Angie & Jim

Still on the Tableby Jim

Just got another call. Angie is still int he Cath Lab and they’re into the ablation now. He said she’s doing great, though she might still be a few more hours. They are mapping out herheart and they’ve even seen some arrhythmia, so that’s good (they have to see it to fix it). We should get our next update by around 3.

Still Goingby Jim

I just got a call from one of the anesthesiologists and he said Angie’s doing fine. They’re still in the cath lab and still taking measurements (they have to measure the pressures and such inside her heart) before doing the ablation. I’ll get another call around 1:00 PM with the next update.

Angie’s Arrhythmiaby Jim

While we’re waiting for our next update, I thought I would catch people up on why we’re here today and what they’re going to be doing in the procedure. Angie’s health has been very good for the last few years. Her activity level is considerably high and she’s been feeling well. Unfortunately, over the last couple years she’s been having some arrhythmia. Half of her heart is paced by her pacemaker, but the other half beats on its own. That other part has been getting into bad rhythms that can be bad over long periods of time. When she’s experiencing arrhythmia, she usually can’t tell it is happening at all. She’ll usually just feel a little funny, and be easily exhausted with any exertion. They’re also worried about her general heart function, which is weakened while in and because of arrhythmia. They tried switching one of her medications to something stronger about and a half ago, but that didn’t fix the problem.

And that’s why we’re here today: to fix the arrhythmia. For today’s procedure, they’re first doing a transesophageal echo (TEE) to check for blood clots. For the TEE, they sedate her and put a scope down her throat and check her heart for blood clots. If they find anything, they’ll abort because the risk of breaking loose a clot while they’re in her heart is too high. If the TEE doesn’t find anything, then they’ll proceed with the rest of the procedure. They go in though the arteries in her leg and send another scope up into her heart. Because she has had a Fontan procedure her heart anatomy is a little different and they have to cut through the Gore-tex tubing (connected to her heart as part of the Fontan) to get into the chambers of her heart. From the inside of her heart, they will actually map out the electrical impulses and conductivity of her heart. This process is slow and meticulous. They get a very complete picture of her heart’s electrical characteristics before they try to fix anything. Angie’s anti-arrhythmia medication (the stronger one they put her on 18 months ago) was discontinued Sunday night so that they can (hopefully) catch some arrhythmia while they’re scoping out her heart. That way they can pinpoint the exact location to scar her heart to inhibit the arrhythmia locally. They use the map of her heart to measure how effective their scarring is and whether they’ve actually fixed it. The catheter can burn or freeze the heart tissue and they use both under different circumstances. They’ll probably do some of each in today’s procedure.

They’ve taken all the precautions necessary to have a very safe procedure. There are always risks of complications, but compared to other procedures Angie has had, this one will be easy. The bigger issue is whether this will help. This is the last thing they want to try before moving forward with getting on the transplant list, which we’d love to delay as long as possible. We know it is an eventuality, but we’re not in a hurry to be in that position just yet. So, here’s hoping for the best!

Another Surgeryby Jim

Hello! It’s been a long time since we’ve had a surgery to post about (which we’re very happy about). Today, Angie is going in for an ablation. I’ll keep posting throughout the day to keep everyone informed. The doctors seem optimistic that everything will go safely and smoothly, though they are less certain that the procedure will fix the current problems.

They’ve taken her back and she’s in the cath lab where they’ll be doing the procedure. I should get an update on progress in about 2 hours. They are expecting things to take 5-6 hours today.

Follow-upby Jim

We just got back from the hospital and Angie’s follow-up appointment.  I dropped her off and she went in to get her labs drawn and chest x-ray.  After that, we went upstairs to see the doctor.  They started with vitals and an EKG.  The EKG was a little hard to read because Angie’s heart rate was a little high, so the doctor wanted Angie to go have her pacemaker interrogated at the children’s hospital across the street.  They showed us the x-ray and her lungs look much better.  The fluid is nearly all gone, thanks to the increased diuretic Angie has been on.  Because the image looked so good, they decided to dial down her dosage, which we’re grateful for.  Before we left, Dr. Lui talked to us about a new drug he’d like to put Angie on.  It is a vasodialator that should help with her pulmonary pressure.  That will (hopefully) decrease the fluid build-up and a nice side effect is increased oxygen saturation levels.  There are risks, as with any medication, so we went over those.  He’s very hopeful that this drug will really help Angie get back to normal.

After our chat, we walked over to Lucile Packard’s and did the interrogation.  Being a children’s hospital, the pacemaker interrogator has a little turtle covering.  It’s very cute.  We were thrilled to find out that Angie is not in arrhythmia!  Hooray!  She did have an episode of arrhythmia a few days ago, but it lasted only 11 seconds, so it didn’t worry them too much.  If it keeps recurring, I’m sure it will worry them, but for today, she’s in great shape.  With that great news, they bid us goodbye and let us go to fight commuter traffic on our way home.

We are also very excited to hear that my sister-in-law, Kelly, is cancer-free!  She went in for surgery last week and today we learned that the doctors found no trace of cancer in her body.  We’re so happy for you, Kelly!

We were so excited about the news of the day that we decided to celebrate by going to Angie’s favorite restaurant in Livermore, which is right of the freeway on the way home.  Thank you all for your love, support, prayers, good thoughts, words of encouragement, and everything you’ve done to help us over the last few months.  We couldn’t have gotten through without you!

Going Homeby Jim

We just received our discharge instructions and I’m walking out to get the car now.  Angie was a little slow waking up, so they kept her in recovery longer than usual.  We’re quite happy wet get to go home tonight.  We have a return checkup on Monday to make sure everything is still okay.  Thanks for your love and support today!

All Doneby Jim

The doctors just finished chatting with me and Angie is all done.  The cardioversion went fine; they pumped 100 Joules through her chest.  It worked on the first try, otherwise they’d have cranked it up to 200.  I asked the electrophysiologist how many volts that works out to be, but he didn’t know.  He showed me the impedance from the printout and was curious to know if I could work it out.  Unfortunately, he didn’t tell me how long the pulse was, so I can’t figure it out yet.  I’ll try and ask for it later.

The transesophogeal echocardiogram didn’t find any clots, including the one they saw a month ago, which is great news.  They did, however, see a pleural effusion in her lung.  This is most likely the same effusion that she’s had since our last stay.  The bad news is that it hasn’t dissolved on its own.  I don’t think it will be a big deal, but they ordered a chest x-ray just to make sure.

The other good news is the doctors said they intend on sending her home tonight!  I was glad to hear that.  She’s recovering right now.  I’ll try and post again after I’ve seen her.  I don’t know how long they’ll want to observe her here at the hospital, but I’m sure we’ll end up having to fight traffic again on our way home 😉