Mark Herpel and Congestive Heart Failure - Part 1

As I’ve been hinting at over the weekend, I have a special guest at A Hearty Life this week. Mark Herpel is a b5media colleague at Digital Money World who responded to my nosy question asking about the contents of people’s medicine chest (his will be featured later in the series). To my surprise, he said he had congestive heart failure so of course I had to know more. Here’s part 1 of my interview with Mark. If you’ve ever wondered what it’s like to be healthy one second, fall ill without explanation, then told you’re dying, you must read Mark’s vivid description of his experience.

Hsien Lei (HL): How long ago were you diagnosed? What kinds of symptoms did you first experience?

Mark Herpel (MH): I was diagnosed in the emergency room in April of last year. It’s a very difficult story to relive, but in mid January 2006 I was pretty healthy, those last two weeks in January I had a really bad cold or flu with the usual symptoms. I never went to the Dr. I thought it would pass but after two weeks it did not and I was having trouble laying flat on the bed and could not catch my breath (very fast short breaths). You could feel fluid flowing from my lower body into my lungs when I lay down and then my heart would try to jump out of my chest, so I did not lay down for several days.

The Dr. initially told me I had pneumonia and I received powerful antibiotics and steroids. A week later I felt fine so I had a pizza (sodium), after that it just got worse again with the fluid and the coughing all night. Thinking I was doing myself some good I drank lots of water, as they tell you to do when you have a cold or flu. Which was the absolute worse thing I could have done.

After a week I went back to the Dr. and again he said the same, gave me some steroid shots, pills and sent me on my way, a week later the same only worse, I could not lay down and my heart was ’skipping beats’ every few moments I could not put on my shoes or do any exercise. 4 weeks went by and 4 visits to the Dr. He said I had asthma, gave me inhalers, nebulizers etc. No chest x-ray. The fifth week, I flat out collapsed on the floor and blacked out several times in one night. I could not ‘catch my breath’ and my heart was jumping around like a Mexican jumping bean, I was ghost white and sweat was pouring off me. I could not walk 5 steps without losing my breath and having to sit. So I went to the emergency room.

Immediately they put me on a heart monitor and it showed the problems. So it was a day of tests and about 10k USD later, the two doctors came in an explained that I had heart failure. Of course I had not really slept in a week so it did not sink in. I said great give me some pills and I’ll go home to rest, he said no we have to admit you and you are dying. I said Ok, well how do I fix it and he explained that this was one of two or three things…ONE, I was an alcoholic and destroyed my heart with booze (not the case and I took great offense to it) or a virus had attacked my heart and cause it to quickly enlarge and that none of the valves worked properly anymore. The strange heartbeat I was feeling was the blood flowing forward and back into the chambers from the leaky values.

After 13 hours in the ER I still could not breath or walk and they had not given me any medicine to make me feel better, so after he gave me the bad news he said I was a good candidate for a transplant. My first thought was “Is this guy nuts, give me some pills and let me go home.” By now I really had to walk my dog.

Then he gave me Lasix and I began to get rid of all the fluid which was built up. With the heart not strong enough to pump blood to my kidneys, the fluid had built up in me for like a month. All that time I had pulmonary edema (fluid in my lungs) and had been coughing it up every 10-15 seconds all night and day. Two hours later after the Lasix and feeling better, I did not want to hear anymore about transplants so I walked out of the hospital (checked out) AMA and went home to walk my dog get on the Internet and find out how to fix my problem. He gave me some small lasix pills, ACE inhibitor and beta blocker, about three weeks worth and I walked out. The diagnosis is below:

Ejection Fraction = 20-25%
The Right Ventricle is borderlined dilated. The right ventricular systolic function is moderately reduced.
The left atrium is mildly dialated. The right atrium is borderline dilated.
(Mirtal Valve) Normal Moderate to severe mitral regurgitation.
(Tricuspid Valve) Normal Severe tricuspid regurgitation. Mild to moderate pulmonary hypertension.
(Pulmonic Valve) Normal Trivial pulmonic valvular regurgitation

Oh, but no asthma or fever like from a cold or flu….

HL: How did you feel when you were diagnosed? What did the doctor say to you?

MH: After my month long experience with a local Dr., then the ER Dr. two of them saying a transplant was the only way to get well and that I needed to stay to check in to the hospital….I was not too happy with Dr.’s. Medicine is a lot different in Central America* than it is anywhere else. The Dr(s) were very glib, and hearing that was very tough, you just don’t believe it at the time… However, I was just so tired getting the fluid out and being able to breath again, was like being reborn. I just wanted to learn more.

At that early time, 3-4 weeks after the ER, I did not understand how serious the condition was and I did not get better I got worse over that month. I did not understand the role of sodium in my diet and that for me it is a real killer–> BIG time. It was 6 weeks after that I finally saw a US specialist and had another series of test and the stress echo etc. He said, my heart was showing some sign of improvement from the ER test and perhaps the virus was finally gone. The heart was getting smaller and more normal size again. He explained that the part of the heart muscle that had stretched was dead and would not get better. This weakness was the big cause of the congestion. The ejection fraction on that visit was 30-35% and that is where it stands today. [Editor's note: Normal ejection fraction is in the 50's.]

In part 2 of my interview with Mark, we’ll learn more about his sodium-free diet.

*Mark is based in Panama where he says the medical care is very good at large hospitals. He’s currently in the U.S. and has an appointment with the cardiologist in a few weeks.

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Tags: mark herpel, congestive heart failure, chf, heart, heart disease, diseases, illness, health, cardiovascular disease