News from Cleveland Clinic -
First and foremost, no transplant yet. The numbers just aren't there. Whatever is going on is complicated and poorly understood. It's believed that some amount of my chest pain is not directly originating from my heart - the current guess is micro-hypertrophied skeletal muscle in the chest wall.
Second, there is a pharmacological issue. There are several different manufacturers for the drug that I was taking, one that is known to produce quality drug with known filling agents that do not interact with the drug metabolism. I not only didn't have the good manufacturer, I had the literal worst one. This manufacturer buys drugs, equipment and filling agents cheap from India, pakistan, and several other places not known for their quality pharmaceuticals. Because of this problem, it's possible that the medication I was taking is either the incorrect drug, the incorrect dosing of the correct drug, or else contains filling agents that interact with the drug metabolism, or some combination of these issues. The doctor confiscated my bad drugs and sent them out for testing.
I've been switched to a different dosing of a different beta blocker from a manufacturer that doesn't cut corners, and batch-tests every lot of drug that is produced. Took my first dose monday evening and I can already tell it's not the right choice. My fatigue is through the roof and I'm dizzy just sitting in this chair. I have a call scheduled for friday to discuss things thankfully.
Third, he wants me off the gabapentin ASAP because it directly interferes with getting me up and active. I have an appointment with a pain management specialist coming up to hopefully begin a wean off that onto something else. No idea what though.
No answers yet, essentially. This new doc found something that he knows he can fix, the drug issue. After we fix that we re-evaluate and try again.