Karin Bartsch's Journals

We had to drive this morning only 9 miles to reach Bay Landing ( a Thousand Trails Resort ). We had to decide whether choosing a 50 AMP site without sewer connection or a 30 AMP site with sewer. We opted for the latter, way outside at the perimeter of the big park. We are members of Resorts of Distinction, which is associated with this park and play the second fiddle only, so to speak, especially on high holidays as the Fourth of July. We have ample space there and wherever we look, it is green. When we set up the trailer I said to Dieter: Susi would have loved this place, with all the bushes!  Yes, he said and he told me that he has the same thoughts when we enter a place, to think that it is so lovely for Susi. Susi died 8 months ago and we miss her dearly. 

As you can see on the picture of this place here in "Karin's Photos only" (En route from Livingston to Bridgeport, TX), we have no big trees around. On our last location, in Possum Hollow RV Park, we parked underneath a very old oak tree. That has a positive aspect of having shade and the negative one of having to face the danger of falling branches, which is exactly what happened to us yesterday. We had a day of heavy rain and a soaked dry branch broke off and fell down onto our livingroom slide-out and damaged the slide-out awning. That was quite a thump when it hit our trailer. Dieter will try to fix it when we are in Deming, NM. 

Here the broadband connection for my notebook is fine and cellphone also, but Dieter's laptop is way out of Park WiFi  reach. His website has to wait for his postings.

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About my heart - my physical heart......

I started to have angina episodes in fall 2008, visited a doctor and was given a prescription of Quick-Release Nitroglycerin.

Boy, was I glad I had those little sublingual tablets handy, the sudden squeezing and pressuring pain underneath my sternum was excruciating.

I had other episodes on April 3. and on May 28. May 28. we called 911 and I was in the hospital in Conroe for 2 days. They checked me out with all modern machines there are, including a stresstest on the treadmill. Every test came out negative, no signs of any damage to the heart. No plaque in arteries, cholesterol level normal, blood pressure rather on the low side, very normal and EKG normal. My stent implant was fine and clear.

Anyway, I had another episode on June 8. and on July1.

On July 1. the cramps were so severe that I could not see anymore, my open eyes saw only white, bright light, I was not able to talk, just moan. I had taken 3 Nitro after 5 minutes each and the cramps were still in full swing. I felt nauseated, was in cold sweat , and according to Dieter I was very pale. I told him to call the emergency crew again when I would pass out. But suddenly it subsided, after 25 minutes.

The next day it came on about 9 PM. it always occurs when I am at rest, doing nothing. At first it feels like I have eaten too much or are bloated, then a pain concentrates itself underneath the sternum. All in the matter of maximum a minute.

After having taken 2 Nitro already, we called 911 . After 3 minutes 2 police cars were arriving first, then a fire truck with 2 first responders, shortly after the emergency vehicle came. The campground had blocked all traffic to give all those vehicles free room until we left the premises.

Eventhough I knew that the Nitro would kick in shortly, I wanted to go to the hospital anyway because I figured it was high time to get a prescription of something to prevent those episodes from occuring. While I was in the hospital in Bridgeport, I had another incident at 9:45 PM on July 3. The nurses rolled in the EKG machine and made that test while I was in pain. All came out normal, at least the doctor could not see any indicators. He said it could be

"Prinzemetal's Angina", also known as variant angina or Angina Inversa.

But in order to confirm this diagnosis technically, a certain test has to be done, an injection which induces cramps. Doctors obviously don't go by symptoms alone. even when those symptoms are crystal clear.

He prescribed  Imdur (Isosorb Mono ER 30 mg tab Wes) to take in the morning, most likely this prescription is for life. When I was released from the hospital on July 4. I was handed over an envelope with all the copies of the tests for my cardiologist in Casa Grande, Arizona. I will make an appointment there for the end of Oct., when we arrive in that region of Arizona. Dr. Thomas Steffen was the one assigned to me as a patient without a steady family doctor because of our traveling. This doctor had my admiration because he looked at me from head to toe - literally. He adressed all possible facts which could lead to a betterment of my condition. And he suggested that I should discuss with my cardiologist the pace maker issue, which was on the talble already when I received the stent. I had a heart rate of 30, which was the lowest so far recorded. After the angina incident my blood pressure is like  89/53.

The Internet has the following to say ( in excerpts) about "Prinzemetal Angina":

It is a syndrome typically consisting of angina (cardiac chest pain) at rest that occurs in cycles. It is caused by vasospasm, a narrowing of the coronary arteries caused by contraction of the smooth muscle tissue in the vessel walls rather than directly by artheroclerosis.

It should be suspected by a cardiologist when the pain occurs at rest or at sleeping and/or in clusters and without apparent cause, and in the absense of a positive treadmill stress test, as Prinzemetal's is exercise tolerant and can generally only be diagnosed after other forms of cardiac disease have been ruled out.  The pain can be quite severe.

Why the coronary arteries undergo those spasms is not known as yet. However, doctors and researchers believe that the lining of the blood vessels are thin and attribute this as the major cause for the spasm. Under normal circumstances, the lining of the arteries release nitric oxide, which helps to dilate the blood vessel. However , when the lining is thin or damaged, then the nitric oxide is not produced in sufficient quantities, and thereby leading to the narrowing of the arteries and the spasms. Even problems with the muscle tissue or nervous system can cause spasm of the artery leading to Prinzemetal's angina.

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July 5.

The pattern of spasms every day seems to be broken. Nothing happened yesterday, I could enjoy fully being in my "house" again. I have the firm resolve to lessen the time doing nothing or sitting at the computer for long times which might trigger those darn spasms. Dieter and I walked yesterday evening for 30 minutes when the sun was going down. I had a good night's sleep. I do not have the feeling that weather conditions have anything to do with it. We sit in our air-conditioned trailer during the day when the heat is high.

July 13.

Prinzemetal's angina comes in clusters alright.......

I had incidents again on the 9., 11. and 12.

Today I contacted my doctor again and asked whether he could increase the dosis of the Imdur. He did. He prescribed Imdur 60 mg/day, which I will start tomorrow. I also asked him for Antibiotics because I have elevated temperatures lately. There is an infection somewhere, maybe in the lining of the coronary arteries???

Hopefully this will turn out to be better for me.   I hate cramps !!!!!!!!! Especially around my heart..