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.

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Author: Andrew Shell

Madison, WI developer, Co-Founder and CTO of Pinpoint Software, founder of Madison PHP.