The first was my heart. As I was looking through the medical reports from my radiation treatment I discovered an alarming point. During radiation the Mayo team was taking my vital signs each day before treatment. My resting heart rate has historically been very low (sub 50) which was not surprising given my exercise level. In the 2nd week of radiation my heart rate suddenly shot up to 110+. This continued each day until the end of the radiation. I measured my rate 6 weeks after radiation ended: it was still high!
Having discovered the issue, I contacted my internist and started down a new path on my health tour: what is going on with my heart?? This led to a meeting with a cardiologist. The cardiologist looked at my CT scan summary from a year earlier and noticed a comment about calcium in my pelvic aorta. "We should get a heart scan to see if you have high calcium". Sure enough, my calcium score was high and I was put on a statin. This, however, had nothing to do with my high heart rate. EKGs where done, a stress test, and finally a meeting with a heart rhythm expert. I was diagnosed with paroxysmal atrial tachycardia. I was put on medication for a few months, ablation was discussed. In the end, at recommendation from rhythm cardiologist, we dropped the medication (which was not having an affect) and decided no further treatment was needed for now. My resting heart rate has dropped into the 60-80 range.
As has been the pattern of my last few years...investigating one malady leads to concern over another. In this case it was the heart scan. The heart scan gave me a calcium score but it also found a "3 millimeter nodule on my lungs". Ahhh!!!! Stop!!! This was discussed with the oncologist and internist. "Not related to the cancer". "Let's keep an eye on that...no reason to do anything yet."
About this time another issue arrived: a discomfort in my abdomen when I slept. More visits to the doctors, another CT scan, a colonoscopy (incidental...it was due) but nothing found. The discomfort is still there and now noticeable during waking hours. I am hoping this is due to diet, stress, whatever....not something grimmer.
Slowly but surely my confidence in my body was disappearing. I started feeling hopeless. I was not the picture of health. I was a mess!
More details...
- I cannot say why the team at Mayo failed to notice the alarming pulse increase. This is, in my opinion, one of several examples of how medicine has been ignoring a huge opportunity: applying artificial intelligence to medical data. It is surprising that the Mayo staff could have missed this (why bother taking my vitals if you are not looking at the data?) but my assumption is that, for the team, each day was a new day. Nobody was looking at the trend. That is exactly the sort of thing machine learning would have caught (quickly).
- The cardiologist's discovery of the calcium in my aorta is another example of medicine's failure to use AI. If I had not experienced the heart rate issue the cardiologist would never have seen the CT scan. It was only quite incidental that he saw it at all. I almost walked out of his office in my first visit when I mentioned the CT scan. He asked to take a look and saw the aorta calcium observation. If an AI algorithm was running over my data this would have been discovered a year earlier: not accidentally.
- It is not clear what caused my heart issue. There are studies suggesting heart issues for men on ADT. However, I had only been on Lupron for 4 months when my tachycardia arrived. In my case it is hard not to wonder about the heart/ADT correlation as my heart seems to have improved post-ADT.
No comments:
Post a Comment