[precaryous]

I have been on PC maybe two weeks or more. I have been mostly hanging out on the psychotherapy forum.

I am dealing with serious depression, PTSD and a survivor of therapist abuse.

My main reason for seeking therapy now after a fourteen year lapse is because my cardiologist told me I need a heart transplant due to heart failure. Thing is, I don't qualify for a heart transplant due to my weight. Last March I had lapband weight loss surgery to help me possibly meet the criteria before my heart gives out. They would only do the weight loss surgery if I agreed to see a therapist.

So, that's how I got back into therapy. My therapy goals are working on weight issues, trauma issues and end of life work. It's ironic, I know.

I hope to learn a lot here.

Thank you,
Pre

[glok]

Hello, precaryous. I wish you well.

[doggiedo]

Welcome. Sorry to hear about your challenges and illness. This forum has been really helpful go me- I hope you find it helpful as well.

[SnakeCharmer]

Precaryous, I have a story to tell you. It has a happy ending, happy enough to be featured in the local newspaper. I know a little bit about the subject of needing a heart transplant because about 15 years ago my best friend was diagnosed with cardiomyopathy (heart failure) and told the only hope for him was a heart transplant, but he was too overweight to qualify for surgery.

His ejection fraction was 16. If your doctors have talked to you about your illness, you know what that means. For others, it's very low, into the hopeless zone.

Fifteen years later, he's going strong, with his own heart. His ejection fraction is now 56, which is in the normal level. He's more than a hundred pounds lighter, but still overweight. He still has heart failure, but he has improved in so many ways that he is able to live with it as long as he takes care of himself.

After he was diagnosed, he became very depressed, as you can imagine. He was also physically weakened. He had to do something he had never done before in his life -- ask other people to help him out. He was the guy who was always doing the helping and it was hard for him to ask for help because he had big trust issues (grew up in an abusive home.) Deep down inside, he believed if he depended on anyone he would be betrayed. And, of course, it always happened, because the slightest disappointment in other people's behavior upset him greatly and brought down big feelings of betrayal. He just found it much easier to be the helper instead of the person asking for help.

If he was going to make it, the first thing he had to do was accept that other people were not perfect and wouldn't always do exactly the right thing and that didn't mean they were were low down dirty curs. It just meant they were human. He decided to start by trusting his doctors, something he had never really done before.

He had to take a ton of medicine, including Coreg, which is a beta-blocker that's especially helpful in cardiomyopathy, diuretics, blood pressure medications, mental health medications, drugs to strengthen his heartbeat, and he had to take them just right, not missing or doubling up on doses or getting careless. That was hard, because he'd always been careless with his health.

Those meds came to over $700 a month and he didn't have medical insurance, which meant he had to sign up for our state's version of medicaid, which he qualified for because of his low ejection fraction. But he almost refused because his frustration tolerance was so low he could barely fill out the forms. That's how things were in the beginning. His emotions were so messed up he'd rather die than spend an hour filling out complicated forms that asked personal questions. Everything seemed impossible to him in the beginning.

The local hospital had a cardiac rehab facility with nurses on staff to monitor progress. This was the best thing he did. It's really what saved his life. The nurses stayed in contact with his cardiologist and his meds were monitored closely. The nurses were no-nonsense, but very friendly at the same time. They kicked his butt, physically and emotionally. Some patients refused to come back because they got mad if a nurse told them what to do. That was another hurdle. Letting someone with expert knowledge be the boss for a while. To really listen. To follow through. All hurdles. Some stumbling now and then, but he eventually surrendered to the idea that being his own boss all the time was not such a great idea.

He had to rely on me to drive him because he was too sick to drive. He hated that. Hated relying on me. It was a difficult situation for both of us. But the only thing that got in the way was his false pride at having to be helped and my reactions when he tried to maintain his dignity by sarcastically making comments. Yeah, it was weird. I was driving him and waiting an hour while he worked with the nurses and driving him home and the only way he knew how to deal with help was to put it down and make snarky comments. Well, that did put a strain on things but we got through it.

He met other people at cardiac rehab who'd had heart transplants and were doing well. He also met a young guy who'd destroyed his heart with methamphetamine addiction and an infection from a dirty needle. That guy turned his life around and had been taken off the transplant list because he had improved so much he no longer needed the transplant. That was supposed to be impossible. But they were finding over and over again that hopeless cases were improving if the patient changed everything.

My friend had to quit drinking and smoking dope. He had to completely change his diet. Especially reducing salt, sugar, fat and junk, which meant everything. He had to exercise, lose weight, take his meds just right and not give into his overwhelming bouts of depression, anxiety and rage. Not easy.

He did all that and his ejection fraction slowly improved until the doctors were no longer talking about a heart transplant. That was 15 years ago. He still has to do all those things to stay well. If he does, he functions at a high level.

Sometimes he goes on eating binges. Excess salt immediately puts him into an episode of acute heart failure. A single KFC chicken dinner with extra biscuits put him in the hospital unable to breathe.

So, he's not cured. He'll never be cured. But for the last 15 years he's led an active and productive life, one he never dreamed possible. It's been a bumpy ride. With ups and downs, but, fortunately, with lots more ups.

I really wanted to tell you this story about living with heart failure. He had to deal with really Big S**T, including coming to terms with childhood abuse of the worst kind. Trusting people, beginning with his doctors. Learning to stop chasing help away because he feared betrayal. And all the hard work. As soon as his doctors saw how willing he was to work, the harder they worked to help him. He didn't know how to access the medical system or talk to doctors, so I went to some early appointments with him. Two different docs said how frustrated they felt working with patients who weren't compliant and how glad they were that he had started working so hard.

You have really Big S**t to deal with, too. Nobody knows what the future holds. But I do know that some things that start out looking and feeling hopeless may have a small little ray of light shining on them. People here at PsychCentral will offer you encouragement and practically 24/7. You came to the right place. Welcome.

[precaryous]

SnakeCharmer:
Wow, thank you for taking the time to tell me about your friend.

I have been diagnosed since 2000 and am on Coreg and many different heart medications, too. My ejection fraction is 20%.

So far, I have lost 28 pounds, but it's early. I just had my third lapband adjustment and I think it will help.

I can't tolerate cardiac rehab but I can walk the dog around the block, weather permitting. I discovered I can still swim, too, which I love. I just need the energy to get ready and go. As you know, heart failure causes great fatigue.
I do what I can around the house- do dishes, rest, get back up and do more dishes, etc.

Even if I don't lose enough weight to qualify for heart transplant, any weight loss will be welcome. I'm not sure if I would want a heart transplant, anyway. If I can have some quality of life at 20%, I will be glad. Maybe I will live a long time at 20%, who knows?

Thank you for replying t me.

[iheartjacques]

Can't imagine what it's like living with a failing heart and needing a transplant. There is a lot of heart disease in my family, and my colleague has an artificial valve after 3 open heart surgeries. It just opens my eyes to how fragile life really is.
I'm interested in end of life work, but I guess you have to go through all the other stuff first?