ER visit results in HCM diagnosis

runnersmist · Jun 7, 2010

My male cat (George) was fine and then on Tuesday, I had his 3 year Rabies vaccination. By Friday night I noticed a low fast/rapid breathing. I thought nothing of it and it continued into Saturday. I planned to go to my vet on Monday but by Sunday morning I was getting worried....so off to the ER. Almost 4 hours there and an expensive x-ray later, the vet told me it was hypertrophic cardiomyopathy. My cat was diagnosed with a heart murmur around 2 years of age but he never suffered any symptoms until now, at age 9. The ER gave me two medications: a diuretic and an ACE inhibitor. They last for 10 days.

My normal vet called this morning because the ER contacted him about my visit (I know...big brother). He wanted me to watch for more symptoms but also wanted to know what his behavior was. The most important thing I noticed was a wet cough that has developed. My vet said the fluid in George's lungs is bothering him. Also, he's not running, playing, sleeping well, and only eating a little. His urination has dropped significantly from yesterday. Actually only once (4 am). That might have to do with the fact that he's not drinking much water. Also, he's not waiting for me at the top of the stairs like normal. He's not allowed downstairs on custom wood floors. Every time I'd go downstairs, he would wait at the top of the stairs, even if I was downstairs for 2 hours! The final thing I noticed was his sleeping style. He doesn't want to lie all the way down. He's trying to prop himself up some how. My vet told me that in 7 days we needed to have a consultation and then a few days after that, a course of action needed to be decided.

Of course, I've spent the last day crying at random times. While doing laundry, while loading the dishwasher, or just watching tv. I'm afraid that he won't respond to these drugs and that his HCM is too progressed. I'm more a "quality of life" type of person and right now, my cat is not the cat I knew. No more head-butts or rolling on my chest while I pet him. He actually doesn't seem to like me touching him too much.

I do have another cat that is a few months older. She's doing fine because at first I thought my cats were given a bad batch of the rabies vaccine. I'm also starting my doctorate this fall and I have no job. My ER visit was with good old fashioned plastic. My vet was honest with me and said that cats are great at hiding their illnesses and that I saw labored breathing was a bad sign and an indication of the advanced stage of the HCM. I don't think he's trying to guide me one way or the other, he's just being honest and giving me all the facts. However, I believe my cat will be 'put to sleep' in about 2 weeks.

I'm single and no kids and I'm not taking this well but I must also think of my other cat and my educational future. If anyone has been through this or can provide a shoulder to cry/lean on...thanks.

mews2much · Jun 7, 2010

My friends sphynx has HCM.
I am going to ask her to give you advice.
Her cat Nelson threw a clot last week but is better now.
Sadly I know so many people and breeders with HCM pos cats.
Brooke can help you.
I only do the Purvax 1 year rabies shots because they are safer then the 3 year.
I can give you iinfo on HCM also.

denali · Jun 7, 2010

I had something similar happen when I took my cat to the ER. My cat was very sick for about a month and a half. One night he was having severe trouble breathing. I took him to the ER and he had severe water build up, enlarged heart. The ER vet, regular vet and internist vet all diagnosed him with heart disease. I gave him heart meds and diuretics for a month or two. Then I started consulting with a holistic/homeopathic vet that did not feel my cat had a heart problem. That's when I made the decision to get a Cardiac Ultrasound. It was worth it. His heart was in good shape. The vets had misdiagnosed his condition.

Did the vets do bloodwork? I would suggest you get a cardiac ultrasound. Here is a supportive group for Feline heart cats http://pets.groups.yahoo.com/group/feline-heart/

Good vibes for you and your kitty!

mizmelzy · Jun 7, 2010

I'm soooooo sorry to hear that George isn't feeling well. I know what it's like to have to make that tough decision. I was about to with my first cat peaches and thankfully she did it for me. I wasn't sure what was wrong with her..but they thought a tumor in her brain.

I also had a cat who had a congenital heart defect. I didn't know it until I found her laying unconscious on the basement floor. She as only two years old. It was heart breaking.

Right now I have my cat smokie who is 9 started throwing up. The vet thought it was an irritated stomach but it didn't stop, so he did a blood test today and I am awaiting the results. It could be his liver which I'm praying it's not.

So my heart is with you and your precious George. I will keep you both in my prayers.

brookesphynx · Jun 7, 2010

Hi Runnersmist. Welcome to TCS. I'm sorry that you've joined us under these unfortunate circumstances. Mews2much asked me to come here and talk to you about HCM, as I have a lot of experience with it... I have had 2 cats with the disease, one of them I lost about a year ago when he was in congestive heart failure and one of them is living with me now, doing well on medication because I caught the disease early. One thing I can tell you that may ease your mind - Every cat is different. There's no way to know how well George will respond to the medications. He's likely been living with this for a long time, and at 9 years old, I would guess he had a milder case than most? I'll make some comments for you (in blue) in your original post below...these are just based on my experience, obviously do not replace the advice of your vet. My best recommendation is for you to get George to a cardiologist if you can. Although they are expensive, that will give him the best chance at the longest life. At the very least, try to schedule an echocardiogram, so you'll know exactly what you're dealing with.

Originally Posted by Runnersmist

My male cat (George) was fine and then on Tuesday, I had his 3 year Rabies vaccination. By Friday night I noticed a low fast/rapid breathing. I thought nothing of it and it continued into Saturday. I planned to go to my vet on Monday but by Sunday morning I was getting worried....so off to the ER. Almost 4 hours there and an expensive x-ray later, the vet told me it was hypertrophic cardiomyopathy. My cat was diagnosed with a heart murmur around 2 years of age but he never suffered any symptoms until now, at age 9. The ER gave me two medications: a diuretic and an ACE inhibitor. They last for 10 days.

Just curious here: what dose of the diuretic? Is it Lasix?
What ACE-I? Is it Atenolol? What dose of that? Did they measure his blood pressure or heart rate? Did they administer any oxygen at the ER? I'm just trying to get a feel for if the ER vet thought he might be in congestive heart failure...if he's showing clinical signs, that might be the case. If so, he might need more aggressive treatment right now to pull him out of CHF. Then you can back down to a maintenance dose of medication.

My normal vet called this morning because the ER contacted him about my visit (I know...big brother). He wanted me to watch for more symptoms but also wanted to know what his behavior was. The most important thing I noticed was a wet cough that has developed. My vet said the fluid in George's lungs is bothering him. Also, he's not running, playing, sleeping well, and only eating a little. His urination has dropped significantly from yesterday. Actually only once (4 am). That might have to do with the fact that he's not drinking much water.

This is all very curious to me. The diuretic should be helping to decrease the fluid in his lungs. It should be helping the wet cough - I'm surprised it would develop after starting the medication. Also, a major side effect of the Lasix is increased drinking and subsequently, increased urination.

Also, he's not waiting for me at the top of the stairs like normal. He's not allowed downstairs on custom wood floors. Every time I'd go downstairs, he would wait at the top of the stairs, even if I was downstairs for 2 hours! The final thing I noticed was his sleeping style. He doesn't want to lie all the way down. He's trying to prop himself up some how. My vet told me that in 7 days we needed to have a consultation and then a few days after that, a course of action needed to be decided.

The way he's propping himself up is a classic symptom of pulmonary edema (fluid in the lungs). He's doing this to keep the pressure off of his heart and lungs so he can breathe more comfortably. I would not wait 7 days. This isn't going to improve on it's own. Again, I'm not a vet...I can't tell you what is right for your cat's situation, but I can tell you what I've experienced myself with 2 of my own cats...that this required an increase in the diuretic when it happened to mine. It could very well get worse in a week. If you act quickly, you could save his life, and have a lot more time with him. Like I said, every case is different...

Of course, I've spent the last day crying at random times. While doing laundry, while loading the dishwasher, or just watching tv. I'm afraid that he won't respond to these drugs and that his HCM is too progressed. I'm more a "quality of life" type of person and right now, my cat is not the cat I knew. No more head-butts or rolling on my chest while I pet him. He actually doesn't seem to like me touching him too much.

Oh, I can tell you, I know this pain. I cried so many tears I didn't think I'd ever be able to cry again. When my first boy was diagnosed with HCM, he was diagnosed in the ER, just like George. I was told right then and there that I should put him down. But I had just lost my dog a month before and I didn't have the strength to do it. I asked the doctor to please do everything she could to make him comfortable, so I could take him home and have just one more night with him. Harold came out of congestive heart failure that night and gave me three more amazing months before he got sick again and I let him go. There are medications that can get that fluid out of his lungs, make him comfortable, and bring him back to the George you know...even if it may just be for a short while.

I do have another cat that is a few months older. She's doing fine because at first I thought my cats were given a bad batch of the rabies vaccine. I'm also starting my doctorate this fall and I have no job. My ER visit was with good old fashioned plastic. My vet was honest with me and said that cats are great at hiding their illnesses and that I saw labored breathing was a bad sign and an indication of the advanced stage of the HCM. I don't think he's trying to guide me one way or the other, he's just being honest and giving me all the facts. However, I believe my cat will be 'put to sleep' in about 2 weeks.

The choice is yours. Whatever decision you make is between you and George, and you have to know that either decision you make is humane. Your vet is absolutely right, by the time cats start showing signs of this disease, it is far advanced and the meds we give them are just to keep them comfortable until the disease finally catches up. That's the grim reality of this awful disease. My heart goes out to you. I've dealt with it, and I don't wish it on anybody.

I'm single and no kids and I'm not taking this well but I must also think of my other cat and my educational future. If anyone has been through this or can provide a shoulder to cry/lean on...thanks.

Feel free to PM if you have any questions or just need to vent. I'm so sorry.

otto · Jun 7, 2010

I can't advise or answer any questions, but wanted to welcome you here and tell you I'm sorry your beloved George is so ill. I think you've gotten some excellent information and advice, please do keep us posted on how things are going.

And as was mentioned, I too recommend getting a second opinion.

runnersmist · Jun 7, 2010

Hi,

Thanks for the vibes. The ER vet didn't do bloodwork and I'm thinking of having it done at my vet. As for the echocardiogram, that is out of reach for me. My vet told me that it would cost almost $400 and I can't afford that. Ironically, as my cat lies.....dying.....my very rich father has refused to give money. In his words....."no, I can't stand those cats."

As you can see, I'm up because I can't sleep. It's 2:58 am

Originally Posted by Denali

I had something similar happen when I took my cat to the ER. My cat was very sick for about a month and a half. One night he was having severe trouble breathing. I took him to the ER and he had severe water build up, enlarged heart. The ER vet, regular vet and internist vet all diagnosed him with heart disease. I gave him heart meds and diuretics for a month or two. Then I started consulting with a holistic/homeopathic vet that did not feel my cat had a heart problem. That's when I made the decision to get a Cardiac Ultrasound. It was worth it. His heart was in good shape. The vets had misdiagnosed his condition.

Did the vets do bloodwork? I would suggest you get a cardiac ultrasound. Here is a supportive group for Feline heart cats http://pets.groups.yahoo.com/group/feline-heart/

Good vibes for you and your kitty!

runnersmist · Jun 8, 2010

Hi,

In the back of my head, I'm hoping that George makes the decision for me. As I'm writing this, he's looking very dull eyed and distant. Keeps going behind the chair. Just unhappy. George hasn't been the healthiest cat but he sure does bring a smile to my face on my travels. He's just the best travel cat. Nothing scares him. Usually motorist look at him in the back of my Subaru while he's in a large metal carry crate. He's fearless. At the hotel he jumps on the bed like he paid for the room. Maid service comes in, ummmmm George can you get off the bed so she can turn it down?

I adopted him at almost 4 months, after a family that adopted him returned him after 3 weeks. They decided they didn't want him but clearly abused him. He was hardly fed...very skinny and had worms. He had ear mites too. He was diagnosed with a lot....ringworms, irritable bowl, ear infections, and eye infection. It took my almost 2 years to get that all under control and then he just stopped urinating. That was a 2 day hospitalization to get him back on track. Vet said he would have died if I didn't bring him in but that this would happen again and might not end so well. It never happened again

7 years later, here we are. No illnesses between 2 and 9. I was thinking he was going to be around forever!

I'm thinking that considering his history, the most humane thing to do is put him to sleep. I couldn't bare having him suffer, regardless of the illness and even it meant me having him for another month or two. I'm trying to use these 7 days as preparation. I don't think I can prepare myself but I think my JumJum (nickname) has been through enough.

Originally Posted by mizmelzyMFCCMA

I'm soooooo sorry to hear that George isn't feeling well. I know what it's like to have to make that tough decision. I was about to with my first cat peaches and thankfully she did it for me. I wasn't sure what was wrong with her..but they thought a tumor in her brain.

I also had a cat who had a congenital heart defect. I didn't know it until I found her laying unconscious on the basement floor. She as only two years old. It was heart breaking.

Right now I have my cat smokie who is 9 started throwing up. The vet thought it was an irritated stomach but it didn't stop, so he did a blood test today and I am awaiting the results. It could be his liver which I'm praying it's not.

So my heart is with you and your precious George. I will keep you both in my prayers.

mews2much · Jun 8, 2010

I would not give up yet.

runnersmist · Jun 8, 2010

Thanks so much for your reply! Let's see if I can make this reply make sense. Since Saturday, I've been working on about 2-4 hours sleep. I'm afraid I'll wake up and find George dead, so I just wander around the house. So, here it is a little after 3:15 am..............I'm doing this information from memory as I've tucked the paper away.

The vet put George in an oxygen tank. When he came in it was 85% and in the tank after 1 hour it was 97%. George's pulse was over 200 and his resp was over 30. The x-ray showed fluid in the lungs and an enlarged artery...while standing up. On his side, his heart showed no visible enlargement which is why the vet gave the HCM diagnosis. He also did based on the earlier diagnosis from my other vet when George was 2 years old. The ER vet gave me Enalapril (2.5 mg) and Furosemide (12.5 mg).

When I got up this 'early' morning, there was a large puddle in the litter box...no doubt George's. I emptied it and no sooner than I turned around, another appeared. He's going, thank God! Right now, he's made his way to the back of the leather chair. It is the farthest corner of the house away from everyone. Ever since I adopted him, he's slept at my feet...ON MY FEET. It's hard to sleep without him there

((((((( Which might explain my odd sleeping pattern.

The issue of rushing him around to vets for just another month or two doesn't sit well with me. I want him home with me and not being picked at. He doesn't like me touching him so I know more vet visits will make him feel anxious. I think I know deep down that it's time to let him go. Especially when I look at his rough start. I was happy to bring him out of that...he was so young and thrown away like so much trash. I knew he would have a good number of years with me. I just didn't think 'now'. Like, when is it 'ever' a good time for your cat to die? Is it more about me 'not' being ready versus him not being ready. I JumJum was still with those first people who adopted him, he'd already be dead...I believe.

Another sunrise will soon be here and I'm going to see what it holds. It just kills me not to wake up to George's morning eyes and pawing at my face for food. He hasn't done that in a couple days now anyway. It has always cracked me up how the first pair of eyes I see every morning are his. All wide-eyed and then the paw spread out that lands on my nose. Then the biggest meow known to humanity comes out and he runs for the edge of the bed and turns around and looks at me. Oh, I didn't follow.....repeat steps 1 through 3

Originally Posted by BrookeSphynx

Hi Runnersmist. Welcome to TCS. I'm sorry that you've joined us under these unfortunate circumstances. Mews2much asked me to come here and talk to you about HCM, as I have a lot of experience with it... I have had 2 cats with the disease, one of them I lost about a year ago when he was in congestive heart failure and one of them is living with me now, doing well on medication because I caught the disease early. One thing I can tell you that may ease your mind - Every cat is different. There's no way to know how well George will respond to the medications. He's likely been living with this for a long time, and at 9 years old, I would guess he had a milder case than most? I'll make some comments for you (in blue) in your original post below...these are just based on my experience, obviously do not replace the advice of your vet. My best recommendation is for you to get George to a cardiologist if you can. Although they are expensive, that will give him the best chance at the longest life. At the very least, try to schedule an echocardiogram, so you'll know exactly what you're dealing with.

Feel free to PM if you have any questions or just need to vent. I'm so sorry.

denali · Jun 8, 2010

I know what you are going through but when a cat is sick they will be distant. And that is OKAY....let George be by himself....he needs to recover. It may not mean it is the end for him. You have to think positive, be strong and not show your stress to George right now. Cats pick up on stress VERY easy. I am single and have two cats (that are my kids) and I just recently went through my cat being REALLY sick for 3 months. His recovery cost me thousands and thousands of dollars (due to some bad diagnosises from different vets) but I never gave up. And because I never gave up he is still here with me today. I am wondering if you qualify for assistance? I have seen many different companies that offer assistance for veterinary care. Many different posts on this forum with these companies. They could help you get the proper care and tests for George to definately diagnose him with HCM. Or he may have some other illness that is the underlying problem. Not all illnesses are death sentences. When properly treated George can live a long happy life.

Can you call around for the cheapest cardiac ultrasound? I did and I found it cheaper at one place that was highly recommended and had my vet refer me there. I think it would be VERY important to get this done. Could you ask your vet if he could take payments on the blood work? One thing I wanted to share with you is many vet offices charge WAY too much on medications. I learned a little too late during my cats illness that I could buy many of the medications he was taking through human pharmacies for half the price. It is so worth it to call around to human pharmacies for the best price if they carry the medications you are giving to George. I could have saved hundreds and hundreds of dollars on medications if I would have known sooner.

Hang in there - I know it is hard to see our furbabies sick and not in good health but think positive....George needs this.....

I forgot to ask - is George eating? He has to eat no matter what or he can get very sick. One trick that worked for my cat when he was very ill was Beechnut baby meat food (should have no onions or garlic). This helped him eat for the short term.

runnersmist · Jun 8, 2010

I went to bed at 5 am, only to be woken up by my father at 6:15 am. Well, when I got up, George had scarfed down his food and my other cat's food (dry). But around 7 am, as usual, I gave some wet food and George went town. His and what was left of my other cat's food. He ate like a champ. He's been very active this morning and walking around. Following me, like his normal self. As I look at him now, he is curled up....I haven't seen that position in a while. His head is rested deep in his tail and hind legs. When my father was leaving this morning, even he said, he looks a lot better. AND my father HATES all cats. So, I'm running off to get some more wet food. I know people always say, get the best of the best. Both my cats won't eat Science Diet wet/dry food. They like Friskies and Fancy Feast. At this point, I just want him to keep eating like this. His diet never failed too much....George is an eater. Always has been. I guess it was luck that he didn't stop eating during this ordeal. I've sent an email off to my confessor/spiritual adviser (I'm a practicing Catholic). Many early morning thoughts about this whole situation has me coming more to a place of peace. I just want him comfortable. Whether for a week or a year, with no intervention. I believe I'm doing the best for him and if he continues to eat and drink and urinate...I can't ask for more. Also, if he does the little circle dance like this morning....that's the JumJum I know.

Originally Posted by Denali

I know what you are going through but when a cat is sick they will be distant. And that is OKAY....let George be by himself....he needs to recover. It may not mean it is the end for him. You have to think positive, be strong and not show your stress to George right now. Cats pick up on stress VERY easy. I am single and have two cats (that are my kids) and I just recently went through my cat being REALLY sick for 3 months. His recovery cost me thousands and thousands of dollars (due to some bad diagnosises from different vets) but I never gave up. And because I never gave up he is still here with me today. I am wondering if you qualify for assistance? I have seen many different companies that offer assistance for veterinary care. Many different posts on this forum with these companies. They could help you get the proper care and tests for George to definately diagnose him with HCM. Or he may have some other illness that is the underlying problem. Not all illnesses are death sentences. When properly treated George can live a long happy life.

Can you call around for the cheapest cardiac ultrasound? I did and I found it cheaper at one place that was highly recommended and had my vet refer me there. I think it would be VERY important to get this done. Could you ask your vet if he could take payments on the blood work?

Hang in there - I know it is hard to see our furbabies sick and not in good health but think positive....George needs this.....

I forgot to ask - is George eating? He has to eat no matter what or he can get very sick. One trick that worked for my cat when he was very ill was Beechnut baby meat food (should have no onions or garlic). This helped him eat for the short term.

denali · Jun 8, 2010

Yay - I am very happy to hear that the medication is working and George is starting to feel better!!

Well, when I got up, George had scarfed down his food and my other cat's food (dry). But around 7 am, as usual, I gave some wet food and George went town. His and what was left of my other cat's food. He ate like a champ.

This is a very good sign. I am happy to hear he is eating!

I just want him comfortable. Whether for a week or a year, with no intervention.

If this is a heart problem George will most likely require medication for the rest of his life. Are you saying that you are not going to help him in this way? To live his life comfortably and pain free?

otto · Jun 8, 2010

Some cats are so stressed by vet visits and being handled that a long term treatment can affect their quality of life. I don't know the OP's George but she did say he doesn't like to be touched and vet visits cause a lot of stress.

In addition, not everyone has the option of spending thousands to help their beloved companion. I do have the option (plastic), and have. But not everyone can. It doesn't mean the cat is not loved. Life sometimes causes us to make harsh or unwanted choices.

This is not a case where the OP didn't want to spend money to take her cat to the vet. (Those kinds of situations infuriate me.) George got the emergency attention he needed. The OP is not planning to let him suffer needlessly.

If s/he can't afford a lot of testing and treatments, and if all that testing and treatment would cause George too much stress, the OP said she will let him go when he begins to suffer. Sometimes that is the only option people have. It's not a cruel or inhumane thing to do. George doesn't know he's sick, and OP will not let him suffer. The one who will suffer is his mama, when she has to let him go.

Runnersmist I'm sure you will do what is best for you and your beloved George.

Thank you for sharing his story with us. Please let us know how things are going.

runnersmist · Jun 8, 2010

Well, George ate again. Twice! More wet food and some Dental Diet that I keep out. He also urinated. He did the lick lick good stuff grooming and now is curled up at my feet.

I guess I need to clarify. If George starts to go down hill again, then I will put him to sleep. Unfortunately, no I don't have the means to spend lots of money trying to find 'exactly' what's wrong with him. I surely don't have the money for life long medication (which my vet said would be the case if he responded to these meds). It's going to hurt me emotionally and physically but I am comfortable with how I have taken care of him for almost 10 years. We've had a great life together! I couldn't ask for a better companion...well Weezie (my other cat) is pretty spectacular

She's the ultimate princess and everyone better realize it

As my father constantly states, she walks around the house like she pays the bills

I must reiterate that George is not great with being touched by anyone other than me and even that is touch and go. He can be 'hand shy'. Due to his time with the other family. It took me almost 4 years to get him to let me touch him while I was standing. While I'm lying down, he's all over me. Under no circumstance will he allow anyone to pick him up off the floor. That will bring out claws. So, right now he is hyper sensitive and I don't want to cause him any undue distress.

It's true, I have to remain positive and not give off any stress. I'm using my high pitched voice and giving lots of kisses to both my cats. I think I was too gushy with George because my other cat has become super aggressive with him. Almost jealous???? Today she's been begging for my attention and I'm giving it. Love all around!

I'll be moving to DC in 2 months for my doctoral work and I'm sure things will be fine one way or the other.

denali · Jun 8, 2010

Some cats are so stressed by vet visits and being handled that a long term treatment can affect their quality of life. I don't know the OP's George but she did say he doesn't like to be touched and vet visits cause a lot of stress.

Medications can be given at home by owner as well.

In addition, not everyone has the option of spending thousands to help their beloved companion.

If you go back and read my post I DID NOT say that she had to spend thousands of dollars on his treatment. Unfortunately that is what hppened in my case. Just sharing my story. No harm in that......and also letting her know that if she was going to have trouble affording veterinary care that there are companies that will help out with these costs if she qualifies. Didn't know if she knew that. Just sharing some options.

The OP is not planning to let him suffer needlessly.

Once again - I never said she was going to let him suffer. I was asking questions so I could understand her decision. And I see that the poster has now responded with an explaination.

brookesphynx · Jun 8, 2010

I'm so glad to hear George is feeling better, and it sounds like he is responding well to the medications! The furosemide (the diuretic) must be working to pull the fluid from his lungs - that's why he was able to lay down again, and wasn't sitting perched up like you described in your first post!

Like I mentioned in my earlier post, the decision is all yours, and if you decide to let George go...there is nothing wrong with that decision.

But, I can give you another perspective... the medications he's responding to are inexpensive. I get the same meds for about $10 per month.

otto · Jun 8, 2010

Originally Posted by Denali

Medications can be given at home by owner as well.

If you go back and read my post I DID NOT say that she had to spend thousands of dollars on his treatment. Unfortunately that is what hppened in my case. Just sharing my story. No harm in that......and also letting her know that if she was going to have trouble affording veterinary care that there are companies that will help out with these costs if she qualifies. Didn't know if she knew that. Just sharing some options.

Once again - I never said she was going to let him suffer. I was asking questions so I could understand her decision. And I see that the poster has now responded with an explaination.

Most cats will adjust to a maintenance med routine. Some will not, and that can affect quality of life. George does not like to be touched or messed with, even at home, is what I read.

However, Denali my post was not aimed at you directly, at least not to the point where you should feel you have to defend yourself, so I apologize if something I said made you feel so.

I was simply posting my opinions.

ER visit results in HCM diagnosis

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