to resolve (i.e. I'm out of shape ). My main problem is that several hours after doing anything that involves using my upper chest repeatedly I end up paying a price for doing it (pain). That includes anything that gets my heart rate to the point where I'm using my chest muscles to breathe rapidly (like a nice brisk walk ). I would let your surgeon or cardio know just to make sure it isn't something serious.

 

[tobagotwo]

Back to The Waiting Game again. Sounds like you've got your fight back, though, and that's good to hear.

We were just a few miles from the TN border yesterday, by Grandfather Mountain, NC, so if you need a passel of good ole boys to come up and explain things to the medical professionals, just holler...

Best wishes,

 

[Bryan B]

Hi Bob!

Yep...I'm actually in NC myself and have been for almost 3 weeks. I think hanging out with my parents and my little girl (see avatar ) has put a bounce back in my step. The waiting is hard (it always is), but Monday is almost here and I think I will finally get some answers and find out what my options are.

Grandfather mountain is a beautiful place. I made it to Emerald Isle for 4 days between my appointment with my surgeon and my MRI. To me that's more effective than a B12 shot . To tell ya the truth thar ain't muchin a difference between the middle of NC and the middle of TN, excepting ya gots a longer drive to get to the coast.

Hope you enjoy the rest of your trip!

 

[Candy]

Bryan and Bob- How lucky you are to travel. I live in Los Angeles and have seen so little out of California, and Chicago (my husband is from there!) sounds beautiful. Bryan I will be seeing my cardio again in 3 weeks, so we wil l definately discuss my pounding heart. Thank you. Enjoy your family! I look forward to hearing about Monday.

Candy

 

[Bryan B]

MRI results

MRI results



That's about it.

Here are the results from the MRI report:

Findings: Examination is somewhat limited due to metallic artifacts from the sternal wires in patient status post median sternotomy. Midline surgical incision is present. There is also linear low T1 signal seen throughout the midline sternum consistent with prior sternotomy. No evidence for high T2 signal along the sternotomy line. No evidence for enhancing mass lesions. No bone marrow is present crossing the sternotomy line, however. Sagittal view demonstrates no evidence for presternal mass. No evidence for displacement of sternal fragments.

Impression: Status post median sternotomy with near-anatomic alignment of the 2 sternal fragments. No imaging findings to suggest infectious or inflammatory process.

My surgeon did another physical exam, and thinks that the pain is coming from where my right chest muscle connects to the cartiledge, i.e. back to more of a costochondritis diagnosis. He couldn't rule out a wire rub, but he was able to trigger the pain ( ), and it wasn't in an area where the wire would typically be located.

So, back on steroids for a 2 week taper, no lifting for another 2 weeks, and I will see him again at the end of 2 weeks. He said that if I felt strongly about having the wire(s) removed that he would do that, but he also wants to see how I respond to the steroid regimen. And since no bone marrow was present "crossing the sternotomy line", that means my sternum is still not fully healed (got milk? ). He cannot remove the wires until the sternum is fully healed, and he said that could take up to a year.

The "good" news is that there is no non-union or infection, and he feels that I won't damage anything by normal activity at this point. So at the end of this 2 week period it sounds as if I may get "cut loose" on all restrictions. If its a "costo" problem it will be a grin and bear it scenario. If it's a wire problem it will be a grin and bear it scenario until he gives the all clear to have them removed. I still didn't quite get the definitive answer I was hoping for, but it seems like we're closing in on it.

 

[Candy]

Well, Bryan, it is good news that there's no infection. I am not familiar with costochondritis. I know "itis" always means an imflammation. Ihopw the steroids do the trick this time. Getting back to working out will be great. I am glad that will be ok. It must be fruatrating not to get a "real" answer. The waiting game is not one of my favorites. Thank you so much for the update.
Candy

 

[Bryan B]

Hi Candy,

I've gone full circle . My PCP originally diagnosed that my pain was being caused by costochondritis in mid May. From there we've checked for a possible non-union, then a possible wire rub...now back to costochondritis. The symptoms I present are exactly the same as described for costochondritis, but mine seems to be of the "persistent" variety. It supposedly improves with inactivity, so I tried doing "nothing" for a few weeks and it improved slightly. But it's hard not to use this area when you live alone and have to cook, clean, do laurdry, and carry groceries up two flights of stairs to one's apartment. If I take a walk it hurts later just from increasing my breathing rate. I think one of the sites below used the word insidious to describe the condition and the other site described the pain as esquisite. I can confirm that those adjectives describe the condition accurately.

Here's a couple of links describing the condition:

http://orthopedics.about.com/cs/sprainsstrains/a/costochondritis.htm

http://www.polychondritis.com/Costochondritis/Costochondritis.html

(this one has a good diagram of where the costal areas are located)

 

[Karlynn]

My surgeon did another physical exam, and thinks that the pain is coming from where my right chest muscle connects to the cartiledge, i.e. back to more of a costochondritis diagnosis. He couldn't rule out a wire rub, but he was able to trigger the pain ( ), and it wasn't in an area where the wire would typically be located.

Bryan,
I think turn about is fair play. Did you ask if you could trigger some pain for him?

Glad to hear you don't have to have anything done. Sorry you are still having pain, but hopefully not for much longer.

 

[Bryan B]

LOL Karlynn!

Actually he has such a great bedside manner and was very apologetic as he was poking and squeezing me. It WAS easy for him to tell when he found "the spot" without me having to say a word!

 

[ALCapshaw2]

OUCH! costochondritis is NOT FUN

Glad to hear you have a diagnosis.

Let's hope the meds work.

Good Luck,

'AL'

 

[Sherry]

Oh, Bryan, I've been diagnosed with this too, after suffering from a few years of chronic chest and back pain. I'm not sure what I make of it (the diagnosis). I'll be interested in hearing how you progress.

 

[Bryan B]

Thanks everyone for the well wishes!

I think the problem when you get cartilage damage is that cartilage is slow to heal if it will heal at all. I guess if this turns out to be a chronic problem I'll just have to pick and choose what activities are worth paying the price for later. But either way, my surgeon has talked me into stopping the pain medication (going to wean off of it). The cox inhibitor NSAIDS really bothered my stomach, so I'm going to try regular NSAIDS, ice and heat to treat the pain.

One other bit of good news I forgot to mention is that he is taking me off the Toprol. I have noticed recently that any time I bend over and then stand back up I get dizzy. He told me that since I'm only on 25mg I could stop taking it cold turkey. Since I just got my Toprol refilled I think I'm going to take 12.5mg daily for a couple of weeks and then 12.5mg every other day for a couple of weeks before stopping it altogether.

Given what I've been through in the last year I have decided to look at this positively. Compared to where I was 9 months ago with endocarditis and impending OHS, I've come a long way baby!

 

[ALCapshaw2]

The 'taper down' schedule sounds good to me Brian.

I went from 100 to 50 to 25 to 0 every 2 weeks. Had to go back to 25 after 10 days at zero. Worked well for several years, then had to ramp back up to 50 and now another type of beta blocker (I had all the risk factors, ovr 60, white male, valve surgery...oh well, I just keep reminding myself that everyday above ground is a good day )

Enjoyed your dog 'tails'
My 'little girl' is a 96 lb Labrador Retriever.

'AL'

 

[Candy]

Thank you for the links, Bryan. Sounds extremely uncomfortable , to say the least. Enough is enough, right? I will keep good thoughts out there for you. I hope the healing is soon. I was weaned from Toprol in June. I had been on 50mg, went down to 25mg for a few weeks, and then off. I actully felt really lousy that week. The heartrate was up, more chest pounding. It mellowed after a week or so. Enjoy that pup. I have a nutcase golden retreiver. Love him to death.
Take care,
Candy

 

[Bryan B]

All good threads must come to an end!

All good threads must come to an end!

I saw my surgeon again today and he released me from all restrictions. The steroid regimen gave me moderate relief, but I just finished it so we'll see how long that holds up. I have successfully weaned myself off of all pain medicine (except Advil), and I'm about half of the way through the process of weaning off of my Toprol with only a slight rise in my heart rate. He had told me I could stop the Toprol 2 weeks ago, and when I told him I was weaning myself off of it he asked why in the world I was doing that. I told him about how many people I know have complained of a racing heart and palpitations stopping cold turkey (even at 25mg) and he was fine with that approach.

So I am heading back to Nashville tomorrow to see if my life there is still intact. This is my second 5 week stay in NC since March...I'm feeling a little confused as to where I really live.

I can't even bear to think about leaving my dog...I'm already sad about that , but my job requires so much traveling that keeping her in Nashville and putting her in a kennel every time I go out of town is something I couldn't do to her. She loves living here with my retired parents.

OK...I'm done...coming out of retirement...back to "life" I go!

 

[Candy]

Hooray for Bryan!

Hooray for Bryan!

Bryan, I am so happy to hear some good news for you. Getting back some normalcy in your life is truly important. Leaving the pup will be hard, no doubt. I know how much I missed mine while I was in the hospital ( has it really already been 5 months?). As far as the Torprol, the weaning was smart. AS I had mentioned when I went off cold turkey from 25 mg, I felt like hell for 1 1/2 weeks. BTW, I go see my cardio tomorrow for a checkup. Haven't been there since the 3 month mark, and haven't yet had a echo. I am looking forward to it. Congratualations again, and stay well.
Love, Candy

 

[Bryan B]

Thanks Candy!

Yes, pup withdrawl will be the hardest part.

I really am looking forward to getting back to a normal routine, even if that means work . I'm also cleared to start swinging the golf club again, which is a big deal to me (used to be a golf pro).

Isn't it hard to believe it's been 5 months? My 5 month anny is tomorrow. Thanks for reminding me, I need to schedule my 6 month checkup and echo. Thanks so much for the words of encouragement along the way, and I wish you good news on your cardio visit tomorrow!