July 2015

Tuesday, July 7, 2015

Uncertainty about death

I feel like I dodged a bullet today. #

Back in May, I found out that my application for life insurance, both personally and for “Key Man” life insurance at work, were denied. I wasn’t completely shocked since two years ago I had heart surgery to repair a prolapsed mitral valve. They said that if I got another echocardiogram they would reopen my application and see if they could cover me. #

I knew that two years ago I got a clean bill of health so having another echo could do nothing but confirm that I’m doing great. It didn’t quite work out that way. #

I had another echocardiogram done end of May but I wouldn’t be able to get in to see the cardiologist until today (July 7th). I had not heard anything from any doctors regarding my echo, which in this case I assumed no news was good news. Surely if something was wrong I’d get a phone call. #

Two weeks ago I get an e-mail from one of the insurance companies. I was still denied. #

The reasoning for the decline was due to a combination of the mitral valve repair and an abnormal follow up echo showing atrial septal aneurysm, ejection fraction of 40% and an abnormal EKG showing t wave changes. #

What the hell is an "atrial septal aneurysm"? What is a normal ejection fraction? Shouldn’t it be 100%? Am I going to die? #

I send my primary care provider an e-mail asking “What’s going on with my echo?” #

It looks like your heart function has been stable since your previous echocardiogram of almost 2 years ago. #

Ok, but he still didn’t address the aneurysm or why my ejection fraction is so low. #

Today I saw my cardiologist. Apparently an atrial septal aneurysm isn’t a big deal. It just means that the wall in my heart is slightly bowed. Almost no chance for rupture because the pressure is the same on both sides. #

Ejection fraction is what percentage of the blood in my heard gets pushed out when my heart contracts. Normal is 55% and my latest was actually 45% (up from 40% right after surgery). #

He was slightly concerned that my ejection fraction wasn’t higher but it wasn’t life threatening and I shouldn’t even feel any different between 45% and 55%. In order to increase it I’m going to start taking some ACE inhibitors although I’m not sure what they do. All I know is that it will also lower my blood pressure (which isn’t high) and it should help my heart recover. #

I feel like there is a lot that could have been handled differently here but I’m not exactly sure how. #

  1. I should not have learned about my echo results from underwriting, I should have heard from a doctor. #
  2. There shouldn’t have been 6 weeks between my echo and my cardiology appointment. #
  3. If there was no way for me to have been seen sooner, I should have gotten a call or e-mail with my results right away. #

Because of the way this was handled I’ve just had two of the most stressful weeks of my life. I was full of anxiety and having difficulty concentrating at work. I broke down in tears at the dinner table with my family. I had to explain to my wife, parents and boss that there could still be something wrong with my heart and I don’t know what’s going to happen. I literally spent the last two weeks thinking that at any moment something was going to pop in my chest and I was going to drop dead or worse I’d have a stroke. #

Two years ago I was a newlywed heading in for heart surgery. I had come to terms with dying and was able to go through my operation with levity. Now I have a 10 month old daughter. My wife is a stay at home mom and we have a mortgage. It’s not like before where if I died my wife could be sad and then move on easily. There is more at stake now. #

I guess I should take away from this that life is fleeting. I try to enjoy each day as much as I can because in a very real way for me I never know if it will be my last. #

Published by Andrew Shell on and last updated .