Angie & Jim

Upcoming Decisionsby Jim

Dr. Lui stopped by a couple hours ago to give us a briefing on what is being discussed among the team of doctors overseeing Angie’s stay here.  Basically, it boils down to this: they want to get Angie out of tachycardia as soon as possible.  The problem is there is a risk in cardioverting her right now because she has a clot in her heart.  They are trying to decide between letting her go home and keeping her on anti-coagulation (blood-thinning) medication and then cardioverting her after a few weeks.  Obviously, that means leaving her heart’s atrium racing for weeks — not a great prospect.  The other option is doing the transesophageal echocardiogram (TEE) to make sure there isn’t a clot in the atrium (where the flutter is) and then just cardioverting her on this hospital stay (probably tomorrow).  This would get her heart back to normal, but the risk of doing a cardioversion with a clot is that the clot will break loose and cause damage in other places, possibly resulting in stroke, heart attack, etc.  They don’t know how long the ventricular clot has been there and what the chances are of breaking off from a cardioversion.  Old clots tend to be sturdier and less likely to break free.

Anyway, Dr. Lui wanted to keep us informed of the options being discussed.  I think they’ll have made a decision by tomorrow morning.  I got the impression that Dr. Lui would really like to not send Angie home in arrhythmia, meaning that he would prefer the TEE and cardioversion.  If they do this, they will probably need to keep her here a little longer while she recovers from the cardioversion (which makes you feel like you’ve been run over by a train).  They would monitor her very closely for the first 3 hours to make sure a clot doesn’t end up where it doesn’t belong.  After that, the risk is very slim that anything would happen.

Dr. Lui told us that we have the final say in whether they do the procedure on this visit.  I don’t think if we insist that they do it if the consensus is that it is too risky.  However, if they decide it would be best to go ahead and do it, we have veto power to say, “no,” and they won’t.  I must admit, I feel a heavy burden in trying to make a decision like this, but we’ve talked it over and we will continue to ponder and pray about this tonight.

Thank you all for your continued support.