Angie & Jim

A Trip in the Emergency Roomby Jim

Well, using her pacemaker to get her out of arrhythmia didn’t work, so they’re going to do the cardioversion tomorrow. We saw both Dr. Dubin and Dr. Lui and they are concerned about the recent developments. Angie’s heart function has decreased even more since her visit last week, which worries them. They didn’t have a bed available on the cardiovascular floor, but they wanted to observe her for the night, so they asked that we head to the emergency room and “check-in” that way. They have a brand new emergency room in the new building and I guess we came at just the right time because there was practically no wait. Fastest emergency room admission ever.

The plan now is that they will observe her tonight and do the cardioversion tomorrow. There is concern that the amiodarone (her new supposedly more powerful anti-arrhythmia drug) isn’t enough to keep her out of arrhythmia after they cardiovert her. The problem is they have no way to know. She’s gotten stuck in bad rhythms like this before on other medications and had to cardiovert out, so the amiodarone may still be good enough, but the initial signs don’t look promising. If she goes back into arrhythmia after the cardioversion, they’ll need to transition her back to her previous medicine (dofetilide), which means she’ll have to wait for a few days for the amiodarone to clear out of her system before putting her back on dofetilide. Once the dofetilide is in her system (it takes a few days: it has a longer half-life than amiodarone), they’ll do another cardioversion to get her out of arrhythmia and keep her out. So that’s our plan for the week.

Awaiting a Cardioversionby Jim

We’re here at Stanford waiting to see the cardiologist and electrophysiologist. We had to schedule these appointments only a week ago, so they had to squeeze us in and so we’ve got to do a lot of waiting. So far this morning they’ve done an EKG and a device check. Angie is still in arrhythmia, which means the plan is to do a cardioversion, but the latest word is that they’ll do it tomorrow morning. Expected recovery is pretty quick, so we shouldn’t need to stay long. Dr. Lui did say, “bring a bag,” when we were talking about it last week, so I expect we’ll be spending at least one night after the procedure for them to observe her. I’ll post again in a few hours after we have heard from the doctors.

The Ol’ College Tryby Jim

Well, we had our post-op follow-up appointment today to do a device check and speak with Angie’s cardiologist, and I’m afraid there isn’t good news. The device check revealed that Angie has been in arrhythmia since January 9, the day of the ablation. Getting into the arrhythmia isn’t surprising, because they had her stop her anti-arrhythmia medications before the procedure to induce arrhythmia so that they could find the rogue circuits while they were mapping out her heart. The unfortunate thing is that the new medication they put her on hasn’t been enough to get her out of arrhythmia since the 9th. That wasn’t really what we wanted to hear.

So, currently the plan is to increase the dosage for another week to make sure we give the new drug “the ol’ college try” before giving up on it. Dr. Lui asked that we come back in a week and if she’s still not in sinus rhythm (or regular heat rhythm), they’ll need to intervene. They’ll try first with her pacemaker and if that doesn’t work, they’ll have to cardiovert (shock) her. We’ve done a couple cardioversions before, but they aren’t fun. Dr. Lui mentioned the possibility of going back to a former anti-arrhythmia medication if this one just can’t cut it. We’re definitely hoping that the increased dosage is all it takes and we don’t have to be admitted to the hospital next week.

We’re Going Home!by Jim

Our nurse just gave us our discharge instructions, so we’re almost done. Angie has an IV in each arm that needs to be removed, which should only take a couple minutes. We’re happy to be headed home. Thanks again for all of your love and support!

Impending Dischargeby Jim

When a doctors says the words, “discharge papers,” you know you’re probably going to leave today. Things go slowly at the hospital, but it was early this morning when Dr. Motonaga said something about getting Angie’s discharge papers started. I anticipate we’ll be on the freeway home by early afternoon today. Hooray!

The doctors gave Angie her 1-2 week at-home care instructions during their regular morning rounds this morning, which was another good indication that we’ll be out of here soon. She’ll finish loading the new arrhythmia drug at home and continue to adjust her other meds to compensate while she gets to her regular dosage. From here on out, we’ll be trying to manage the arrhythmias with a combination of medicine and hardware (her pacemaker). They’ll check her pacemaker in a couple weeks to see how the medicine is doing. This should allow her body to acclimatize to the new drug and hopefully we’ll see a decreased (or ideally eliminated) occurrence of the arrhythmias.

I’ll do a quick post when we’ve been discharged and before we go so you will know when we’re on our way home. (We’ve had to stay an extra day after being told we were being discharged, so it isn’t official until you’re walking out of the hospital.) Thank you all again for keeping up to date and following along with our medical adventures this time. It means a lot to us that you’re aware of what we’re going through.

Out of the ICUby Jim

I’m here with Angie in our room on the cardiac unit. Angie’s mom stayed here with Angie while I went and took a nap. While I was gone, they moved her out of the ICU (yay!). Now we just play the waiting game while her new medicine kicks in to stop the arrhythmias. It’s a little frustrating because there isn’t really anything she can do to speed things up. For other recoveries, there have been goals, like walking down the hall 3 times a day, or breathing a certain amount, etc. that she can focus on, but this time the observation is just how for her heart and is out of her control. We’ll make the best of it and try to keep her active.

Speaking of breathing exercises, Angie asked for an incentive spirometer (her absolutely favorite thing about hospital visits) so she can work on her breathing. It’s kind of like a game, except much less fun. She was able to get just above 1000 mL, which is her new high score. We’ll see if she can keep breaking her record. 🙂

Shortly after I returned, Angie’s first cardiologist here in California, Dr. Murphy, paid us a visit. It’s been many years since I’ve seen him, but he was still very interested in Angie and had been following her case closely. He had a lot of very kind words to say about Angie, which was very nice. He told us he was always so impressed with how much support Angie has from her family and friends, which he said was so very important in the cases he’s seen. He said he was never worried about us, even though Angie seems to have the worst luck medically, she always takes things in stride and does better than expected. He said she’s the poster child for the adult congenital heart clinic. It was great to see him again and to know that even though he’s stepped away from an active cardiologist role, he’s still very involved here.

Angie’s mom stepped out for a minute, but we’ve got a whole list of movies to watch. Thank you for your care and concern. It means a lot to know you’re following along and aware of what we’re going through. Please comment below if you’d like to leave some words of encouragement for Angie.

Friday Updateby Jim

Today has been relatively uneventful. We’re still in the ICU, but there’s talk of getting us to a regular room. Angie’s blood pressure took a little while longer to bounce back to normal, which is why we stayed in the ICU overnight instead of getting to a room yesterday. Since it’s on the children’s hospital side, they have fold-out beds in all the rooms, so I was able to stay with her last night. (I’m not sure my back will be able to handle 2 nights in a row, but I think Mom may take the watch tonight so I can sleep in a regular bed.) Her arterial line was taken out a little while ago, which always helps with the comfort level. Angie had an x-ray this morning and an extensive echocardiogram last night all checking to make sure there is nothing wrong after yesterday’s procedure. She’s had her first two “loading” dosages of the new med and she’s not had any of the acute side effects (nausea, dizziness, etc.), which is great news. The doctors seem to be saying we’ll probably go home “maybe tomorrow, but more likely Sunday.”

I’ll probably post again later today or tonight after we are on the floor to keep you all updated.