One of my writer friends once commented that I am an emotional writer. Yes I believe so too. I tell my stories with the emotions that go with it, and I remember patients and their stories together with the emotions that I felt at that time. As a doctor, we strive not to be overly involved or have emotional attachments. Yet success stories are sources of joy. And the patient’s and family’s happiness when shared are also uplifting events that you go back to time and again to reassure you that what you are doing is relevant.
This is the case of MJC, 42 year old male from Laguna. It was our long time patient, and his older brother who brought him to the Center. “Naawa ako sa kanya Doc”, was his brother’s words and referring to his condition to be so grave he verbalized later on, “akala ko mamamatay na siya.” It was a deep sense of care for a sibling that prompted the consult. And a deeper sense of concern for own well being and for the welfare of his children that kept MJC into the treatment regimen and willed himself to come despite the distance from his home in order to get better.
MJC’s case is Hypertrophic Cardiomyopathy, Valvular Heart Disease, Hypertension, and T/C Coronary Artery Disease. His heart is dilated and his heart muscles diseased. His heart is so weak his Ejection Fraction is down to 17% when he first came. (Normal is at least 55%). He has shortness of breath or “hingal”, cannot sleep because of it (orthopnea), is easily fatigued, coughing incessantly and looks very pale, and weak. On his first day, he can barely speak, and was sitting upright in our lounge chairs because of shortness of breath, barely talking or responding, even to his companions. I thought then (even my staff) that maybe he is not amenable in coming for consult, or just plain “suplado”, but as the days went on, and he came in more frequently, his personality emerged, and later we discovered, his jovial character is extraordinary.
Cardiomyopathy according to the American Heart Association refers to “diseases of the heart muscle wherein the heart muscle becomes enlarged, thick or rigid and may be replaced with scar tissue.” Some people with cardiomyopathy may not have symptoms but for some people, it can be life threatening according to the Mayo Clinic. It can be attributed to having irregular heartbeats (arrythmias), blood clots or sudden death.
Conventional treatments proposed to him and his family were not without risk, and costly. While looking for options, they thought of doing some complementary therapies that might alleviate his symptoms in the meantime. This was in July 2016.
Oxygenation was one of the main problems identified and it was addressed by providing Oxidative Therapy (hydrogen peroxide therapy) along with IV Chelation Therapy to address poor circulation to the heart, facilitate repair and improve heart muscle strength. Patient came in 2-3x a week religiously since then, with full support from family. With counselling, he was able to recognize the detrimental effects of his very hectic and stressful work, as well as his high fat, high sugar, mostly processed food diet. He promised, and up to some degree, made positive changes to his lifestyle, and quite reluctantly, rested 100% and enjoyed the peace and quiet, as well as the clean air of Laguna.
Seven (7) months into the treatment, his EF improved minimally, from 17% to 23%. But clinically, MJC was much improved. His color is better, not anymore coughing (coughing was attributed to heart disease), is able to sleep better, can tolerate mild to moderate activities like brisk walking several kilometers, has a more positive outlook and eager to work again. He was encouraged to maintain and come back regularly for his therapies, and to comply religiously with his medications. He would have regular visits to his doctors in Laguna as well and would come to Manila 2x a month for TLC follow up.
Patients have to understand, especially heart patients, that the body (or the heart) needs time to repair itself. Injury most often than not happened in a chronic course, over several months, years or decades and would need almost the same time to get back to health. Like a typical patient, MJC too became impatient but a little improvement is better than a deteriorating course which has been happening to him for years. With further encouragement and positivity from his whole family, he forged on.
Almost 2 years from his first visit, patient looks well. He has started doing a part time assignment and is full of great stories, mostly funny ones, on his visits. His 2-D echo in December 2017 showed a more improved EF of 33%. Our goal now is to reach 40% at least at the end of the year then he could say he is better than his old self. His 2D Echo in 2014 (way before he came into TLC) revealed an EF of 30%, with severe global hypokinesia.
Photo above: With MJC taken in 2017 during one clinic visit. By this time, patient and his family were very eager to share his story. His brother’s words, “ikuwento niyo Doc yung kay (MJC) na case kasi maraming ganyan na baka akala nila wala nang pag asa”. The patient gave his consent as well. His words, “para maraming matulungan”.
I personally feel happy every time this particular patient comes in, because I can still remember his condition when he came in the first time. These days, he stays a bit to update on his activities and his family. Some patients do become more attached to their health caregivers, and vice versa.
This is a 2 year course of a patient in not so many sentences. How can you tell the nitty- gritty details of the personal (and medical) journey of a patient? But this is a start. How I wish I get to share those of patient’s who have been coming to TLC since 2003 or 2004 when the center started or those who were TLC originals, patients since 2010. Here’s to celebrating more emotions, especially joy, of life renewed, and a chance at life with a healthier heart. 🙂
Dr. Glorybelle Molano
The Longevity Center