Omron and AliveCor

I bought an Omron wrist blood pressure monitor several years ago. It connects to my phone so I created an account with one email address. Recently, I purchased an AliveCor KardiaMobile 6L and registered it with another email address. I guess in 2018 the two companies combined or something so the new Omron app can now connect to the KardiaMobile and get EKG’s. I’m debating whether or not to start recording EKG’s on the first account since it would be nice to have one less app on my phone. I would lose a few EKG’s and probably the free month of premium account but its features are pretty much useless.

I now have a full page of medical related apps on my phone: Follow My Health, UCLA Health (transplant), pharmacy, health insurance, FSA, Fitbit, Accu-Chek, Omron, Kardia, Kinsa (thermometer), 23andMe, etc.

Sleep Update 1/24/2020

After getting over eight hours of sleep on January 12th, hours slept each night has been highly variable but generally trending down again.

I’m not really sure why sleep has been so elusive. I’ve been going to bed earlier, around 10:00 – 11:00 pm, but would still wake up around 2:30 am then have difficulty falling back asleep. Since the surgery, I’ve tried the following:

Changed mattress
Purchased a new mattress and bed with adjustable base
Removed heating blanket
Lowered output on space heater in bedroom
Changed cover back to original queen sized comforter

I’m still not getting the temperature right since I woke up all sweaty again last night. Also, the duvet/comforter I was using since surgery is too light in weight. I think I need my heavier comforter that has some weight to it. I sleep better with cooler room temperature but with a heavier blanket to offset the cold.

Genetic Disposition (updated)

My mom just got home from the hospital after spending the night. She went in for surgery yesterday. We thought she was getting a carotid stent for a blocked artery. It turned out it was a carotid endarterectomy instead.

The procedure is similar to my heart bypass surgery that it removes plaque from arteries, just in a different location. Now I’m worried that I have more blocked arteries in other locations since the heart bypass surgery only cleaned up arteries in the heart.

Most of my issues are from lifestyle choice in food and exercise (or lack thereof). However, likely some of it is genetic. I’m more like my mom’s side of the family rather than my dad’s. For example, a lot of relatives on my mom’s side are diabetic as well, and there are a few heart bypass surgeries too. Sometimes I wish I had better genes, like people that can eat whatever and still are healthy and look good with minimal exercise.

I think my mom’s surgery went well and there doesn’t seem to be any complications, especially signs of stroke. Unfortunately, I am also going in for surgery next week so both of us will be recovering. My dad may be real busy for a few weeks taking care of both of us.

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My dad showed me the insurance statement from Blue Shield. My parents have a Medicare Advantage plan through Blue Shield. I though Medicare only paid up to 80% of medical costs but it looks like insurance paid 100% of my mom’s surgery, which came out to be ~$31,000, including one night at the hospital. I’m must surprised how fast the claim was processed. I’m still seeing claims from my ER visit and surgery from three months ago. Maybe that’s the difference between HMO and PPO claims.

Cardiac Rehabilitation Goals

During orientation, the nurse handed me a packet of reading materials. Inside was a sheet with risk factors and goals. I’ll summarize:

Risk Factor	Goal
Physical Activity	> 30 – 45 min. 5 to 6 days/wk (3 – 5 METs achieved)
Diet	Saturated fat < 15 g/day Salt intake < 1500 – 2000 mg/day
Diabetes	Fasting Blood Sugar < 100
Blood Pressure	< 120/80
Lipids	Total Cholesterol < 200 Triglycerides < 150 HDL (m) > 45 (f) > 55 LDL < 70
Weight/BMI	< 25
Stress Management	Practice stress management techniques: relaxation, yoga, exercising at least 25 minutes
Depression	No depression
Substance Misuse	Alcohol <= 2 (m) / 1 (f) drinks/day Caffeine < 2 – 3 cups/day (24 oz brewed) Recreational Drugs = 0 Tobacco = 0

The problem is that after orientation and four sessions, I’ve only seen a few nurses helping with the exercise portion. I have not seen or even heard mention of nutritionists or psychologists. Also, I hope they aren’t grading me at the end of the program (24 sessions) based on the above goals. There is no way I will meet the Weight/BMI goal since that means another 25 lbs of weight loss after losing 25 lbs post surgery. The blood pressure goal will be hard too. I only come in at ~140/80 after taking all three medications beforehand. My nephrologist will need to increase the dosage on something to lower it more. Likewise for blood sugar. I’m on less than minimal dosage with one medication only in case of a hypoglycemia repeat so we may need to increase dosage or add more meds.

Looking through my lab results, the last lipid panel I could find is from late 2016. In it, my HDL is 43, LDL is 71, triglycerides is 184, and total cholesterol is 151. The triglycerides number is a bit high but I think the numbers should have improved in the last three years. I just drew blood for labs that my cardiologist ordered; it included a lipid panel so I’ll know more next week. The rest of the goals are doable.

Cardiac Rehab 1/24/2020

Four down, 20 to go.

Like on dialysis days, I took all three blood pressure medications before going to rehab this morning. Once again, the meds were pretty effective. My starting blood pressure was 137/72 which meant no complaints or delays from the rehab nurses. Even though the gym was pretty full, there was no one on the treadmills so I didn’t have any problems with the cardio portion. My arms are still pretty weak though; I think they also look a lot flabbier than before surgery. All this from sitting around for four weeks?

One interesting observation. The treadmills face a large window which overlooks the entrance to a large parking garage for CHOC (Children’s Hospital of Orange County) employees. On the entrance, there is an electronic counter that show the number of open spots remaining. Each time a car enters, the number would decrease by one, and when a car leaves, it would increase by one. Anyway, on Wednesday morning, the signed showed only three spots were open at 8:00 am. Today (Friday) at 8:30 am, there were over 150 spots open. Does CHOC schedule less people to work Fridays or employees starting the weekend early? Make sure your kids don’t get sick on Fridays.

Valley Loop

I complete another virtual hikes in Fitbit today. The hike is called Valley Loop and it was abut 36,000 steps. Like Vernal Falls, this hiking path is also in Yosemite National Park.

Like the previous virtual hike, there are a lot of scenic areas along the path were Fitbit uploaded pictures. This hike is very pretty too.

After Valley Loop, there is one more solo hike called Pohono Trail. It’s also at Yosemite National Park. This one is a bit longer; Fitbit has it at ~60,000 steps. At the rate I’m going, it’s going to take me two weeks to complete.

Acupuncture 1/23/2020

Today was my fourth acupuncture session and it was much longer. Usually the acupuncturist sets a timer and leaves the room. Today, I think she set the timer a bit longer but also had another client/patient in a different room. I can hear the timer go off but she didn’t come to pull out the needles until 5-10 minutes later. Instead of 25 minutes, it felt more like a 45 minute session today.

At the beginning, when she stuck the needles into my scalp, one of them stung pretty bad. She said it may have hit a hair follicle. Also, for the first five minutes, I felt a pinpoint pain in my left shin that throbbed with my heartbeat. I was going to hit the bell to bring her back but it subsided after 5 minutes. Finally, about halfway through the session, I could specifically feel the numbness increase around my right big toe. Typically the numbness is all over, like a large sock. I believe this was the first time that the numbness felt localized. I’m not sure if it meant anything but the acupuncturist was kind of excited when I told her. She is going to leave the needles in longer in future sessions to see if it will have more effect.

*Just kidding. i think I only got three needles in the head.*

I did feel more numbness while I was laying there but couldn’t tell if it was real or if I just imagined it. I which you could objectively measure sensations like pain or numbness instead of relying on an subjective feeling scale.