9.5

I had a full day of cardiac tests on Monday. I started with 12 vials of blood for labs — kidneys and liver look stable. Then I had an echocardiogram — ejection fraction of 25% but stable. Then a 12 lead ECG — very low voltage but stable.

My last test of the day was a cardiopulmonary stress test. It’s also called a VO2 Max test. I walk on a treadmill with increasing speed and incline while measuring the output of my lungs with a mouth piece. It measures how well my lungs work given my weak heart. If the heart gets too weak, lung tissue can be compromised so they keep a close eye on these numbers. (Trying to avoid having to do a heart AND lung transplant.) I had scored a VO2 max of 12 or 13 every test since 2022. But Monday I scored a 9.5. I knew right away the test was harder than before. I knew I didn’t walk as long and I knew my breathing was difficult right away.

After all the tests, I took the shuttle from the hospital to the clinic for an appointment with my transplant doctor. While waiting to see him, I debated the likelihood of him wanting to do a right heart cath (RHC) now rather than the currently scheduled May 2026 given the poor results from the VO2 Max test. The RHC is invasive and unpleasant so they don’t like doing it more than absolutely necessary. But the RHC results – specifically my cardiac index – will determine whether I am eligible for hospitalization and able to move up the transplant list.

When I finally saw my transplant doctor, he told me that my VO2 Max results were concerning but “we aren’t going to panic.” Instead of May, he wanted to do the RHC in January or February so I can enjoy the holidays. Since I was anticipating him wanting to schedule the RHC now, I left the appointment feeling like I had a victory. But I was also disappointed my heart function might be slipping again.

Maybe I just had a bad day. Maybe my heart was a little more grumpy than normal. But after watching my heart function slowly fall for the last 30 years, it’s too exhausting putting effort into the optimism of “maybe”. Instead I will focus on the two or three months until the RHC. I will enjoy the holiday season with Ava, Mark and my family. And then I will cross the RHC bridge in a couple months. I will check in with you again after the RHC. Thank you for continuing this journey with me. I really appreciate your support. ❤️