Ron's Experience
Summary
- Born in Illinois, grew up in Westchester County, NY and have lived in Connecticut since 1987. (USA)
- 61 year old caucasian male.
- Married with three grown children and four grandchildren.
- Diagnosed with Cardiac Sarcoidosis in May, 2021 at age 60.
- Covid Vaccination (Pfizer): (1) 3/10/21 (2) 4/7/21 (Booster) 9/21/21 - No real side effects to speak of other than sore arm and slight headache.
March 2021
I had been sailing along for 60 years with no major health issues
other than having high blood pressure, which was diagnosed and
treatment started in my 40s. In the first week of March,
2021, I experienced a pretty intense issue of tightness in my
chest accompanied by significant shortness of breath. I
wouldn’t describe the chest tightness as painful, just a very
perceptible squeezing which intensified over the course of a
few hours while I was at home. While I wasn’t sure, I became
increasingly convinced I was having a heart attack and I finally
relented to my wife’s wishes and went to the ER, with the
stubborn caveat that she drive me there ... no ambulance.
In the ER, tests showed no evidence of heart attack, but the
doctor informed me I was in AFib and they were going to admit
me to the cardiac telemetry floor to have me monitored and
treated. Chest X-Ray was done and the tightness in my chest
and shortness of breath persisted as I was moved into a room.
When I say “shortness of breath,” at no time was I really
gasping for breath, but I would describe it as every 30
seconds or so, I would have the feeling that I was a breath
behind what I needed and I would have to pant and grab some
air to catch up. As a result, I was completely unable to
get comfortable laying on my back or side in the bed and
the only way I could get any relief was to sit up in a
reclining chair that they moved into my room. I actually
didn’t sleep from Wednesday night when I was admitted
until Saturday night when they finally got things regulated
enough that I could nap a bit, still sitting up.
I will leave out lots of details, but during this 6 day
hospital stay, after CT scan, echocardiogram and an ultrasound
on my legs, the cardiologists and pulmonologists diagnosed
me with pericarditis, mild acute heart failure and inflammatory
irregularities in my lungs, likely associated with the CHF
and a DVT in my left leg. The echo on March 5 showed my LVEF
to be “the low side of normal at 50-55%” per the cardiologist’s
report. When they got my AFib into a more controlled and
satisfactory pace, they discharged me with lots of follow-ups
for the coming weeks.
April 2021
I had another CT scan with contrast in early April which showed
mildly enlarged lymph nodes in addition to other inflammatory
“shadows” in my lungs. A TEE and Cardioversion was scheduled
for the third week of April to take care of the AFib. The
cardiologist aborted the procedure with no shocks delivered
because the TEE showed a blood clot in the left atrium. I was
already on a blood thinner due to the DVT found the previous
month. Throughout the month, I continued experiencing the
shortness of breath, which, while it never got to the degree
I had experienced the previous month, caused me lots of
difficulty with sleeping and I spent most nights sitting up
in a chair. The cardiologist, to his credit, for various
reasons and test results and unbeknownst to me, began to
become suspicious of sarcoidosis and ordered a Cardiac MRI
for me on May 4.
May 2021
A Cardiac MRI on May 4 showed severe biventricular
dysfunction with my LVEF having dropped to 20% and the
gadolinium enhancement imaging was “highly suggestive of
sarcoidosis.” The doctor called me the same afternoon
he got the results and consulted with my pulmonologist,
and asked me to check into the hospital so that the
pulmonologist could do a biopsy on lymph nodes to
confirm the sarcoidosis. He briefly explained to me
what sarcoidosis was but of course I had no idea what
he was talking about. Unfortunately, the biopsy of
the lymph node came back as “inconclusive,” but various
markers they told me about and after bringing in a
Rheumatologist, the specialists all felt a high degree
of confidence that the diagnosis of Cardiac
Sarcoidosis was correct. They ordered a PET scan to
further corroborate that diagnosis. In the meantime,
they had me see a specialist from Columbia Presbyterian
in NYC who agreed with the strong suspicion of Cardiac
Sarcoidosis and agreed with the treatment begun by my
current specialists and continues to consult with
them on my case.
I saw an electrophysiologist who explained the
arrhythmia problems I was having and the risks
particularly associated with the ventricular arrhythmias
I was at significant risk of and showing for some brief
monitored periods and that I was going to definitely
need to have an ICD implanted. With all of the
inflammatory issues and blood clots etc, he told me
that they couldn’t do that right away, and they wouldn’t
let me leave the hospital without wearing a
LifeVest external defibrillator.
The PET scan was done on May 25 and the results were
bad. In addition to telling me that it “lit up like a
Christmas tree,” they said my LVEF had dropped to an
alarming 11% in three weeks. Pulmonology, Cardiology
and Rheumatology all agreed that even without the
smoking-gun of the lymph node biopsy, the PET scan
confirmed Cardiac Sarcoidosis as the correct diagnosis.
Summer 2021
I am thrilled that the treatment that these fine
doctors have provided me, seems to be working extremely
well. I have been on LOTS of medication in various
combinations because of Sarcoidosis, CHF, Hypertension
and Kidney failure. I started on 60mg of prednisone
and they weaned me down on that dosage while adding and
slowly increasing Cellcept at the same time. As of now,
I am down to 5mg per day of prednisone and up to 1,500
mg of Cellcept 2x per day. The Electrophysiologist
also added Amioderone in June. Additionally,
Spironolactone, Entresto, Xarelto, Metoprolol,
Atorvastatin, Vitamin D and Calcium are on my daily
list.
In July, after confirmation that my DVT in my leg had
resolved, the cardiologists rescheduled a TEE/Cardioversion
for the Afib and it worked. I went back into, and continue
to be, in regular sinus rhythm. Encouraging news from that
procedure was that my LVEF which had dropped to 11% in
late May, was back to about 25% at that point. I was
feeling a lot better and the shortness of breath problems
had disappeared through June.
They ordered another echocardiogram in mid-August and the
heart was looking really good. My LVEF had risen back to
45-50%! The electrophysiologist and regular cardiologist
agree that because of the sarcoidosis, my risk of
extremely dangerous arrhythmias remains and I still need
the ICD. Consequently, as of this writing, I have been
wearing this LifeVest for 5 months! Just in case anyone
reading this might have to deal with the LifeVest as a
temporary insurance policy, I want you to know … it is
a pain in the ass to deal with and it especially
sucked over the summer, not being able to swim with my
grandkids etc., but it honestly isn’t as cumbersome as
I was afraid it would be at first and it is manageable
on a day to day basis. The hardest part for me is
sleeping, because I am a pretty active sleeper, and
while the vest itself isn’t too bad, being tethered to
the battery pack in bed takes some real adaptation.
That said, as I write this, today is my last day to
wear this vest! Tomorrow morning (10/12/21) I am headed
to the hospital to get the ICD. While any trip to the
hospital and the whole idea of the ICD makes me a bit
apprehensive, I am resigned to the fact that I need it
and so I’m anxious to get it done, recover and get
on with what my new normal is going to be.
To all of my fellow sarcoidosis travellers, I wish you
good luck and good health. I pray that our doctors are
given the wisdom to help us navigate through this.
Remember that although, as we have all been told, this
disease is very rare and incurable, it is treatable.
I hope your treatment works for you and gives you
comfort.