HEART and KIDNEY Patients: SOME POTENTIALLY USEFUL SCIENCE: Disclaimer: I am not a medical doctor. If you read anything below, double check with an authoritative medical source, or a licensed medical doctor. This is information from my experience of stuff that happened over time. I generally giving back to society, so one extra person can learn a tad bit more, or maybe even save some lies. This writing is not capricious BS, but real world advice. I wrote this piece because I got to learn some very bitter lessons, and my intention is that upon imbibing the flesh of the following discourse some points might come in handy for you or your loved ones, providence forbidding, similar issues occur that you are privy of. Any medical doctors in the group can correct the information herein; and actually if they provide input it would be useful for you to give elevated credence to their words compared to mine, because they are specifically well trained in the subject matter. HEART ATTACK: Myocardial Infarction---meaning death of heart muscle): This is a circulation problem where blood flow to some part of the heart muscle is significantly impeded, which may result in death of affected heart muscle tissue(necrosis) if not counteracted in a timely fashion. Ischemia is the restriction to blood flow; and chest angina the associated pain as a result. Normally once blood flow normalizes the pain goes away. May be mild and short, or sometimes prolonged duration, and in few cases fatal depending on location of blockage and speed of intervention, or entirely undetected by some such as some diabetes patients, whose systems are kind a diluted in detecting issues. With heart attack immediate medical attention is advised and preferably inside of 30 minutes to minimize potential death of the affected heartmuscles causing their death and compromising the functionality of the heart. (There is this one ghetto version of CPR to yourself by either coughing or sneezing very hard repeatedly and it generates activity that assists in some cases---hapa ndio mnauliza the properly trained medical doctors in the forum). Heart Attack Symptoms: Difficulties breathing Tightness or pain in the chest and especially when you cough or inhale deeply. Radiated pain of Jaws, Arms, neck etc. Breaking into a cold sweat and others. Better safe than sorry! (There is a saying that when confronted by a mkora, give it up and live to tell the tale; an ex-school mate went into recording and 4 years after graduation, the guy, named Carlton Juma, was flying high with events around the country. He was on the way to Nakuru for some performance. Car Jacking of Nissan. He said those guns were fake and reached out and got a bullet to the head--He should just have lived to tell the story instead of that….Get yourself to the ER quickly. There they can reassure you it was just a huge fish bone you swallowed whole with no damage rather than neglecting to do so and blacking out never to rise). 2007: Dad rushed to hospital with chest pains and abdominal pain. Misdiagnosed as “Pancreas” problem and were going to schedule “intervention surgery”. A cousin said no, get a SECOND OPINION-3 months ex post facto a heart attack was the prognosis. It inflicted massive damage because the real issue was never properly addressed during the. occurrence. I still can’t believe the degree of chest discomfort that was described and an EKG or the equivalent wasn’t immediately done to diagnose. 2012: System was drastically down and it was suspected death might be imminent. LVEF (Left Ventricle Ejection Fraction): It’s a measure of the efficiency of your left ventricle activity. LV is critical for the role of pumping blood to all parts to all parts of the body down south. It is the fraction of blood taken in by the ventricle that actually gets pumped out via the aorta to the body. 50 to 70% is roughly normal. Below 40=>heart failure might be suspected. My Dad’s=>12(less than a third of that). June 2016: Second heart attack and prognosis was heart failure and kidney failure(one of the most dreadful combinations of organ failures there is). This KNH cardiologist completely threw out the virtues of his Hippocratic oath: Primum Non Nocere=>First Do No Harm. He NEVER made a nephrologireferral(to keep the consultation fees flowing, and my parents confirmed he had been doing the relevant blood tests. He was my Dad’s primary caretaker and 4 days into admission for multiple organ failure(he had passed it to some Residents or something) he had never stepped anywhere near my Dad’s bed and I called him, then roasted him almost into oblivion. Unless this fool was in the much dreaded KNH Resuscitation Room every family dreads having a relative in. The only thing this greedy bastard said was “he might do dialysis”, and never said why. I told that cardiologist that is the last time he was going to display his professional malfeasance and to later my lady friend had a heart attack(those clots in your legs that swim up your body) and she ended up with him. She said she would come for an appointment at 12 Noon and be seen at 7PM by the Cardiologist. That’s how much he was saturating himself with patients, at the expense of their well being. I told the lady, look, you are somebody I do care for, but I am not at all comfortable with the cardiologist you are seeing and explained everything. She said she felt apprehensive from the long delays etc. but wasn’t sure. She changed cardiologist; thankfully. If you want the name of that disaster of cardiologist in KNH to potentially protect a loved one ask me privately. GET THE RIGHT DOCTOR!!! Off to Aga Khan: Kidney Data: GRF-Glomerular Filtration Rate(filtration unit for the kidney) was slightly less than 15. South of 15 is the range of CKD 5(Chronic Kidney Disease Stage 5 aka END STAGE); it is just as it sounds. BUN was rather elevated (Blood Urea Nitrogen) was quite elevated. One of 3 things will happen; 1. Dialysis will soon be needed. 2.The damaged Kidney will replaced by a transplant 3. Death. We had a scheduled cardiologist session(Same guy who had handled him in 2012 at MP Shah above). The FIRST thing he did was refer us to the Nephrologist. He said looking at these numbers, I am not sure if we are in Dialysis territory so I will refer you to Nephrology, and that is the JOB OF A GOOD DOCTOR! My mum looked at the blood tests and he said the cardiologist had run the SAME tests at KNH for several years. I was so pissed that fool had seen my Dad almost 10 years. He also almost killed him in 2013 with a certain surgical procedures (He was rescued by visiting doctors from Harvard who said yeah y0ou will take him in for that surgery to evacuate the clot, with a very very high chance he won’t wake up ever-so they attacked it medicinally. SECOND OPINION my people. The Nephrologist asked if we had seen a Nephrologist before and we said no we were never referred. He said the kidney function doesn’t go down overnight; basically his kidneys were systematically dying over years(with effectively little over 10r% functionality left. And that piglet had been running these tests for years, but didn’t want consultation fees going elsewhere. CHOOSE THE RIGHT DOCTOR!!!! Kidneys: We laymen generally understand the kidney as those mbosho shaped ograns that filter out stuff and make pee. What I had no idea was the SHEER IMPORTANCE of the kidney in entirety; I was stunned! It will do filtration of toxins for sure, it plays a big role in blood volume(excess as piss etc), red blood cells(produces hormone EPO or Erythropoietin that helps the bone marrow with Red Blood Cell Manufacture—failed kidney patients are prone to anemia!!), osmolarity(balance of the gradient to fluid flows to dilution or concentration), Blood Pressure role via the renin-angiotensin mechanism, some calcium disturbances, and others. A cursory glance and it might be confused for the heart! That’s how vital they are. Kidney Failure: Key causes might include 1. Energy starvation(those beans pack a punch!)-a very plausible knock-on effect of heart failure, which is lack of sufficient circulation of oxygenated blood for nourishment. 2. Prostrate Enlargement: Men after 40s may get enlargened prostrate which can apply undue pressure on that pee pee system of bladder etc. 3. Congenital; defects you were born with. That surmise is instructive in my Dad’s case: His heart failure probably starved the kidneys out and the units slowly but surely died. Intervention years back he very likely would still be around. So once those 2 organs fail in light of the explanations try and imagine the devastation on the body. And it becomes a vicious cycle literally speaking…..You can imagine the tug of war of trying to say regulate blood pressure with both those power houses wounded; or when your heart is too weak to effectively pump blood, and exacerbated by anemia from EPO related complications. Effects: These ones are very unbearable to witness for a loved one. That’s the best summary. Pains(Abdomen, Back, and Shoulders) that from time to time peak and its like somebody dived inside of you and started mercilessly stabbing away, it was literally described-excruciating pain. Systematic Starvation: Absolutely self-explanatory: compromised filtration builds up toxins that may make it to the salivary glands and with chemical composition similar to toothpaste and food tasting like toothpaste. Ever tried to swallow toothpaste directly? Consumption of food is reduced to such amounts you won’t even believe, and the appetite does not spring back in few days either, just keeps going so you slowly starve. With starvation, with the devastation already impacting the body, there is literally no fuel. Heart: Left Bundle Branch Block: This is an electrical problem. Your heart has a pacemaker I think right Atrium where some node transmits electrical via an A/V node towards right ventricle and thence conduction horizontally to the LV. Normally ventricles do this in unison for efficiency. The LBBB is when the horizontal electrical path is impeded, resulting in the LV signals being received through a slow, inefficient path, thus LV contracts later and this compounds the plethora of physiological Armageddon that you are already contending with, and amplify chances of a “Cardiac Arrest” Heart Attack has already been described as a circulation problem, where blood flow to nourish the heart muscle is abridged resulting in potential of heart muscle death or infarction. Intensity ranges from low to fatal. Many times the patient is conscious but with discomfort and quick medical(trying to get in inside of 30 minutes as fast as is practical). Pulmonary Embolism: This a potentially fatal condition caused by a blood clot that blocks blood flow to the lungs, and things can spiral down fast from there. Cardiac Arrest: This is an electrical problem, whereby, due to electrical disturbances, the heart may entirely stop beating, or do so very erratically and result in the heart flattering instead of beating possibly due to breathing irregularities (called arrhythmia or something like that; where bradycardia is too slow and tachycardia too fast). Generally cardiac arrest is just about 100% fatal with no intervention. CPR or Defibrillation(shocking the heart to reboot it); should be immediately rendered preferably inside of about 3 minutes, and chances of brain death or irreversible increase dramatic thereafter. Prognosis is about 90%. Can't remember if this was with immediate intervention or not, but generally speaking will kill you almost certainly with no quick intervention. In a cardiac arrest, generally people collapse and lose consciousness in a couple seconds with very thready or no pulse at all. It should be noted that on occasion a heart attack may trigger a cardiac arrest depending on the specifics.