Chapter 29 – Matters of the Heart

After he detected her heart enlargement I decided to keep Dr. Slobody as Gabby’s heart doctor. He had all her test results so it made sense, and he also owned Cavalier King Charles Spaniels, which are known for having heart problems. He had a lot of experience with cardiac patients and I did not think I would find a better cardiologist for her.
I thought Gabby’s enlarged heart would lead to congestive heart failure (CHF) within a few years. Typically what happens is the heart keeps enlarging, murmurs develop, it gets worse and turns into CHF.  I’ll reveal the end of the story right now and tell you that didn’t happen with us.  In fact, any changes in her heart the next four years were insignificant and almost unmeasurable.  That isn’t what usually happens, and I feel very blessed. 
After Gabby’s dental I gave her the enalapril as prescribed and also gave her a CoQ10 supplement every day, mixing it with her food.  She was still going at warp speed, playing, running, always in a good mood, but sometimes her belly felt cold so I thought her circulation may be worsening. A few months after the dental I took her in for a follow-up to see if there were any changes in her heart, given the cold belly. I was worried as we drove to Meadowlands.  More than anything, I just wanted her life to be an open book, and not see a steady decline to heart failure.  On the way there I prayed that it might be so.
We met Doc first thing on a Thursday morning.  He explained the cold belly was an enalapril side effect and nothing to worry about.  He gave a good listen with the stethoscope, everything sounded good.  Then he did the x-rays.
He put the x-rays up on the monitor and I asked which was the new one.  He said the one on the left.
“It can’t be,” I said.  “The one on the left looks better. The trachea is completely open and the heart is not pushing on it, and the heart looks a little smaller.”
“Look at the chip we put in her during the dental,” he replied.  “It’s on the left.”
I saw the chip. It was true.  It looked better. She had shown improvement, which I did not think was possible.
I was ecstatic as I drove back to Pittsburgh.  I had what I prayed for… an open book about her future.

The rest of the story

For the next two years her doctors never heard a murmur, despite the heart enlargement and leaky mitral valve. I kept listening and waiting for a “cardiac cough” to develop, but it never came.  We did another echocardiogram two years later.  Doc had a new, higher-tech echo machine this time and he took a few days to interpret the readings and call me back. When he did, he was almost laughing.  Any changes he found were tiny and insignificant.  Gabby’s heart was enlarged, but it was holding steady exactly where it was two years before.

About a year after that a barely audible murmur could be heard at times, but only with the pediatric side of the stethoscope.  Sometimes it was audible, sometimes it was not, and that is the way it was for the rest of her life.  We changed the enalapril from half a tablet once a day to half a tablet twice a day, and I kept up with the CoQ10 supplement. I never held Gabby back from playing or restricted her activity at all. Everything worked out just fine as far as her heart was concerned.
I am glad we did not detect the heart enlargement until we did.  Had I known earlier I would have worried about it, and it never had any clinical effects that affected her life or activity level.