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What Are The Chances Of Cardiomyopathy And Water Retention Recurring?
Question: Dear Dr Sharka,
I had a rather disheartening conversation with a hospitalist today. I was explaining my unreasonable fears about water retention and recurrence of cardiomyopathy and he believed that all my fears were warranted- that in fact cardiomyopathy could recur quite quickly and that I needed to be vigilant about keeping track of my weight or else I could miss the earliest signs of recurrence
Should I disregard this information coming from
someone who is a generalist who only treats hospitalized patients? I am trying so hard to get over my fears but for every doctor like you who tells me my fears have no basis, there is a doctor like that who tells me the danger is real.
I want to believe I am cured and get on with my life but it is currently so very difficult.
Thank you so much, dr.
XXXX
I had a rather disheartening conversation with a hospitalist today. I was explaining my unreasonable fears about water retention and recurrence of cardiomyopathy and he believed that all my fears were warranted- that in fact cardiomyopathy could recur quite quickly and that I needed to be vigilant about keeping track of my weight or else I could miss the earliest signs of recurrence
Should I disregard this information coming from
someone who is a generalist who only treats hospitalized patients? I am trying so hard to get over my fears but for every doctor like you who tells me my fears have no basis, there is a doctor like that who tells me the danger is real.
I want to believe I am cured and get on with my life but it is currently so very difficult.
Thank you so much, dr.
XXXX
Brief Answer:
Strongly disregard the conversation that enhances unjustified fears.
Detailed Answer:
Hello!
As you have repeated the same question, I am writing the same answer.
You need to disregard (reject or disapprove) one of them to refund your money.
Dear XXXX!
I am sorry to hear about that unpleasant conversation. I have been trying several times to give you evidence based explanations that your cardiac performance is actually perfectly normal and that fortunately your previous heart disorder has completely vanished.
Since those days of cardiomyopathy diagnosis, you have passed through a wonderful cardiac improvements, and I am glad to repeatedly assure you (and will keep being so) that you are actually a healthy normal individual.
It is a logical medical reasoning after reviewing all your medical data (medical history, cardiac tests [several cardiac ultrasounds, cardiac imagine perfusion test, rhythm study, repeated lab tests, etc.], your satisfactory clinical course, etc) to come to these conclusions.
As you are considered completely healed (as your cardiac ablation resulted successfully) from the previous arrhythmia or any signs of inflammation, with a subsequent regression of cardiomyopathy and reversion to normal cardiac function; there is no medically justified evidence to support an increased inclination to arrhythmia or cardiomyopathy recurrences, compared to other normal individuals.
So, I would not approve any excessive restrictions of fluid intake or increased attention to urine output or body weight fluctuations (except for the general purpose of avoiding overweight and its consequences).
Such fears are not medically justified.
So, for the above reasons, I strongly recommend you disregarding those suggested opinions on frequent disease relapses.
Of course, you need to be alert of your health issues, as all we do, but no evidence oriented medical judgment would justify those excessive fears on the above mentioned issues.
You need to get over your fears, as this is the right way to face with your only health problem (anxiety).
I will be happy to give my support and advice on better management of this issue.
Once again, I am concluding that you are on a perfectly good health conditions and nothing serious could affect your well-being. You just need to follow medical checkups as all the other healthy individuals do (yearly physical exam, lab tests and a cardiac ultrasound as well).
I wish you are going to be fine after my dedicated opinions.
Please write me back, for any other clues of concern regarding this issue!
Hope to have been helpful!
Best regards,
Dr.Iliri
Strongly disregard the conversation that enhances unjustified fears.
Detailed Answer:
Hello!
As you have repeated the same question, I am writing the same answer.
You need to disregard (reject or disapprove) one of them to refund your money.
Dear XXXX!
I am sorry to hear about that unpleasant conversation. I have been trying several times to give you evidence based explanations that your cardiac performance is actually perfectly normal and that fortunately your previous heart disorder has completely vanished.
Since those days of cardiomyopathy diagnosis, you have passed through a wonderful cardiac improvements, and I am glad to repeatedly assure you (and will keep being so) that you are actually a healthy normal individual.
It is a logical medical reasoning after reviewing all your medical data (medical history, cardiac tests [several cardiac ultrasounds, cardiac imagine perfusion test, rhythm study, repeated lab tests, etc.], your satisfactory clinical course, etc) to come to these conclusions.
As you are considered completely healed (as your cardiac ablation resulted successfully) from the previous arrhythmia or any signs of inflammation, with a subsequent regression of cardiomyopathy and reversion to normal cardiac function; there is no medically justified evidence to support an increased inclination to arrhythmia or cardiomyopathy recurrences, compared to other normal individuals.
So, I would not approve any excessive restrictions of fluid intake or increased attention to urine output or body weight fluctuations (except for the general purpose of avoiding overweight and its consequences).
Such fears are not medically justified.
So, for the above reasons, I strongly recommend you disregarding those suggested opinions on frequent disease relapses.
Of course, you need to be alert of your health issues, as all we do, but no evidence oriented medical judgment would justify those excessive fears on the above mentioned issues.
You need to get over your fears, as this is the right way to face with your only health problem (anxiety).
I will be happy to give my support and advice on better management of this issue.
Once again, I am concluding that you are on a perfectly good health conditions and nothing serious could affect your well-being. You just need to follow medical checkups as all the other healthy individuals do (yearly physical exam, lab tests and a cardiac ultrasound as well).
I wish you are going to be fine after my dedicated opinions.
Please write me back, for any other clues of concern regarding this issue!
Hope to have been helpful!
Best regards,
Dr.Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr Iliri,
Thank you so much, you are like an XXXXXXX of hope to me while I suffer through this terrible anxiety and OCD and PTSD. I want to believe I am normal again but the frightening things I was told keep taking me back to the time when I was ill and yet didn't feel sick.
Your very direct approach and clinical details are helping me a lot. I hope that soon it will completely sink into my brain that I am truly ok now. It is miserable for me to constantly track everything I eat and especially drink. It's not even precise, just that I mentally keep track automatically now, without wanting to. I know it is maddening for my doctors (and I include you at this point as you know my case and details so well by now) that I can't just accept that I am cured and just feel normal but it isn't fear that I am able to control or rationalize away. I just accepted that I would die young and I have not been able to go back to thinking I could have a normal life. I am too afraid that it will be taken away from me again.
Thank you so much. You are helping me more than you can imagine. I try to keep your words in my head when I am most afraid.
Many, many thanks,
XXXX
Thank you so much, you are like an XXXXXXX of hope to me while I suffer through this terrible anxiety and OCD and PTSD. I want to believe I am normal again but the frightening things I was told keep taking me back to the time when I was ill and yet didn't feel sick.
Your very direct approach and clinical details are helping me a lot. I hope that soon it will completely sink into my brain that I am truly ok now. It is miserable for me to constantly track everything I eat and especially drink. It's not even precise, just that I mentally keep track automatically now, without wanting to. I know it is maddening for my doctors (and I include you at this point as you know my case and details so well by now) that I can't just accept that I am cured and just feel normal but it isn't fear that I am able to control or rationalize away. I just accepted that I would die young and I have not been able to go back to thinking I could have a normal life. I am too afraid that it will be taken away from me again.
Thank you so much. You are helping me more than you can imagine. I try to keep your words in my head when I am most afraid.
Many, many thanks,
XXXX
Brief Answer:
I am sure good results will be achieved soon.
Detailed Answer:
Dear XXXX!
I believe that you have all is needed to overcome this suffocating condition; you have the commitment and willingness to get to the end; a great passion for your family and life; there is nothing insuperable from this muggy situation.
Getting through a positive meditation and spending your valuable time with your close and beloved people will be the best treatment for your fears.
I will be happy to feel useful in achieving the beneficial effects of all these attempts.
And I am sure that soon, good results will appear as we all want this to happen.
Please let me know if you have additional clues to discuss with me!
Best wishes,
Dr. Iliri
I am sure good results will be achieved soon.
Detailed Answer:
Dear XXXX!
I believe that you have all is needed to overcome this suffocating condition; you have the commitment and willingness to get to the end; a great passion for your family and life; there is nothing insuperable from this muggy situation.
Getting through a positive meditation and spending your valuable time with your close and beloved people will be the best treatment for your fears.
I will be happy to feel useful in achieving the beneficial effects of all these attempts.
And I am sure that soon, good results will appear as we all want this to happen.
Please let me know if you have additional clues to discuss with me!
Best wishes,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr Dr Iliri,
Thank you so much for your kindness and wisdom. It does help to calm me.
I spoke with a nurse practitioner today (and I know I should maybe speak less with medical people but my mother is very ill so I can't avoid it, it seems) and I explained my anxious condition following my illness and she told me that mental stress leads directly to lowered systolic function of the heart. While I know you and others have told me that's not true, it did alarm me. Is there any truth to that?
I keep telling myself again and again that my heart and kidneys are fine now but after every drink, I remember the doctor taking the bottle out of my hand and telling me that water was my body's enemy and would kill me. I have never been so scared in my life.
Is it highly unusual for normal dilated cardiomyopathy to resolve within weeks on low dose meds? If it was only PVCs causing my heart weakness, then I shouldn't have further problems?
Thank you so much, Dr Iliri. You are so helpful and kind.
Thank you so much for your kindness and wisdom. It does help to calm me.
I spoke with a nurse practitioner today (and I know I should maybe speak less with medical people but my mother is very ill so I can't avoid it, it seems) and I explained my anxious condition following my illness and she told me that mental stress leads directly to lowered systolic function of the heart. While I know you and others have told me that's not true, it did alarm me. Is there any truth to that?
I keep telling myself again and again that my heart and kidneys are fine now but after every drink, I remember the doctor taking the bottle out of my hand and telling me that water was my body's enemy and would kill me. I have never been so scared in my life.
Is it highly unusual for normal dilated cardiomyopathy to resolve within weeks on low dose meds? If it was only PVCs causing my heart weakness, then I shouldn't have further problems?
Thank you so much, Dr Iliri. You are so helpful and kind.
Brief Answer:
No intriguing statement with deteriorate your actual health status!
Detailed Answer:
Hi dear XXXX!
I always try to understand your difficult situation; how you are feeling and persisting fears perturbing your mind.
You are in a continuous struggle with your unconscious persuasion that your actual health status is quite fragile, highly susceptible from minor water balance or body weight fluctuations, or a cardiomyopathy recurrence is simply behind the door, waiting for just a tiny spark from those multi-level feedback homeostatic parameters.
I don’t believe that this hypothetical version would have the minimal chances to become real, as I could hardly find any clinical predictors to support such an idea.
When it comes to reassure your perturbed mind, a nurse practitioner statement (whose supposition in fact isn’t reliable, as she/he lacks the adequate professional expertise) is enough to aggravate your psychological status and to put out once again the genie from the lamp.
I strongly suggest disregarding this trivial statement and keep going on your positive healthy meditation process.
From my professional clinical practice with critically ill patients, I want to assure you that it is quite possible for a cardiomyopathy to resolve when the underlying cardiac disorder and its triggering factors are effectively treated (as in your case).
So, just relax!
No intriguing statement with deteriorate your actual health status!
Best wishes,
Dr. Iliri
No intriguing statement with deteriorate your actual health status!
Detailed Answer:
Hi dear XXXX!
I always try to understand your difficult situation; how you are feeling and persisting fears perturbing your mind.
You are in a continuous struggle with your unconscious persuasion that your actual health status is quite fragile, highly susceptible from minor water balance or body weight fluctuations, or a cardiomyopathy recurrence is simply behind the door, waiting for just a tiny spark from those multi-level feedback homeostatic parameters.
I don’t believe that this hypothetical version would have the minimal chances to become real, as I could hardly find any clinical predictors to support such an idea.
When it comes to reassure your perturbed mind, a nurse practitioner statement (whose supposition in fact isn’t reliable, as she/he lacks the adequate professional expertise) is enough to aggravate your psychological status and to put out once again the genie from the lamp.
I strongly suggest disregarding this trivial statement and keep going on your positive healthy meditation process.
From my professional clinical practice with critically ill patients, I want to assure you that it is quite possible for a cardiomyopathy to resolve when the underlying cardiac disorder and its triggering factors are effectively treated (as in your case).
So, just relax!
No intriguing statement with deteriorate your actual health status!
Best wishes,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr Iliri,
You are very eloquent; I could not describe my condition as precisely as you just did. I was able to step back for a moment and see myself as a fictional character, one suffering from a mental, not physical condition. At another time, I would have sympathized with this person and yet not understood how she would not be able to believe that she has recovered and that she was suffering almost from a delusion. I don't quite understand how everything you say makes sense to me and I trust your vast wisdom about these medical issues and yet my fear hangs on. And it is exactly as you described.
I think I had the misfortune of getting some bad and overly severe information just as I was diagnosed and so fearful. And then I had a dr who is older and didn't believe in pvc-induced cardiomyopathy. After I found an EP and scheduled an ablation, he took considerable time to let me know I would never have a normal life and that I might not survive surgery. He is the one who said if I gained several ounces, I was in heart failure. It is why I have had many ER visits. He even called the operating room during my surgery to try and convince my EP not to do the ablation. It was odd and he really managed to get scare me as he told me to never believe my EP or any other dr who would tell me I was cured or would not need medication. He said I'd always be in grave danger. I know I have to let it go. It is very difficult.
Thank you so much for all your help. You help me to see things more clearly. I am working with an OCD specialist and hope to improve.
Still I struggle to believe that a month echo still means my heart is strong today. I try to tell myself I am ok.
Thank you so much.
You are very eloquent; I could not describe my condition as precisely as you just did. I was able to step back for a moment and see myself as a fictional character, one suffering from a mental, not physical condition. At another time, I would have sympathized with this person and yet not understood how she would not be able to believe that she has recovered and that she was suffering almost from a delusion. I don't quite understand how everything you say makes sense to me and I trust your vast wisdom about these medical issues and yet my fear hangs on. And it is exactly as you described.
I think I had the misfortune of getting some bad and overly severe information just as I was diagnosed and so fearful. And then I had a dr who is older and didn't believe in pvc-induced cardiomyopathy. After I found an EP and scheduled an ablation, he took considerable time to let me know I would never have a normal life and that I might not survive surgery. He is the one who said if I gained several ounces, I was in heart failure. It is why I have had many ER visits. He even called the operating room during my surgery to try and convince my EP not to do the ablation. It was odd and he really managed to get scare me as he told me to never believe my EP or any other dr who would tell me I was cured or would not need medication. He said I'd always be in grave danger. I know I have to let it go. It is very difficult.
Thank you so much for all your help. You help me to see things more clearly. I am working with an OCD specialist and hope to improve.
Still I struggle to believe that a month echo still means my heart is strong today. I try to tell myself I am ok.
Thank you so much.
Brief Answer:
Just keep going your positive way.
Detailed Answer:
Dear XXXX!
I hope you will soon realize that all those incredulous opinions of that dr or any other medical staff, are not going to be consistent, and that nothing could harm your perfect well-being. Just try to control your fears through comprehensive meditation and other alternatives I have suggested you before.
I will be here to support you whenever you need.
Wishing you a pleasant weekend!
Dr. Iliri
Just keep going your positive way.
Detailed Answer:
Dear XXXX!
I hope you will soon realize that all those incredulous opinions of that dr or any other medical staff, are not going to be consistent, and that nothing could harm your perfect well-being. Just try to control your fears through comprehensive meditation and other alternatives I have suggested you before.
I will be here to support you whenever you need.
Wishing you a pleasant weekend!
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr Iliri,
As always, thank you so much. I have to get out of my head that the doctor was being unnecessarily severe by calling water "toxic" and saying it would kill me but as I was also told I was dying, my mind was pushed into a panicked/traumatized state which I am finding so very difficult to leave.
It has been 3 weeks since I last had any blood tests/ultrasounds. I feel so sure I am sick again that I really need to fight myself to not end up in the ER for more tests. Is it impossible for me to have deteriorated to a state of heart/kidney dysfunction in that amount of time?
I try to relax but I find it so difficult to believe I am truly cured. I appreciate your kindness and knowledge very very much, thank you.
XXXX
As always, thank you so much. I have to get out of my head that the doctor was being unnecessarily severe by calling water "toxic" and saying it would kill me but as I was also told I was dying, my mind was pushed into a panicked/traumatized state which I am finding so very difficult to leave.
It has been 3 weeks since I last had any blood tests/ultrasounds. I feel so sure I am sick again that I really need to fight myself to not end up in the ER for more tests. Is it impossible for me to have deteriorated to a state of heart/kidney dysfunction in that amount of time?
I try to relax but I find it so difficult to believe I am truly cured. I appreciate your kindness and knowledge very very much, thank you.
XXXX
Brief Answer:
I recommend some tips to help you face with your fears
Detailed Answer:
Dear XXXX,
I understand your emotional state.
This is a normal reaction for an emotive and sensitive person.
I would recommend you to try to manage your anxiety and this fear.
There are many different ways to manage it (pharmacological and non pharmacological).
I believe that a good psychotherapist would help you face with this phobia and manage your anxiety.
You should try to have more fun and enjoy the life you are living.
There are a lot of beautiful things out there, that you are missing while thinking about your problem.
Meditation and Yoga are also very helpful!
If all the above tips don't help, an antidepressant may be needed. (antidepressants are very effective in phobic disorders and anxiety, acting in the the neurotransmitters).
The same thing does meditation, yoga and physical exercise, only in a smaller degree.
Hope to have been helpful !
Best wishes,
Dr. Iliri
I recommend some tips to help you face with your fears
Detailed Answer:
Dear XXXX,
I understand your emotional state.
This is a normal reaction for an emotive and sensitive person.
I would recommend you to try to manage your anxiety and this fear.
There are many different ways to manage it (pharmacological and non pharmacological).
I believe that a good psychotherapist would help you face with this phobia and manage your anxiety.
You should try to have more fun and enjoy the life you are living.
There are a lot of beautiful things out there, that you are missing while thinking about your problem.
Meditation and Yoga are also very helpful!
If all the above tips don't help, an antidepressant may be needed. (antidepressants are very effective in phobic disorders and anxiety, acting in the the neurotransmitters).
The same thing does meditation, yoga and physical exercise, only in a smaller degree.
Hope to have been helpful !
Best wishes,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you so much, Dr. Iliri-
Yes I see an OCD specialist and also a psychiatrist for medication. I am taking prozac, buspar, and aprazolam. I know I need the therapy but my brain keeps insisting I must be sick because I didn't feel sick when I had the cardiomyopathy.
It has been one month since I had last echo and kidney function and other blood tests. I am resisting going to ER for rechecks. Are you sure nothing could change so quickly and my heart and kidneys are ok? I am trying so hard to get my brain to accept the message that I am ok.
Thank you so much, dear Dr Iliri. You are so helpful and wonderful.
Best to you,
XXXX
Yes I see an OCD specialist and also a psychiatrist for medication. I am taking prozac, buspar, and aprazolam. I know I need the therapy but my brain keeps insisting I must be sick because I didn't feel sick when I had the cardiomyopathy.
It has been one month since I had last echo and kidney function and other blood tests. I am resisting going to ER for rechecks. Are you sure nothing could change so quickly and my heart and kidneys are ok? I am trying so hard to get my brain to accept the message that I am ok.
Thank you so much, dear Dr Iliri. You are so helpful and wonderful.
Best to you,
XXXX
Brief Answer:
Nothing dangerous is going to happen with your heart.
Detailed Answer:
Hi dear XXXX!
I am quite sure that your heart and kidney functions keep being perfect, but I could hardly believe it is the same with your mind and thoughts, as your unjustified fears are persisting even after numerous medical reassurances and checkups.
Probably we should give more time to the medications to achieve beneficial effects and may be additive strategies like cognitive behavioral therapy, etc. would yield a better anxiety management.
I recommend thinking positively and be more optimistic, as nothing dangerous is going to happen with your heart. As I know your entire medical history, you have to believe me.
Regards,
Dr. Iliri
Nothing dangerous is going to happen with your heart.
Detailed Answer:
Hi dear XXXX!
I am quite sure that your heart and kidney functions keep being perfect, but I could hardly believe it is the same with your mind and thoughts, as your unjustified fears are persisting even after numerous medical reassurances and checkups.
Probably we should give more time to the medications to achieve beneficial effects and may be additive strategies like cognitive behavioral therapy, etc. would yield a better anxiety management.
I recommend thinking positively and be more optimistic, as nothing dangerous is going to happen with your heart. As I know your entire medical history, you have to believe me.
Regards,
Dr. Iliri
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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