## Zachary Vance - Medical History
All tests, labs etc should be attached.
-Childhood: Standard vaccines. Grew up in military bases abroad so somewhat more vaccines than usual, unsure which.
-2002-2004: Ankle surgeries on both ankles to correct pronation. Screws inserted in both
-?: Tonsils removed
-?: Dental surgeries to remove baby teeth
-?: Dental surgery to remove wisdom teeth
-2007-01-10: Blood donation
- heart rate 100bpm
- blood pressure 130/70
-2014: Adult vaccinations due to Vietnam trip. Typhoid, Japanese Encephalitis, Rabies, Tdap
-
-...
-
-2018-10-17: Got in a fight, eye injury. Glasses lens popped out of frame and hit eye.
-(2018): Treatment for eye injury (trauma). Dignosis of glaucoma, emergency surgery. Recovered fine, still seeing optometrist twice a year. Developing cataract in one eye.
-2019-03-29: Began physical therapy for ankle issues (repeated sprains)
-2019-04-15 End physical therapy for ankle.
-2019-05-07: OneMedical Doctor appt.
+- **Childhood**: Standard vaccines. Grew up in military bases abroad so somewhat more vaccines than usual, unsure which.
+- **2002-2004: Ankle surgeries on both ankles to correct pronation. Screws inserted in both
+- **?**: Tonsils removed
+- **?**: Dental surgeries to remove baby teeth
+- **?**: Dental surgery to remove wisdom teeth
+- **2007-01-10**: Blood donation
+ - heart rate 100bpm
+ - blood pressure 130/70
+- **2014**: Adult vaccinations due to Vietnam trip. Typhoid, Japanese Encephalitis, Rabies, Tdap
+---
+- **2018-10-17**: Got in a fight, eye injury. Glasses lens popped out of frame and hit eye.
+- **(2018)**: Treatment for eye injury (trauma). Dignosis of glaucoma, emergency surgery. Recovered fine, still seeing optometrist twice a year. Developing cataract in one eye.
+- **2019-03-29**: Began physical therapy for ankle issues (repeated sprains)
+- **2019-04-15**: End physical therapy for ankle.
+- **2019-05-07**: OneMedical Doctor appt.
blood pressure 122/88
heart rate 92
-2019-05-14: OneMedical Doctor appt. Topics were heart palpitations, longstanding finger injury.
+- **2019-05-14**: OneMedical Doctor appt. Topics were heart palpitations, longstanding finger injury.
height 71 inches
blood pressure 126/88
heart rate 83 bpm
weight 183 lb
-2019-05-19: CBC w/differential/platelet; metabolic panel; lipid panel, hemoblogin A1c (all attached)
-2019-05-19: ? hospital. Finger x-ray
+- **2019-05-19**: CBC w/differential/platelet; metabolic panel; lipid panel, hemoblogin A1c (all attached)
+- **2019-05-19**: ? hospital. Finger x-ray
Finger x-ray showed no fracture
-2019-06-18: Allergy panel (environmental)
-2019-06-24: Allergy panel (food)
-2020-12-10: First heart racing
-2020-12-09: Began new exercise program. Previous had started laying down 20-22 hours a day during quarantine. Instead started sitting all day, using standing desk at least an hour a day, eating more veggies, etc. Still going as of 2021-04
-2020-12-12: Confirmed heart is racing for no reason (90-130bpm, for half hour to hour), feeling of it being 'exhausted' outside those periods. Some B-2 and riboflavin supplimentation. Symptoms disappeared a few weeks after this.
-2020-02-05: OneMedical Doctor appt. Subject was chest pain a few days earlier. Diagnosis was not a heart or lung abnormality (best guess was muscular). Prescribed 40mg atorvostatin daily due to two past blood tests, years apart, showing high cholesterol.
+- **2019-06-18**: Allergy panel (environmental)
+- **2019-06-24**: Allergy panel (food)
+- **2020-12-10**: First heart racing
+- **2020-12-09**: Began new exercise program. Previous had started laying down 20-22 hours a day during quarantine. Instead started sitting all day, using standing desk at least an hour a day, eating more veggies, etc. Still going as of 2021-04
+- **2020-12-12**: Confirmed heart is racing for no reason (90-130bpm, for half hour to hour), feeling of it being 'exhausted' outside those periods. Some B-2 and riboflavin supplimentation. Symptoms disappeared a few weeks after this.
+- **2020-02-05**: OneMedical Doctor appt. Subject was chest pain a few days earlier. Diagnosis was not a heart or lung abnormality (best guess was muscular). Prescribed 40mg atorvostatin daily due to two past blood tests, years apart, showing high cholesterol.
EKG normal
blood pressure 118/78
resp rate 14 bpm
heart rate 112 bpm
-2020: Self-diagnosed chronic (whole-body) inflammation. Went away when I fixed my ankle problems in early 2021.
-2020-12-21: Very bad ankle sprain. Couldn't sleep much or even sit up for a week.
-2021-?: Fixed ankle problems after resuming physical therapy on my own.
-
-2021-03-24: Current symptoms begin (see "symptoms" and "recent timeline")
-2021-04-05: Telemedicine (phone) appointment with Dr. Rahoul Ahuja.
-2021-04-16: Highland Hospital cardiac tests. EKG. Echocardiogram TTE. (attached)
-2021-04-16: Highland Hospital blood tests. CBC w/auto differential; comprehensive metabolic panel; lipid panel; hemoglobin a1c; tsh w/reflex to ft4 if abnormal (attached)
-2021-04-16: Highland Hospital, first COVID-19 vaccine (Pfizer)
+- **2020**: Self-diagnosed chronic (whole-body) inflammation. Went away when I fixed my ankle problems in early 2021.
+- **2020-12-21**: Very bad ankle sprain. Couldn't sleep much or even sit up for a week.
+- **2021-?**: Fixed ankle problems after resuming physical therapy on my own.
+---
+- **2021-03-24**: Current symptoms begin (see "symptoms" and "recent timeline")
+- **2021-04-05**: Telemedicine (phone) appointment with Dr. Rahoul Ahuja.
+- **2021-04-16**: Highland Hospital cardiac tests. EKG. Echocardiogram TTE. (attached)
+- **2021-04-16**: Highland Hospital blood tests. CBC w/auto differential; comprehensive metabolic panel; lipid panel; hemoglobin a1c; tsh w/reflex to ft4 if abnormal (attached)
+- **2021-04-16**: Highland Hospital, first COVID-19 vaccine (Pfizer)
## Zachary Vance - Symptom Timeline
### Non-recent, heart-related
-2019-06-04: Retired (became more sedentary)
-2020-01-23: **"Skipped" or hollow-feeling beat** (first heart palpitation). At colorado airport (high-altitude), on some caffein.
-2020-05: Gradually reduced and stopped caffein consumption, which reduced heart palpitations.
-2020-10-09: First **heart racing**
-2020-12-09: Began new exercise program. Previously had started laying down 20-22 hours a day during quarantine. Instead started sitting all day, using standing desk at least an hour a day, eating more veggies, etc. Still going as of 2021-04.
-2020-12-12: Confirmed heart is racing for no reason (90-130bpm, for half hour to hour), feeling of it being 'exhausted' outside those periods. Some B-2 and riboflavin supplementation seemed to relieve "exhausted" feeling. Heart racing and tiredness symptoms disappeared a few weeks after this. I stayed on occasional B-2 but not riboflavin.
+- **2019-06-04**: Retired (became more sedentary)
+- **2020-01-23**: **"Skipped" or hollow-feeling beat** (first heart palpitation). At colorado airport (high-altitude), on some caffein.
+- **2020-05**: Gradually reduced and stopped caffein consumption, which reduced heart palpitations.
+- **2020-10-09**: First **heart racing**
+- **2020-12-09**: Began new exercise program. Previously had started laying down 20-22 hours a day during quarantine. Instead started sitting all day, using standing desk at least an hour a day, eating more veggies, etc. Still going as of 2021-04.
+- **2020-12-12**: Confirmed heart is racing for no reason (90-130bpm, for half hour to hour), feeling of it being 'exhausted' outside those periods. Some B-2 and riboflavin supplementation seemed to relieve "exhausted" feeling. Heart racing and tiredness symptoms disappeared a few weeks after this. I stayed on occasional B-2 but not riboflavin.
### Recent (complete)
The first time a symptom appears, it is **bolded**.
I've had two distinct kinds of lightheadedness--ask me about it. The first kind was the usual kind--like when you stand up too quickly. It usually got better or went away if I sat or laid down. The second I don't know how to describe, but it seemed to be hard to focus, and it was correlated with feeling like blood was pooling in my head.
-2021-03-24: Had a short **episode** where I felt like I increasingly wasn't getting oxygen (but could physically breathe fine). Checked using a pulse oximiter--blood oxygen was 96%, but pulse was 120 and rose to 180 by the time I grabbed my roommate to keep an eye on me. Went back down within a couple minutes. Legs/arms were clenching on their own. Had a glass of water and an ibuprofen. Heart rate was relatively normal (85-90) an hour later so didn't go to the ER. Episode was about 2 hours after a stressful falling-out with a stranger. Trouble sleeping.
-2021-03-25: Try to relax. Feeling ok.
-2021-03-26: Center of **chest tender**.
-2021-03-27: Fine.
-2021-03-28: Fine. **Muscles twitching**. **Bottom of throat feels lightly choked**
-2021-03-29: Fine. Muscles twitching, esp chest. Choking feeling.
-2021-03-30: Muscles twitching. **Throat feeling 'pinched' and closed up**, choking. **Green poop**. **Possible heart racing episode.**
-2021-03-31: **Lightheaded**. Choking feeling absent.
-2021-04-01: Chocking feeling returning. Lightheaded when standing. At night, **mechanical trouble breathing**, especially face down or face up. In evening, **throat swollen, irritated feeling in chest**. Worried I was stopping breathing when falling asleep--body felt like it just wouldn't bother with the inhale. Moved to living room to sleep, had roommate watch me a bit. Sleep apnea also worse than usual.
- Developed theory that the cause might be environmental (ex. allergy) and stayed in living room for several days to test.
-2021-04-02: Living room. Made Doctor's appt at Highland Hospital. Breathing fine in morning. Lightheaded in evening sitting down (worse standing). Throat closing up in evening. **Blood pooling in hands** in evening.
-2021-04-03: Living room. Throat slightly closed up. Chest, right side twitchy. Short of breath just sitting. Throat closing up in evening. Chest tight/sore. Just **right half of throat swollen**, **feeling of something stuck in throat**. While laying on floor nearly asleep, sudden huge **spasms on one side of chest (forget which)**--whole lower chest rapidly compacting and releasing. checked heart rate right after, 160bpm. I seemed fine, so went back to sleep about 5-10 minutes later.
-2021-04-04: Living room. **Cold sore.** Quick heart race, felt hard to breathe. **Heartbeat looked irregular** while standing (and checking pulse). Trembly, flushed, lightheaded sitting after. Throat swollen+lightheaded in evening.
-2021-04-05: Living room. Cold sore. Lightheaded.
- Telemedicine visit
-2021-04-06: Living room. Cold sore. Internal hemmorhoid starting? Poss irregular heartbeat.
-2021-04-07: Slightly lightheaded. Out of breath from things like drinking water. Left leg 'pulsing a little'. **Feel heavy** / trembly. Feeling of something caught in throat. Slight **feeling of having inhaled water**, like down nose.
- Swapped air filter in my room.
-2021-04-08: Feeling of something stuck in throat. Slightly out of it. Lightheaded. Dizzy. Poss vertigo+panic at night.
-2021-04-09: Cold sore gone. Internal hemmorhoid starting? Something stuck in throat. **Heart rate extremely low at night (50s, dipped below once)**. Monitoring heart rate. Felt/saw like heart stopped (unclear if true), then sudden fast heart rate (50 to 160). bpm ~59 after this.
-2021-04-10: Stressed. Short of breath. More weird-beat palpitations than usual.
-2021-04-11: Lightheaded when standing. Head feels weird and intense when standing, like **blood pooling in my head**. Feeling of **hearing shutting off** in one ear.
-2021-04-12: Head weird and floaty. Blood in left leg twitching. When nearing sleep, a **whomp of blood vessels tightning or releasing or something for 2-3 sec**? Trouble sleeping.
-2021-04-13: **Feeling of all the blood suddenly rushing from my head** while sitting there. Up until then, had felt some pressure/extra blood in head. Dizzy for a minute or two after, like room was swaying a bit. Heart went a little fast (95-120). Blood rushing to head slowly while falling asleep. Trouble sleeping.
-2021-04-14: Lightheaded. Blood suddenly rushed to/from head. **Face slightly numb**, sweat. Minor acid reflux. Heart went a little faster for a bit. Trouble standing even a few minutes. Trouble sleeping.
-2021-04-15: Feeling of blood pooling in face/head. Very lightheaded standing. Trouble standing even a few minutes. Did not sleep.
-2021-04-16: Hospital visit. Feeling much better, can walk around and stand. Became lightheaded around 3pm in hospital. Lightheaded and a little dizzy. Head feels heavy. Slept. Rapid shallow breathing, felt fine. Extra sleeping. Floaty/dreamy. Tilting my head past vertical feels weird. Acid reflux. Trembly arms. Palpitations, feel dizzy.
+- **2021-03-24**: Had a short **episode** where I felt like I increasingly wasn't getting oxygen (but could physically breathe fine). Checked using a pulse oximiter--blood oxygen was 96%, but pulse was 120 and rose to 180 by the time I grabbed my roommate to keep an eye on me. Went back down within a couple minutes. Legs/arms were clenching on their own. Had a glass of water and an ibuprofen. Heart rate was relatively normal (85-90) an hour later so didn't go to the ER. Episode was about 2 hours after a stressful falling-out with a stranger. Trouble sleeping.
+- **2021-03-25**: Try to relax. Feeling ok.
+- **2021-03-26**: Center of **chest tender**.
+- **2021-03-27**: Fine.
+- **2021-03-28**: Fine. **Muscles twitching**. **Bottom of throat feels lightly choked**
+- **2021-03-29**: Fine. Muscles twitching, esp chest. Choking feeling.
+- **2021-03-30**: Muscles twitching. **Throat feeling 'pinched' and closed up**, choking. **Green poop**. **Possible heart racing episode.**
+- **2021-03-31**: **Lightheaded**. Choking feeling absent.
+- **2021-04-01**: Chocking feeling returning. Lightheaded when standing. At night, **mechanical trouble breathing**, especially face down or face up. In evening, **throat swollen, irritated feeling in chest**. Worried I was stopping breathing when falling asleep--body felt like it just wouldn't bother with the inhale. Moved to living room to sleep, had roommate watch me a bit. Sleep apnea also worse than usual.
+ - Developed theory that the cause might be environmental (ex. allergy) and stayed in living room for several days to test.
+- **2021-04-02**: Living room. Made Doctor's appt at Highland Hospital. Breathing fine in morning. Lightheaded in evening sitting down (worse standing). Throat closing up in evening. **Blood pooling in hands** in evening.
+- **2021-04-03**: Living room. Throat slightly closed up. Chest, right side twitchy. Short of breath just sitting. Throat closing up in evening. Chest tight/sore. Just **right half of throat swollen**, **feeling of something stuck in throat**. While laying on floor nearly asleep, sudden huge **spasms on one side of chest (forget which)**--whole lower chest rapidly compacting and releasing. checked heart rate right after, 160bpm. I seemed fine, so went back to sleep about 5-10 minutes later.
+- **2021-04-04**: Living room. **Cold sore.** Quick heart race, felt hard to breathe. **Heartbeat looked irregular** while standing (and checking pulse). Trembly, flushed, lightheaded sitting after. Throat swollen+lightheaded in evening.
+- **2021-04-05**: Living room. Cold sore. Lightheaded.
+ - Telemedicine visit
+- **2021-04-06**: Living room. Cold sore. Internal hemmorhoid starting? Poss irregular heartbeat.
+- **2021-04-07**: Slightly lightheaded. Out of breath from things like drinking water. Left leg 'pulsing a little'. **Feel heavy** / trembly. Feeling of something caught in throat. Slight **feeling of having inhaled water**, like down nose.
+ - Swapped air filter in my room.
+- **2021-04-08**: Feeling of something stuck in throat. Slightly out of it. Lightheaded. Dizzy. Poss vertigo+panic at night.
+- **2021-04-09**: Cold sore gone. Internal hemmorhoid starting? Something stuck in throat. **Heart rate extremely low at night (50s, dipped below once)**. Monitoring heart rate. Felt/saw like heart stopped (unclear if true), then sudden fast heart rate (50 to 160). bpm ~59 after this.
+- **2021-04-10**: Stressed. Short of breath. More weird-beat palpitations than usual.
+- **2021-04-11**: Lightheaded when standing. Head feels weird and intense when standing, like **blood pooling in my head**. Feeling of **hearing shutting off** in one ear.
+- **2021-04-12**: Head weird and floaty. Blood in left leg twitching. When nearing sleep, a **whomp of blood vessels tightning or releasing or something for 2-3 sec**? Trouble sleeping.
+- **2021-04-13**: **Feeling of all the blood suddenly rushing from my head** while sitting there. Up until then, had felt some pressure/extra blood in head. Dizzy for a minute or two after, like room was swaying a bit. Heart went a little fast (95-120). Blood rushing to head slowly while falling asleep. Trouble sleeping.
+- **2021-04-14**: Lightheaded. Blood suddenly rushed to/from head. **Face slightly numb**, sweat. Minor acid reflux. Heart went a little faster for a bit. Trouble standing even a few minutes. Trouble sleeping.
+- **2021-04-15**: Feeling of blood pooling in face/head. Very lightheaded standing. Trouble standing even a few minutes. Did not sleep.
+- **2021-04-16**: Hospital visit. Feeling much better, can walk around and stand. Became lightheaded around 3pm in hospital. Lightheaded and a little dizzy. Head feels heavy. Slept. Rapid shallow breathing, felt fine. Extra sleeping. Floaty/dreamy. Tilting my head past vertical feels weird. Acid reflux. Trembly arms. Palpitations, feel dizzy.
Got lightheaded in the hospital with a mask on--some evidence this is not environmental.
-2021-04-17: Worrying about stroke because of headaches/blood pooling in head. Called 911 in the morning, thought I had a transient stroke--woke up or was almost asleep when I suddenly head a headache and couldn't move or call out. Was probably a false alarm--EMTs decided I did not need to go to the ER. Feeling heady, especially head, like gravity is turned up.
-2021-04-18: Pretty good. Heart races in morning (5-15 sec), felt a surge of adrenaline when waking up for 1st one. Lightheaded and dizzy. Head heavy.
-2021-04-19: Feeling good. Head heavy, dizzy.
-2021-04-20: Feeling good. Heart a little fast, somewhat stupid.
-2021-04-21: Feeling good. Heart a little fast, somewhat stupid.
+- **2021-04-17**: Worrying about stroke because of headaches/blood pooling in head. Called 911 in the morning, thought I had a transient stroke--woke up or was almost asleep when I suddenly head a headache and couldn't move or call out. Was probably a false alarm--EMTs decided I did not need to go to the ER. Feeling heady, especially head, like gravity is turned up.
+- **2021-04-18**: Pretty good. Heart races in morning (5-15 sec), felt a surge of adrenaline when waking up for 1st one. Lightheaded and dizzy. Head heavy.
+- **2021-04-19**: Feeling good. Head heavy, dizzy.
+- **2021-04-20**: Feeling good. Heart a little fast, somewhat stupid.
+- **2021-04-21**: Feeling good. Heart a little fast, somewhat stupid.
## Zachary Vance - Measurements (at-home)
Measurements are with a "ZacVrate" pulse oximeter
### Blood Pressure Measurements
+
| Date | Arm | Blood Pressure | Notes
|------------|-------|-----------------|
| 2021-04-04 | right | 125/91, bpm 87 | First time using pressure cuff
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