Question: I had a "Grieving Haerat Syndrome" event on Feb. 19th of this year with a follow up Echo test this week that showed my number is only "halfway"(46 from it's 36 at event time). I was put on Carvedilol 12.5 at 2x's/days 3-8-17. When I got in my car to drive 5 days ago, my right eye had no depth perception and creates double vision. I had an extensive eye exam yesterday that was normal in terms of cataracts, glaucoma and optic nerve size. So I investigated as to,whether that med could be the cause and it's highly unlikely. I should NOT be driving and All's my heart doc just said was stop taking that med and call him in 2 weeks and not even return to taking the Atenolol I was previously on for quite a while with no side effects. Not taking a Beta blocker right now increases my,anxiety about my heart recompensating or getting worse. After reading that even one eye issue like mine can be a symptom of a stroke, I am even more concerned even though Imdon't have any other signs of a stroke....mild or otherwise. So what else could be the cause as it's Friday morning an. O other docs to consult with about this phenomena. I'm 68 and have not started any other new medication.

I completely agree with your recommendation of continuing a beta blocker as I was shocked he didn't even want me to go back on the Atenolol and told me to not call him for 2 weeks! I need a new cardiac doctor and will insist on someone else in his group! Meanwhile, I called my regular doctor who told me to just go to the ER as she's not a fan of my heart doctor who is retiring soon, so that's where I am right now.....waiting for a cranial cat scan. I begged for an MRI instead because of all the radiation and numerous cat scans in my life but no go. I think the blood work is also checking cardiac enzymes, but will CERTAINLY relay your assessment! A new thing happened on my half hour drive to the hospital, though, in that my vision was clear in both eyes for maybe 5 to 10 seconds and then BOTH eyes got horribly defocused and I felt like I was cross eyed. All the blinking in the world didn't clear it up, but when I tried shaking my head a bit and it magically cleared up in BOTH eyes......but only for 3-15 seconds and went blurry again! So my anxiety response was to tell them I literally fit into the saying of having "a screw loose"! They also did an EKG. And you can be assured I will not be leaving here until I know the results of ALL the testing they are doing and getting copies of it.

I've never used your site so I don't know how to send you those 2 reports you asked for, but I can take a photo of them on my IPad and email them to you as I really want your opinion too.....and not just what my visit here concludes. So I will contact the website to see how to do that. I'm so shocked someone of your caliber was available to me today, but unsure if this was a one time use thing. You seem to indicate I'm able to continue to consult with you! Amazing! I can't thank you enough for responding to me so efficiently and with a direction for a solution via your diagnosis!

I just accidentally deleted an almost finished email to you for the 2nd time while trying to watch the Master's golf with one eye. Clearly (no pun intended), I can't multi-task anymore! So let me try to be more concise about my ER visit yesterday as per my primary doctor's insistence (an Internist). Cranial cat scan=normal. (I asked for an MRI="no"). Bloodwork=normal. EKG=normal! Eye exam via bright light gadget=normal. ER doc hoped that made me happy and had no recommendations except to go back to my cardiologist. He wouldn't call in a specialist, tried to make it about my return to stronger narcotic use on Thursday by my new pain management doctor until I reminded him my eye started on Monday and sent me on my way home. Didn't ask about falls....I've had 3 in 2 months, but did not hit my head. Tripped on a curb at night in a howling rainstorm, and slipped due to bad footwwar the other two despite also needing 2 full knee replacements for 6 years where I now don't pick my feet up as my knees hurt to bend. (Am trying Ablation nerve burning soon instead). So no diagnosis with only telling me to go back to my cardiologist.

So I'm left a bit confused about this clot possibility since you said it might have already done a "hit and run" anyway. If it's gone, my vision is still completely impaired, and to "forget it" with re-testing showing no changes, does that mean I'm permanently "disabled" in that eye (if not worse) for the rest of my life?

I'm going to leave out the other 3 paragraphs I'd previously typed so I don't lose this much! Other than to say I live alone very secluded on 12 acres in the mountains a half hour from a major food store with no children or relatives to either live with or take care of me. Can I find happiness with only having one eye since I'm an outdoors/nature freak, social being who already only gets about 2 hours a day to be in the "world" due to my pain issues that require me to not sit, stand or walk anymore than that? Of course, with help to fight depression. Is that where I'm at now because the tests were normal and you suggest a clot could have already done it's "hit and run" thing? How can I "forget the episode" when I still can't see right in that eye? What can I do next to find a solution......oops.....a diagnosis!!!!

I will start with your last comment about your availability. Again, not very knoweldable of my IPad functions as they are somewhat different from computers. But there is a clock clicking off time above and I don't know what "discussion" means and who defines it and when it ends. I'm a "process girl" who has difficulties with things people see as "events". I see continuums. Since I've lost long, thought-filled writings to you in this format, I don't know what happens, then, when the "discussion closes automatically" as I don't see a "save" button if unfinished. Can you enlighten me or should I try to contact the website. I so hope that it's not a constraint placed on YOU as part as any contractual agreement you have with this website. The clock triggered a bit of codepency in that I didn't want to write to you on a traditional weekend.......even though doctors live at a beat to their own drums when they can. And then there's the time zone difference, if that matters. I won't know that sigficance until I learn the intention/purpose of the clock.

Lastly, a brief eye update as of 9:00 this morning, Sat., pacific time zone: I had to do a 40 minute drive (one way) and I didn't have to cover my eye at all! The vision was about ...hmm....70% more clear?? No head shaking needed! But now that I'm back home being flat doing pain management for hours now, it's partially double plus fully blurry! Oh and I've been wearing the same glasses for years. so the identifying difference today is movement. And not eye movement but physical space movement, if you understand what words I'm using here. If I sit outside a box and think about that and tried to convince someone my auditory system (ear problem) was the cause of my eye issue, I could be at risk to be taken to either a psych unit or back to my spaceship! (Sorry...bad attempt at some levity. It's just that smiling is working for me right now)

So no worries. I will be on the phone first thing in the morning to an Opthomologist's office. I'm both disappointed in my Optomotrist exam in that she said there was no result difference if I chose to be dilated or the 3D photo way. I can make a good guess why, in hindsight. And that word now applies to the ER doctor who kind of arrogantly blew off the possibility of the Occlusion concern and was completely convinced the light gadget would have showed all that. But what do I know! I also realized today how odd he only referred/suggested a return to my cardiologist. No mention/referral of a need to see an Opthomologist even though I did my best to keep him focused on my eye symptoms and not just my heart! He just wanted me gone as tests were normal. That's completely appropriate, but he was extremely high strung and borderline rude, so it was the way and tone he used.

I really am trying to end this email! But great thinking about a Thyroid test! I've never had it or spoken about it to any doctor ever. If it's ever been a question in my doctor's head and it's just another category on A bloodwork form, I would hope she would bring it up with me as she "gets" my desire for real, honest, full truths as I prefer to have my initial reaction to a negative possibility and take time to allow myself to absorb it intellectually to set up emotional safeguards and protection for the possibility and not allow anxiety to stick around nor sleeplessness. Preparing and doing my homework before an appt. helps me cope better. I don't like shocks and negative surprises as I'm not just perceptive, but kninesthetically sensitive. It's an art form to deliver bad news as usually words aren't what people receive first anyway. They just look at the facial expression of the news-bearer.

Oh for crying out loud....I lied. I'm still typing. The Holter monitor? The PVC's have been sparse. Not even one a week maybe? I have to practice disconnecting from frightening stuff as I tend to put too much weight on it if I don't . Besides, those things just contaminate my "present". Ah, I love the practice of awareness. Anyway, another good suggestion and thank you.

I hope you realize and acknowledge to yourself how dedicated you are in the quest to help a patient. You don't seem to be a "linear" thinker, thank goodness. As a patient, if I see my medical problems whole-listically in the sense of "the knee bone is connected to the hip bone"....and that continues upwards, things other than bones ...like organs....are in the way and can be ignored, of course, but shouldn't be (yes, bad analogy).......well, you know what I'm trying to say because you're doing it!

Heartfelt thanks and
Be Well

Hello again. I'm going to try to start emailing you my cardiac test results and I have an Opthomologist exam today. My vision, when looking with both eyes is still a problematic, but oddly, I can see/read television printing clearly with each eye when covering one to read. It just doesn't make sense.

And that takes me right to my struggles to get customer care to explain this website! After numerous responses, the one thing I understand is you don't get paid UNLESS our connection doesn't "close"!! This last response from them seemed to say when it does....if I don't ask you anything within a 3 day period, there is a space somewhere on the page where I can type your name in to request you. I have the "unlimited questions" agreement.

I want you paid! So don't write anything back to me and I'll hold off on emailing tests, etc. for 3 days and. (Yikes) trust I can figure out how to reconnect again. But my heart issue has morphed to more focus on my eye...except for the conflict about the Cardevilol. So I guess it's appropriate I move away from my circulatory system and focus more on my vision issue. Oh and I did check with my primary doc and my thyroid has been tested after all. Guess I never noticed that on the lab referall form since my bloodwork tends to be normal. My only new question to her (when she gets back from vacation) is my shock and concern the blood test done when I had my "heart event" showed I had zero protein!! Zero! And that is another category I don't know if it's been regularly included in my annual checkup.

Thank you again for your help and warm support. You've helped me feel more "grounded" as I decided to trust you are who you represent yourself to be. XXXXXXX

Hi again and thanks for your continued thought/ideas. I will do my best to send you the tests when I had the heart event mid Feb. I thought I was scheduled for an Opthomologist today at a big group, but it was an Optomotrist. I just saw one last Thurs. at a large store where glasses are sold, but they talked me into another one today where I got dilated. She also seemed "stumped" until I mentioned my poor memory with a family hx loaded with Alzheimer's. So I googled it to see if there was a correlation as she's now referred me to a Neuro-Opthomologist after I asked her why. Then I read other possible things like Myasthenia Gravis disease and several other possible causes, so I'm thinking this is not going to be an easy road for me to accept even though I've probably already started accommodating to driving with one eye. Unfortunately, my magic wand is broken or I'd wish for my vision to be restored in the morning...just like it appeared overnight to begin with!

My primary doctor is on vacation this week, but the office can tell me when my thyroid was last tested. The Optomotrist, today, was upset the ER didn't even do a SED rate and wants that done too. Oh and when I showed my cardiologist the bloodwork sheet from my heart hospitalization about the zero protein, All's he told me to do was eat more protein and did not react to seeing the zero. I'll double check it again.

Oh and I'm taking the Cardevilol, so no worries. You asked me about the lenses? Confession: if you're talking about glasses and not the lenses of my eye, I've only ever been to an eye doctor 1x ever until now and I've never worn prescription glasses. Just dry store ones. Nevertheless, last week's Optomotrist the 2 strengths I'm constantly jumping back and forth with are the strength that I need, pretty much. It's so weird to only see double when both eyes are open!

I will do my best not to "awfulize" my eye problem. I'm a gourd artist and do intricate carving, a seamstress with a business starting my.handbags, and I make jewelry too. Double vision takes those skills and XXXXXXX away if this is,not a fixable problem. And perhaps where I then decide to live......staying here in California or moving into the home I just inherited after the death of my dearest mother...in Pennsylvania! I'm now glad I held off on that decision, now, despite everybody constantly asking me if I've decided yet!

I'll try to attempt getting test stuff to you tomorrow.
Smiles back with thanks, XXXXXXX

Unfortunately, my only intention for this email is for personal closure with you. My trust has been skaken. Imagine my reaction, since your last email still asking for heart test results amongst other things along with your reassurance I could always have access to you.....to have customer care write me an email that you said you were finished with advising me as all cardiac issues were resolved.....to paraphrase. Even if a doctor feels that way and tells customer service, they should NOT make the physician the "bad guy" by telling the patient!!! Then they offered a second opinion with another doctor and that came off as my only option. Felt harsh.

So your email along with customer services doesn't match at ALL and I just needed to invite you to please have the courtesy to let your online patient know you're ending...and not just the automatic 3-day cutoff if no contact thing. And if you got scapegoated or have been mininformed by them, I hope you better success in the future.

I'm just not very trusting of personal online work with strangers, so this was a huge huge risk I took. So much for my progress. More work to be done.
I will pray for you, XXXXXXX Tillman

Each morning I awaken, I am trying to be more aware of being grateful I was granted another day of having a "clean slate" to work from. And to reflect on correcting any mistakes I've made and forgive myself. One of my weaknesses/habits/liabilities I am more aware of is being "reactive". Of allowing my past to determine my present. Or contaminate it, at least. And that's what I did with you in not allowing to hear "both sides" of the story before making an impulsive decision. No, you didn't own or admit or didn't or did tell customer service you were done with me which is still a red flag for me, but what am I to do about that? Not sure yet.

I know exactly why I did my closure thing with you and what triggered that. It wasn't customer service. They were the catalyst. And it wasn't your response above, either, as to why I'm asking you to forgive me for doing the closure speech. It was an "emotional relapse" of my trust. Loss and betrayal has been a strong theme in my life the past 6 months that slammed me into a deep clinical depression I've done great work to recover from, but clearly have a long way to go in "discerning" when I'm being scammed/duped/manipulated or being taken advantage of. Besides losing my mom which created such a massive hole in my life and an identity problem, I was robbed by the woman I trusted to live in my house while taking care of my beloved cat (no security cameras to prosecute her), and had 2 electronic devices hacked twice.....2 different times.....by a group of supposed microsoft technicians from XXXXXXX who were just as warm and inviting as you. There are more events that happened, too, but my point is I became completely overwhelmed and unable to step back from my life and get perspective.

I do have a "cardiac" question regarding the revised use of a medication, but asking about that in this email seems not to "fit" with what I'm trying to express. So I will send this as is.......after I take a deep breath exhaling the word "trust" and push past my past, so to speak, and slow my thoughts and feelings down and send this much for now. I realized my behavior in stopping talking to you in the way I did was just like customer service seemingly cutting me off from you! Yikes.

My biggest fear and association with you is you are not who you say you are and will hack into my computer just like those "technicians did. There you go. I admit that was wrong, unfair, and biased. And now must get off to my therapy appointment with my Clinical Psychologist who happens to be from XXXXXXX ........and someone....a person and not a culture or nationality!.......that I completely trust!!!!

My guess is you will understand me a bit more and be willing to continue consulting with me. But I apologize. And that I do for myself as a step in self-forgiveness as my behavior was a serious insult to and of you.

Must go to my session. At least I'm not searching for a topic for today. And my hope is you will allow me my mistake, for lack of a better word, we can continue to consult.
I'm sorry for being so unfair. XXXXXXX

I responded to your last note numerous times but it didn't seem you got them. So I contacted customer service who told me to try again. Unfortunately, this will most likely be a condensed version as my thoughts have been worked over.

So, first...I agree with all you said above, albeit somewhat idealistic. I'm glad we can still consult! So I forgot to tell you my cardiologist changed my use of Captopril, too, after my abnormal echo a couple of weeks ago. I've been taking one a day for years, and now he only wants me to take it if my B/P goes over 140/90. Yes, he wants me to take it 4 x's / day and I've not come close to doing that. I think I also rely on how I feel as I'm good at even guessing what it is. So I know when it spikes. Anyway, thoughts on the Captopril?Whew! It looks the problem is fixed! I cut off my response above as I kept losing long paragraphs. So, to continue, I've only taken one pill so far.

Plus, he put me back on Diltiazem as I used to take that for years and stopped this fall by my primary doctor.

So I'm on the Carvedilol, Diltiazem and Captopril as needed.
Thoughts?
Thank you once again.

Oh no, it happened again! I just typed more for the last half hour and "poof"... it was gone! I'm going to make some quick outline notes and get back to you later. I just wanted to make contact now so the timer keeps going.

What I was going to get into next fro where I left off was I had a nerve block on one knee yesterday and I think the first step is successful. So I imagine the Ablation nerve burning will be scheduled soon too. When I asked this pain management doctor why he suggested this over the total replacement surgery, he said he wanted to "buy me more time." After he saw my puzzled response, he said something about being able to do it again if it works for 6-8 months the first time. But I think he wanted to do the Ablation because of his facial expression when I told him my cardiologist, in his cavalier manner, said something to my unresolved heart condition that still troubles me not being a big deal and everybody with heart problems get surgery all the time I'd of thing. The pain doctor's face went into a frown with a question mark in his head. I then commented that I wouldn't want to be the Anesthesiologist Or my ortho doc with my heart thing. I mean, I was in bed last Thursday all day because I was having breathing problems again. I'll be standing at the kitchen sink not doing anything much and it suddenly feels like there's not enough oxygen in the air. I told my heart doc that, he asked how long it lasts , and...yes....wasn't concerned at all. He did ask me what I do when it happens and I told him I don't even allow myself to start hyperventilating and just take 5 deep breathes in a row TO get some 0-2 in my body and then do slower deep breathes, holding the inhale for 2 seconds before exhaling. In doing that, it all returns to normal in a few minutes. But last week, it was lasting for 15 minutes sometimes! And all the handouts still you to go to the ER but what is the cut off marker for that! It is a about a 35 minute drive to the closet hospital, so that would be nuts. But I could go 2 miles from home to the fire dept where paramedics are stationed. I've done that before as a screening type intervention as they used to run an EKG without a feecharged back when I was having the esophageal spasms I thought were aschemic attacks. And the breathing problem kept popping up throughout that day. In general, it hits maybe every other day or so?

Gosh, I hope this is making sense and I won't lose all this typing! I'll end this one with saying how excited I am about my appointment today with a Ph.D. In the pain doc group for my His Mindfulness coursework. He also does Acupuncture so I will ask him about that for my back. Work comp never approved me even a month of trying, and I'll have to check with my current secondary insurance and if Medicare covers it too, of course.

Ok. Must end here. I will re-do my first attempt that was full of medication questions and asking for definitions of what it a "too low" heart rate and a "weak" heart, for one thing.
Thank you with gratitude, as usual. XXXXXXX

I stopped by my cardiologist's office and got the Echo report from a few weeks ago. They also made me a disc of the study, too. And I changed heart docs within the same group and will see the new one next Tuesday already, so I'm tackling all of this. Yesterday, my ankles were only very slightly swollen but my abdomen felt swollen/bloated too. When I was getting in my car, I noticed a small sound of wheezing at the bottom of my exhale, too. I'm also had a nurse check with my new doctor about the Diltiazem, and he said hold off on it until we meet to discuss all my meds. I also asked about the use of Captopril when my b/p spikes, but we're holding on that too.

If my vreathing gets worse over the weekend, and it resolves by the time I get to the ER, what test would they do for that? My primary doctor ordered a chest x-ray I haven't done yet plus, when I mentioned that to my now former heart doc, he didn't know why she wanted it.

So Imwill attempt to get you the reports by taking pictures of them with my IPad. If the reports don't show up clearly, let me know and I'll take 2 close-ups of the same page. I have the Doppler from whe. The event happened and a few weeks ago. I also had an echo done last year when I was back east, but I have to go to the fa. Place to get that. My doctor back there said I was "fine... whatever that meant, but I was suspicious about some abnormality based on his reaction when looking at the report.

I forget. Did you want any copies of ekg's?

Thank you again, XXXXXXX

I just attempted to send you 2 photos and send them via this website. They were of one page of my most recent Doppler. Please let me know of you got those. I can also send the normal 3KG from my recent trip to the ER. But I forget to get the EKG from my cardiologist the day of that Doppler.

I can also send you the initial event studies that happened in February. The anigiogram.....well, I think they printed out my whole chart of my 3 night stay! So.......

Thank you, but I knew most of this. I guess I am more concerned why what most literature says should have happened by now and it hasn't. What the "born" of recovery time is. And what I'm supposed to do about taking the Captopril. And that swollen legs and abdomen are symptoms of heart issues...which has been my main theme lately. And why the theory about takotsubo seems to get away with saying it rarely hits the same person twice!

To break some of that down, the paperwork the hospital gave me stated most cases recover within 2-3 weeks. Weeks!!! And if my angiogram was so wonderful in that I didn't have much coronary arteriosclerosis, nor valve problem that was serious, etc.....whey haven't I recouped after about 12 weeks!! Of course, I'm happy to see I've recovered "some", but that's a Big difference in time! And then the articles seem to, then, mislead and patronize people by stressing they are rarely NOT capable of generating that much more stress that could cause MOrE cortisol release!!! How does saying that help me?? Or anybody!! Have there been any longitudinal studies of recover an eye of takotsubo that's valid? Of course! someone can create just as much stress again! I would hope the medical handouts would instead suggest what people can do after such an "event" to specifically understand cortisol, the why and how it gets released and be minimally given some breathing pointers. It just worries me that as I continue with problems, it subsequently creates! more fears that a doctor has missed something...and that all causes anxiety then ... you guessed it.....stress!! And it seems like suggesting to people that in 99% of the time say they won't again ever go thru another episode of takotsubo seems to give them a "cop out" to NOT take responsibility for trying address their stress levels. Most people are ablivious to how stressed they are and also have varied definitions of even the word "stress"!

Sorry. I got a little riled up out of frustration. It happens. I'll breathe that out. At any rate, I'll continue my meds, even though they're going to change again! next week. I will get the chest x-ray and see the Neuro-Opthomologist tomorrow even though my vision is normal still, thank goodness. It sounds like you don't want any more tests? Any reasons why?

Oh, and if I may, it's really not helpful to tell someone you KNOW is struggling stress and also trying to manage their stress they were unconsciencesly feeling (denial), be giving the message of validating their reality of having stress and not coming off more like they were discounting it (making it the elephant in the living room, if you know what that metaphor means) by telling them to avoid stress. When you're knee deep in it, you need that lifeguard to reach down and grab you. It too late for them! They've already been drowning in it for a while, most likely! Make sense, I hope?
Warmly XXXXXXX
The emotional recovery from a medical problem is VERY underrated nor given enough care and attention. Besides, who's job is that?
Hmm......... XXXXXXX

I don't have much battery time left, but want to get started on a response. So first, I was glad to see a longer recovery time frame from my heart event. And, again I agree with your thoughts about creating happiness no matter what. You, actually, exemplify my other point about emotional support in that you always listen with empathy and say encouraging, positive things. You are not the norm, though, and it's very hard for most people...especially men....to go to therapy/counselors. Certain cultures even frown on it and not just because of the expense.

So, now, back to specifics. I will get my chest x-ray this week and see my primary doctor Thursday. So I'm going to tell her all your ideas and tests....like another thyroid test, the new one you said above, etc.

I had a frustrating neuro-Opthomologist appt on Friday...mostly because I was asymptomatic. That's valid, but he didn't seem interested in even doing an exam until I made a comment about seeing a neurologist next. (He's a neurologist too). But he really rushed through the eye part, I got flustered, and he seemed annoyed with my questions.

A new awful bodymthing happened Friday morning too. I woke up in extreme upper back and neck pain with my arm. Uncles (both sides) sore to the touch, too. And then a headache starts in the back. By the time I got home from the eye appointment, I was in agony with the worst headache I've ever had. I should say head pain, not ache! And the deep strong pain in my muscles got worse. I really was in agony for hours and don't know what to take. Something to constrict my blood vessels to reduce my head pain, but something opposite to lessen mymusculature pain.this lasted for almost 5 hours and was gone by the night. I've never had this before.

And now today, my vision is blurry again! Both long distance and short. And it, again, feels like it's coming from my right eye. It's not double vision, but I'll know more later. You know, when I googled causes of double vision back when that happened, a couple of rare diseases popped up. One was Myasthenia Gravis. I read a bit and stopped when I noticed starting feeling anxious. But there are some blood tests for that too. My issues of breathing problems fits into that too.

But I'm continuing my "homework" from my Mindfulness coach by listening to his imagery tape on You Tube every day and writing down 3 good things that happened at the end of each day.
Wishing you "balance" - XXXXXXX I just remembered a question I hope you can answer by Tuesday very early my time. I see the new cardiologist who will look at that report I sent you, and I want to know when/how soon could I or should I get another Echo done. My former doc said 4 months but he also said I could have surgery with a weak heart. ( I'm trying to decide when I'm having a knee surgery). Oh and my vision is clear again.
Thank you XXXXXXX