Sorry for the delay in updates, but things have been going so well I have actually been SLEEPING at night. It's not that things have not be progressing with Kristi, in fact, quite the opposite. She has her central line taken out, her chest tube and catheter have been removed, one of the IV's in her hand are out and she doesn't need oxygen at night to keep her level up. Instead of wearing a gown she is wearing PJ's and she can walk without the aid of a walker. It is truly amazing to see. Thursday morning was the only "bad" time she had. That was the day she was taken off Morphine and the pain was really intense. In fact, she still takes 1000mg dosages of Vicodin every 4 to 6 hours for pain. I guess when they cut you in half length-wise it tends to hurt when you heal. The doctors were telling her that it will take 6 weeks for her breast bone to heal and then she can start to get back to normal.
For the past two days she has been spending most of her days sleeping, chatting with visitors and trying to walk and sit whenever she has enough energy. Yesterday she got to spend time in a private room with her boys. She got time to feed and change Hudson and he got some time to cuddle with her. Harrison got a little fussy and only lasted a few minutes. But then he got to see a Helicopter take off from the roof of the building, so he was feeling better.
And Today, we get to go home. She's gonna get discharged sometime around 11 or 12 and we will get to head to our house for the first time in almost 2 weeks. We will be able to share a bed for the first time since 2 Saturday's ago. Needless to say, we are excited...a little nervous, but excited. My Mom and Karen are going to be staying with us for a while to help. Help Kristi get up and around and help with the kids while she heals and I go back to work. It's going to get crowded in our tiny hose, but we appreciate and need the help.
We will have to very diligent in her home care to make sure she stays healthy for the rest of her life. She will be on Coumadin forever and in the beginning she will need to have her blood tested every few days to see what her Prothrombin time is. That is a measurement of one the clotting factors in her blood. It needs to be in a very specific range so clots don't form around her mechanical valve. We will have to adjust her medication (with the help of her doctors) to match her diet so that her body doesn't convert too much Vitamin K into this clotting factor and thicken her blood. Vitamin K counteracts the effects of the Coumadin. So eating foods high in Vitamin K like Avocados, Spinach and Broccoli not in moderation can be very harmful to her. As a matter of fact, high amounts of Garlic, Onions and some vegetable oils can be bad a well. So we will have to make some lifestyle changes. We will also have to take her blood pressure in the morning and evening for a few weeks and her temperature to make sure she is not getting an infection. So I will be acting as home nurse for a while, which I don't mind at all.
Saturday, March 21, 2009
Wednesday, March 18, 2009
30 HOURS LATER
So let's see...30 hours...that's 1800 minutes...at 80 beats per minute, that's 144,000 beats. 72,000 openings and 72,000 closings. Yeah...I'd say the valve works.
It has only been 30 hours since she was closed up and sent to the ICU for observation and recovery. When she arrived up there she has a ventilator breathing for her, had 8 IV bags hanging going into a central line in her neck and was going in and out of consciousness due to the Morphine they were administering. When I left tonight, she was walking with the help of a walker and doing laps around her ward. She is truly an amazing woman with incredible willpower.
This morning when I came to see her, she was awake, smiling, watching some TV and making friends with her nurse Lori. That is what Kristi does. She always makes friends with the nurses so she can break the rules (like use cell phones, eating things she's not supposed to, etc.) Once Kristi stabilized her blood pressure they were able to take her off most of the IV's she was on. That was a big change in the amount of plastic tubes leading to her central line. She was still on some oxygen to keep the level up in her blood and over all she was doing really well.
She was visited by her doctors later in the morning. Dr. Bailey and Dr. Razook both came to talk to her again about her procedure. They both said that her surgery was very difficult. Her heart was physically stopped for 158 minutes while they replaced the valve and aortic arch. They reiterated that her valve was in much worse shape than they had originally thought. The ruptured cuspid was hanging on by millimeters of tissue and could have broken free in a matter of hours or days. Had that happened, that tissue would have gone downstream and lodged somewhere in her body. And then her replacement would have been an emergency, which would have a much worse prognoses. They told her that they thought she was doing real well and they were sure she would get back to her regular active self in no time.
This afternoon they had her move from her bed to a chair to eat her lunch. It is quite an ordeal to get her up and moving. You have to make sure no lines are kinked and she is taking all her "gear" with her. But between the nurse and I, we can manage it. After she finished eating and had some time to relax from sitting up she really wanted to stand up and start walking. This made everyone really happy because it is very important for her to move and get everything working again. So we got her up, hung her collection bags, IV's and got moving. She was slow in the beginning, but got moving at a pretty good clip by the time we were nearing the end of our first lap. She got pretty tired when she made it around and we maneuvered back into her room so she could lie down. After a quick nap, she got up again and walked around the nurses station 3 times. Getting faster each time. It is truly amazing to see her push herself to get up and get moving. To get better. And to ensure that she can get back home to me and her 2 babies.
They say that if she continues at the pace she is going, she could get discharged on Friday night or Saturday. Which is crazy to think of. Only 4 days in recovery after a 7 hour open heart operation. We will see what happens. On a better note, I may be able to sleep tonight for the first time since last Sunday.
It has only been 30 hours since she was closed up and sent to the ICU for observation and recovery. When she arrived up there she has a ventilator breathing for her, had 8 IV bags hanging going into a central line in her neck and was going in and out of consciousness due to the Morphine they were administering. When I left tonight, she was walking with the help of a walker and doing laps around her ward. She is truly an amazing woman with incredible willpower.
This morning when I came to see her, she was awake, smiling, watching some TV and making friends with her nurse Lori. That is what Kristi does. She always makes friends with the nurses so she can break the rules (like use cell phones, eating things she's not supposed to, etc.) Once Kristi stabilized her blood pressure they were able to take her off most of the IV's she was on. That was a big change in the amount of plastic tubes leading to her central line. She was still on some oxygen to keep the level up in her blood and over all she was doing really well.
She was visited by her doctors later in the morning. Dr. Bailey and Dr. Razook both came to talk to her again about her procedure. They both said that her surgery was very difficult. Her heart was physically stopped for 158 minutes while they replaced the valve and aortic arch. They reiterated that her valve was in much worse shape than they had originally thought. The ruptured cuspid was hanging on by millimeters of tissue and could have broken free in a matter of hours or days. Had that happened, that tissue would have gone downstream and lodged somewhere in her body. And then her replacement would have been an emergency, which would have a much worse prognoses. They told her that they thought she was doing real well and they were sure she would get back to her regular active self in no time.
This afternoon they had her move from her bed to a chair to eat her lunch. It is quite an ordeal to get her up and moving. You have to make sure no lines are kinked and she is taking all her "gear" with her. But between the nurse and I, we can manage it. After she finished eating and had some time to relax from sitting up she really wanted to stand up and start walking. This made everyone really happy because it is very important for her to move and get everything working again. So we got her up, hung her collection bags, IV's and got moving. She was slow in the beginning, but got moving at a pretty good clip by the time we were nearing the end of our first lap. She got pretty tired when she made it around and we maneuvered back into her room so she could lie down. After a quick nap, she got up again and walked around the nurses station 3 times. Getting faster each time. It is truly amazing to see her push herself to get up and get moving. To get better. And to ensure that she can get back home to me and her 2 babies.
They say that if she continues at the pace she is going, she could get discharged on Friday night or Saturday. Which is crazy to think of. Only 4 days in recovery after a 7 hour open heart operation. We will see what happens. On a better note, I may be able to sleep tonight for the first time since last Sunday.
Tuesday, March 17, 2009
IN RECOVERY
We are up in the ICU and she is recovering.
When I got up here she was still on a vent and she had a central line (IV) in her neck. They were giving her platelets, insulin, nitroglycerin, antibiotics and morphine. She had color in her cheeks and was awake. When I touched her finger with mine, she squeezed it in her hand and opened her big green eyes. I was so happy to see her again.
Her BP, pulse and oxygen levels all were normal and the valve was working. If you get real close, you can hear it clicking. Something we will all have to get used to.
She was getting really annoyed that she was on a vent and kept pointing at it and moaning for them to take it off. They turned the machine off so she could breathe on her own (tube was still in just in case) and checked her blood gasses. All was fine and 15 mins later they took the tube out. They still have her on oxygen to help keep her levels up.
The doctors are amazed that she is doing so well, so early on. She was under for 7 hours and although they tried to slowly bring her back, she woke up very quickly. He first requests were for lip balm and cold towels on her feet because she was hot. We talked for a while and then the morphine took over and she went to sleep.
I am staying here tonight until they kick me out and I will be back in the morning. Early.
Kristi is very grateful that so many people followed along with her surgery. I want to personally thank Mike, Shawn and my parents for being here with me today and helping me get through it. Although I was coming off as calm on the outside, I was full of anxiety on the inside. Thank you Ron for watching Hudson today and Tiffany for hanging out with Harrison (he is feeling much better). You helped more than you know.
I will let everyone know how she is doing over the next few days. You can come see her starting Thursday and through the weekend...she will most likely be here until Monday of next week. Then...we get to to home. :)
When I got up here she was still on a vent and she had a central line (IV) in her neck. They were giving her platelets, insulin, nitroglycerin, antibiotics and morphine. She had color in her cheeks and was awake. When I touched her finger with mine, she squeezed it in her hand and opened her big green eyes. I was so happy to see her again.
Her BP, pulse and oxygen levels all were normal and the valve was working. If you get real close, you can hear it clicking. Something we will all have to get used to.
She was getting really annoyed that she was on a vent and kept pointing at it and moaning for them to take it off. They turned the machine off so she could breathe on her own (tube was still in just in case) and checked her blood gasses. All was fine and 15 mins later they took the tube out. They still have her on oxygen to help keep her levels up.
The doctors are amazed that she is doing so well, so early on. She was under for 7 hours and although they tried to slowly bring her back, she woke up very quickly. He first requests were for lip balm and cold towels on her feet because she was hot. We talked for a while and then the morphine took over and she went to sleep.
I am staying here tonight until they kick me out and I will be back in the morning. Early.
Kristi is very grateful that so many people followed along with her surgery. I want to personally thank Mike, Shawn and my parents for being here with me today and helping me get through it. Although I was coming off as calm on the outside, I was full of anxiety on the inside. Thank you Ron for watching Hudson today and Tiffany for hanging out with Harrison (he is feeling much better). You helped more than you know.
I will let everyone know how she is doing over the next few days. You can come see her starting Thursday and through the weekend...she will most likely be here until Monday of next week. Then...we get to to home. :)
A Phone Call
Dr. Razook called me on the house phone. He explained to me that her Aortic Valve was completely distroyed when they opened her heart. Much worse than they thought. She didn't bleed too much which he said was amazing. He thought for sure she would need a transfusion. Her Pulmonic valve looked good and he thinks it will last for a while. The physical size of her ventricle (which was enlarged when he first came in because it was compensating for the aortic problem) began to shrink as they closed her up.
He thinks that the surgery went really well and that she will make a full recovery.
He thinks that the surgery went really well and that she will make a full recovery.
SURGERY IS DONE
Dr. Bailey came out to meet us in the waiting area. He said that she's a fighter, she's strong and she made it through. Should be about 30mins until she is rolled into recovery. And then I can see her again.
Thank you all for your thoughts and prayers. It is still going to be a long recovery, but the hard part is over.
Thank you all for your thoughts and prayers. It is still going to be a long recovery, but the hard part is over.
HOME STRETCH
"Off Bypass...things are still going well".
Not in the clear yet, but the new valve is working. A huge sigh of relief...but we are still waiting for the final word that all is good and she can go to recovery.
Not in the clear yet, but the new valve is working. A huge sigh of relief...but we are still waiting for the final word that all is good and she can go to recovery.
Noon
Karen and I hunted down Dr. Jutzy. He called the OR for us to get an update on her. They have already sewn on the mechanical valve and new aortic root and they've connected the coronary arteries to the graft. The device is 1 piece so they do not need to attach the graft to the valve. They still have to connect the graft to the aorta.
He says that they told him it is going well.
He says that they told him it is going well.
11am
"Working on Aortic Valve. She is stable."
By this time they would have cooled her body temperature in order to slow down her circulation. She is fully on bypass and a machine is acting as her heart, pumping and oxygenating her blood. I hope it isn't too long until the next update.
I am spending a lot of time staring at the floor.
By this time they would have cooled her body temperature in order to slow down her circulation. She is fully on bypass and a machine is acting as her heart, pumping and oxygenating her blood. I hope it isn't too long until the next update.
I am spending a lot of time staring at the floor.
9:45
New update just came through. "Surgery in progress. All things going well." Kristi wanted to make sure I ate while I was in the waiting room. I did. One of her favorite breakfasts... breakfast burrito from Bakers.
WE HAVE BEGUN
Got the first page. It said "Surgery started at 8:22. She is doing good." We're sitting around in the waiting room talking nervously anticipating the next update. Will probably be in a few hours.
SHE'S IN
Her mom and I rode with her down to the OR. Gave her one last kiss, one last I Love You and away she went.
ALMOST TIME
Our families showed up at 5:30 to say good luck. They all gave her kisses and hugs and told her they'd see her this afternoon. There was a lot of nervous talk in the hallway as she changed into her gown. They were sent away at 5:45 and told to wait in the waiting room.
She and I are still together. They will call for her to be rolled down soon.
She and I are still together. They will call for her to be rolled down soon.
Monday, March 16, 2009
12 HOURS TO GO
It's 7:30 on Monday. 12 hours left until Dr. Razook raises his scalpel and makes his first incision. He stopped by today to reassure her that he is ready to go, fully prepared and has reserved the OR for the whole day so there is no rush to get done. She was with her dad when he came in and Phil reminded him that she was his baby. Dr. Razook assured him that she would be treated like family and well taken care of. I have all the confidence in the world that he will do all in his power to fix her heart and bring it back to me and her sons.
While she was visiting with her doctors, I took Harrison to his doctor because he woke up last night with a fever of 103. He was still warm this morning and as a precaution we decided to have him checked out. Turns out he has double ear infections. Yeesh...as if we didn't have enough to worry about. His doctor told me to give him antibiotics and to hurry back to Kristi's side. He said that Harrison was a lot like his mom. If he's gonna do it, might as well do it big. I dropped him off at Phil's house, took a shower and left him playing with Kathy with a big Popsicle grin on his face. He waved at me and said "Bye Dad" and looked at me like he knew. Like he was saying don't worry about me Dad, go help Mom get better. She hasn't seen him since Wednesday because he's been sick. I can only imagine how much that hurts.
When I came back, Kristi and I sat together and talked. Talked about our boys, our life together and about how important it is for her to come back.
Tomorow is going to be a trying day for me, our families and especially for her. She will be wheeled down around 6:30 and I will stay with her until they kick me out. I plan to be the last face she sees before she goes under. She wrote me a letter that I just finished reading, by myself, in her car in the parking lot. I can't share the details but I can say that it was hard to finish through the tears. I wrote her a letter too and I'm sure she is reading it as I write this. It amazes me to see the amount of strength she has, the confidence she has in her doctors and her will to live. Her will to come back to us.
Stay tuned tomorrow as there will be many updates. They give me a pager and are supposed to update me every hour. Join as a follower to this blog and I think they will email you when something new gets posted.
Please say a prayer for her tonight. Give your babies hugs until it hurts. And please let Kristi be in your thoughts tomorrow.
While she was visiting with her doctors, I took Harrison to his doctor because he woke up last night with a fever of 103. He was still warm this morning and as a precaution we decided to have him checked out. Turns out he has double ear infections. Yeesh...as if we didn't have enough to worry about. His doctor told me to give him antibiotics and to hurry back to Kristi's side. He said that Harrison was a lot like his mom. If he's gonna do it, might as well do it big. I dropped him off at Phil's house, took a shower and left him playing with Kathy with a big Popsicle grin on his face. He waved at me and said "Bye Dad" and looked at me like he knew. Like he was saying don't worry about me Dad, go help Mom get better. She hasn't seen him since Wednesday because he's been sick. I can only imagine how much that hurts.
When I came back, Kristi and I sat together and talked. Talked about our boys, our life together and about how important it is for her to come back.
Tomorow is going to be a trying day for me, our families and especially for her. She will be wheeled down around 6:30 and I will stay with her until they kick me out. I plan to be the last face she sees before she goes under. She wrote me a letter that I just finished reading, by myself, in her car in the parking lot. I can't share the details but I can say that it was hard to finish through the tears. I wrote her a letter too and I'm sure she is reading it as I write this. It amazes me to see the amount of strength she has, the confidence she has in her doctors and her will to live. Her will to come back to us.
Stay tuned tomorrow as there will be many updates. They give me a pager and are supposed to update me every hour. Join as a follower to this blog and I think they will email you when something new gets posted.
Please say a prayer for her tonight. Give your babies hugs until it hurts. And please let Kristi be in your thoughts tomorrow.
Sunday, March 15, 2009
Lazy Sunday
Today was a really lazy Sunday in Loma Linda. We woke up around 7:30. I folded up my blanket while Kristi got some blood drawn and then I tipped up the recliner I sleep in. I sleep surprisingly well in that chair. The only drawback is that when I sleep, my elbows rest on the wooden armrests and my pinky on each hand falls asleep. So every time I woke up in the middle of the night I was greeted by pins and needles in my finger.
The resident (a.k.a. Dr. Dummy) came in at 9 and listened to her heart, asked some pointless questions, acted confused and left. He has been coming in for the last 3 days and really has not helped at all. He always asks her how the chest pain is (she never had pain, just pressure) and if she feels like the Lasix are working. I donno Doc...I lost 23 pounds in a week. What do you think? He also has a stuffy nose and a cough which does not make us feel to good as it is very dangerous for Kristi to have a URI (Upper Respiratory Infection) while she is trying to have her body accept a prosthetic heart valve and during her recovery. It will probably be VERY painful to cough. Dr. Dummy, probably due to clogged ears, didn't hear that she was developing fluid in her lungs again (something her nurse heard) and needed more Lasix. Like Kristi's clients has always said, "Residents kill people because they don't know anything yet. If you want help, ask your RN or the attending."
Some people came to visit today. Of course our families were there. My parents came early and Karen, Ron, Phil and Kathy later on in the afternoon. My friends Mike and Jen and my next door neighbor from growing up Erica (who is like family) came to see us which was really great. Her friend Emily stopped by for a few and Kristi's brother Jeff came for a while. Tiffany hung back with the Warner Brothers at Karen's house and played with them for most of the day. My parents also helped relieve Karen and Ron so they could run some errands. In the afternoon they brought Hudson to us so Kristi and I could have some bonding time with him. He slept in her arms for a while and everyone left so we could be alone together. Is was really nice to be alone with him. He's only 3 weeks old and we have been apart from him for a third of his life which is really hard for us. Harrison still had a runny nose, so he hung back. He should be better tomorrow so the 4 of us can be together for a few hours. I have a feeling that that is going to be really difficult emotionally. The four of us alone together for the first time a week, the day before Kristi has her surgery.
I left the Hospital at 5:30 to go give Harrison dinner, a bath and put him to sleep. He was really excited to see me and I was equally as excited to see him. He gave me a big hug and a kiss before I lied him down and now he's sleeping like a rock. I am glad that he is so young that he doesn't know what is going on. It would make it all that much harder for us if her knew what could happen on Tuesday.
On a sad note, today was the last day for Kristi's daytime nurse Mae. She was the sweetest nurse Kristi and I had ever met. She was always checking on her, making sure she got what she needed, got her snacks when she was hungry and most importantly made sure that she was able to get into a private room with her sons. They both hugged each other and cried together when she left at the end of her shift. She promised to check on her when she is recovering after her surgery and will make sure that our new nurse is treating her the same way.
Big day tomorrow. Dr. Razook is back for the final question and answer session before her surgery. Pre-Op screenings as well. The wait is almost over.
The resident (a.k.a. Dr. Dummy) came in at 9 and listened to her heart, asked some pointless questions, acted confused and left. He has been coming in for the last 3 days and really has not helped at all. He always asks her how the chest pain is (she never had pain, just pressure) and if she feels like the Lasix are working. I donno Doc...I lost 23 pounds in a week. What do you think? He also has a stuffy nose and a cough which does not make us feel to good as it is very dangerous for Kristi to have a URI (Upper Respiratory Infection) while she is trying to have her body accept a prosthetic heart valve and during her recovery. It will probably be VERY painful to cough. Dr. Dummy, probably due to clogged ears, didn't hear that she was developing fluid in her lungs again (something her nurse heard) and needed more Lasix. Like Kristi's clients has always said, "Residents kill people because they don't know anything yet. If you want help, ask your RN or the attending."
Some people came to visit today. Of course our families were there. My parents came early and Karen, Ron, Phil and Kathy later on in the afternoon. My friends Mike and Jen and my next door neighbor from growing up Erica (who is like family) came to see us which was really great. Her friend Emily stopped by for a few and Kristi's brother Jeff came for a while. Tiffany hung back with the Warner Brothers at Karen's house and played with them for most of the day. My parents also helped relieve Karen and Ron so they could run some errands. In the afternoon they brought Hudson to us so Kristi and I could have some bonding time with him. He slept in her arms for a while and everyone left so we could be alone together. Is was really nice to be alone with him. He's only 3 weeks old and we have been apart from him for a third of his life which is really hard for us. Harrison still had a runny nose, so he hung back. He should be better tomorrow so the 4 of us can be together for a few hours. I have a feeling that that is going to be really difficult emotionally. The four of us alone together for the first time a week, the day before Kristi has her surgery.
I left the Hospital at 5:30 to go give Harrison dinner, a bath and put him to sleep. He was really excited to see me and I was equally as excited to see him. He gave me a big hug and a kiss before I lied him down and now he's sleeping like a rock. I am glad that he is so young that he doesn't know what is going on. It would make it all that much harder for us if her knew what could happen on Tuesday.
On a sad note, today was the last day for Kristi's daytime nurse Mae. She was the sweetest nurse Kristi and I had ever met. She was always checking on her, making sure she got what she needed, got her snacks when she was hungry and most importantly made sure that she was able to get into a private room with her sons. They both hugged each other and cried together when she left at the end of her shift. She promised to check on her when she is recovering after her surgery and will make sure that our new nurse is treating her the same way.
Big day tomorrow. Dr. Razook is back for the final question and answer session before her surgery. Pre-Op screenings as well. The wait is almost over.
Saturday, March 14, 2009
3 DAYS TO GO
Last night we both slept really well. They swapped out my chair for one that reclines more and I put it right next to her bed so we could feel like we were right next to each other. The night nurses are more laid back and let Kristi sleep 4 or 5 hours at a clip before coming in to check her vitals. She's always on a monitor but they do manual checks as well. Even though they wake her up, it's only for a few minutes and then they let her go back to sleep.
We woke up at 7:30 this morning to the Resident on the floor coming in to talk with her. He said that her blood pressure had stabalized, her pulse was looking much better and overall she was doing very well. And he's right...if you look at her you can't tell that anything is wrong. She looks totally healthy. She looks dirty, but healthy. We spent the morning watching TV, talking to each other and waiting to see Dr. Bansal who was the attending on the floor today. We were so happy it was him because we are having a little issue.
It seems that our good friends, our partners in health care, Anthem Blue Cross are watching the bottom line a little to closely. They feel that Kristi is good to go home in her condition and come back on Tuesday for her surgery. Hunh? Never mind the fact that she can't walk for 5 minutes without getting weak or that all 4 of her doctors have told her not to leave. They were all shocked when they heard the insurance company wanted her discharged. The Nurse Practioner told her that when she's home, if she feels weak or dizzy to put her feet up and lie down. And to weigh herself on the bathroom scale to see if she is retaining water. That is nuts. Her doctors want her monitored, they have told the insurance company that she needs to be monitored and yet they may refuse to pay for it. Let's get one thing straight here, unless her DOCTORS say she is OK to leave, not some pencil pusher at Blue Cross, she is not going anywhere. Dr. Bansal confirmed that she gets weak under minimal exertion and thus gave us a medically compelling reason (that's what they need) to stay another night. I guess we will just have to confirm this every day. We will deal with the insurance company later. I hope they've enjoyed the premiums.
On a lighter note...our families were here today. Harrison still has a runny nose, so he stayed behind with either Kristi's Dad or my parents. Hudson got to cuddle with his mommy and I was able to take off for a few to shower, see Harrison and go to the bank. Her Mom and Ron, Kathy, her Dad, my parents and her brother and Tiffany all got some good time in with her. Her friend Candice also came over with her Mom and we all sat around, talking, laughing and playing with the baby. It is so weird to be laughing and having a normal conversation when we all know what she is going to have to endure in a few days. But I guess it makes the waiting more tolerable.
***sorry if the spelling errors were worse than usual. I am not only tired, I typed this whole thing on my phone***
We woke up at 7:30 this morning to the Resident on the floor coming in to talk with her. He said that her blood pressure had stabalized, her pulse was looking much better and overall she was doing very well. And he's right...if you look at her you can't tell that anything is wrong. She looks totally healthy. She looks dirty, but healthy. We spent the morning watching TV, talking to each other and waiting to see Dr. Bansal who was the attending on the floor today. We were so happy it was him because we are having a little issue.
It seems that our good friends, our partners in health care, Anthem Blue Cross are watching the bottom line a little to closely. They feel that Kristi is good to go home in her condition and come back on Tuesday for her surgery. Hunh? Never mind the fact that she can't walk for 5 minutes without getting weak or that all 4 of her doctors have told her not to leave. They were all shocked when they heard the insurance company wanted her discharged. The Nurse Practioner told her that when she's home, if she feels weak or dizzy to put her feet up and lie down. And to weigh herself on the bathroom scale to see if she is retaining water. That is nuts. Her doctors want her monitored, they have told the insurance company that she needs to be monitored and yet they may refuse to pay for it. Let's get one thing straight here, unless her DOCTORS say she is OK to leave, not some pencil pusher at Blue Cross, she is not going anywhere. Dr. Bansal confirmed that she gets weak under minimal exertion and thus gave us a medically compelling reason (that's what they need) to stay another night. I guess we will just have to confirm this every day. We will deal with the insurance company later. I hope they've enjoyed the premiums.
On a lighter note...our families were here today. Harrison still has a runny nose, so he stayed behind with either Kristi's Dad or my parents. Hudson got to cuddle with his mommy and I was able to take off for a few to shower, see Harrison and go to the bank. Her Mom and Ron, Kathy, her Dad, my parents and her brother and Tiffany all got some good time in with her. Her friend Candice also came over with her Mom and we all sat around, talking, laughing and playing with the baby. It is so weird to be laughing and having a normal conversation when we all know what she is going to have to endure in a few days. But I guess it makes the waiting more tolerable.
***sorry if the spelling errors were worse than usual. I am not only tired, I typed this whole thing on my phone***
Friday, March 13, 2009
WE GOT THE SCOOP
3/13/09 - 2:30pm
I slept lightly for about 5 hours in Kristi's old room in her Dad's house. Woke up this morning at 6, took a quick shower and headed to the Hospital. By the time I got there Kristi had just woken up. Her nurse was in there taking her vital signs and asking her questions. She asked her if she was ready for her bypass surgery. Kristi said, "No, I am having an Aortic Valve Replacement." The nurse said "Oh...Heart Transplant?" Kristi said "Noooo....wrong patient." And then the nurse started to prepare some injections for her. We were sure to check and make sure that those meds were for HER and not for the guy getting the heart transplant or bypass operation.
After that fiasco, Dr. Razook came in to talk with her and he brought her old friend Dr. Bailey to talk to her as well. She "I spied" him while he was talking outside her room. They had had a meeting earlier that morning and decided on what kind of Aortic Valve Replacement they wanted to do. They decided on Bentall Procedure. It is a replacement of the aortic root, aortic valve and ascending aorta. I will expain... On the top of your heart you have an arch. That entire thing is called the aorta. Attached to that are the coronary arteries. She will have the lower section of that arch replaced with a one piece prosthetic composed of plastic, metal and cloth. When they cut the damaged section out, they will snip off the coronary arteries that connect to the Aorta and cut out the lower section of the Aorta including the valve. That entire section will be replaced with this device. The coronary arteries will be attached to that cloth part. They said that back when this procedure was invented the doctor that invented it sewed the cloth section on his mothers sewing machine. Crazy, right? They said that the chance of her having a stroke during the procedure is minimal due to her age and the chance of her having a heart attack due to the Arteries pinching are also small. There biggest concerns they have are infection and bleeding. They say that attaching tissue to cloth instead of tissue to tissue, there is more likely to be bleeding. That is why they want to take their time with the surgery to make sure it is nice and tight. There is scar tissue to deal with as well because they have cut into her Aorta 3 times already. When you do surgeries like this over and over and over again the tissues in that area tend to get really tight. They may have to extend the coronary arteries to reach and if that is the case they will have use another type of cloth device to get them to attach. The other problem is that as you do these open heart operations the heart, when it heals, get closer and closer to the breast bone. If it is too close, they will need to insert a piece of fabric between her heart and her breastbone so it does not touch. They took 2 X-Rays this afternoon to check to see what the distance is between the two.
So that is the long and short of it. They decided to do the Surgery on Tuesday at 7:30 in the morning. They want to make sure that all 4 of the Doctors, and most importantly Dr. Razook and Dr. Bailey will be fresh, well rested and have a fresh team of nurses to work with them. They said that the operation will take 6 to 8 hours...which will be excruciating for all of us in the waiting room. Before he left he wanted us all to say a prayer with him. He prayed that god watch over her, watch over her babies, me and all that are supporting her. He asked that he join him on Tuesday and give him guidance when he is operating. Let's hope that happens...we need all the help we can get. She is a fighter, she has a great attitude towards the surgery, she loves and respects her doctors and is confident she will make it through.
Here is a link to Wikipedia on the procedure: Wiki
Here is a link to a picture of the heart so you can see what I am talking about when I mention the aorta parts: Heart
I slept lightly for about 5 hours in Kristi's old room in her Dad's house. Woke up this morning at 6, took a quick shower and headed to the Hospital. By the time I got there Kristi had just woken up. Her nurse was in there taking her vital signs and asking her questions. She asked her if she was ready for her bypass surgery. Kristi said, "No, I am having an Aortic Valve Replacement." The nurse said "Oh...Heart Transplant?" Kristi said "Noooo....wrong patient." And then the nurse started to prepare some injections for her. We were sure to check and make sure that those meds were for HER and not for the guy getting the heart transplant or bypass operation.
After that fiasco, Dr. Razook came in to talk with her and he brought her old friend Dr. Bailey to talk to her as well. She "I spied" him while he was talking outside her room. They had had a meeting earlier that morning and decided on what kind of Aortic Valve Replacement they wanted to do. They decided on Bentall Procedure. It is a replacement of the aortic root, aortic valve and ascending aorta. I will expain... On the top of your heart you have an arch. That entire thing is called the aorta. Attached to that are the coronary arteries. She will have the lower section of that arch replaced with a one piece prosthetic composed of plastic, metal and cloth. When they cut the damaged section out, they will snip off the coronary arteries that connect to the Aorta and cut out the lower section of the Aorta including the valve. That entire section will be replaced with this device. The coronary arteries will be attached to that cloth part. They said that back when this procedure was invented the doctor that invented it sewed the cloth section on his mothers sewing machine. Crazy, right? They said that the chance of her having a stroke during the procedure is minimal due to her age and the chance of her having a heart attack due to the Arteries pinching are also small. There biggest concerns they have are infection and bleeding. They say that attaching tissue to cloth instead of tissue to tissue, there is more likely to be bleeding. That is why they want to take their time with the surgery to make sure it is nice and tight. There is scar tissue to deal with as well because they have cut into her Aorta 3 times already. When you do surgeries like this over and over and over again the tissues in that area tend to get really tight. They may have to extend the coronary arteries to reach and if that is the case they will have use another type of cloth device to get them to attach. The other problem is that as you do these open heart operations the heart, when it heals, get closer and closer to the breast bone. If it is too close, they will need to insert a piece of fabric between her heart and her breastbone so it does not touch. They took 2 X-Rays this afternoon to check to see what the distance is between the two.
So that is the long and short of it. They decided to do the Surgery on Tuesday at 7:30 in the morning. They want to make sure that all 4 of the Doctors, and most importantly Dr. Razook and Dr. Bailey will be fresh, well rested and have a fresh team of nurses to work with them. They said that the operation will take 6 to 8 hours...which will be excruciating for all of us in the waiting room. Before he left he wanted us all to say a prayer with him. He prayed that god watch over her, watch over her babies, me and all that are supporting her. He asked that he join him on Tuesday and give him guidance when he is operating. Let's hope that happens...we need all the help we can get. She is a fighter, she has a great attitude towards the surgery, she loves and respects her doctors and is confident she will make it through.
Here is a link to Wikipedia on the procedure: Wiki
Here is a link to a picture of the heart so you can see what I am talking about when I mention the aorta parts: Heart
Thursday, March 12, 2009
A GOOD DAY
3/12/09 - 7:00PM
After dropping Harrison off at school this morning, I headed back to the Hospital to give Kristi a kiss goodbye before I went to our house. I needed to get her some more pajama pants, tank tops and some toothpaste. Going home was hard for me. Being 40mins away felt like I was on the other side of the country. Walking into the house when it was empty...quiet...just the sound of the central heat blowing in the background. I gathered up the things she requested, luckily they were all folded on the dining room table as Karen had done some laundry when we were at the ER on Sunday. Got some clothes, toys, a favorite book for Harrison, some diapers, socks and a blanket for Hudson. Took a long hot shower and brushed my teeth. I ended up emptying and running the dishwasher with the 5 dishes that were in the sink and then I just kind of wandered around. Looked at old bills that were due, cleaned up some stuff, got some clothes for me...sat on the couch for 10 minutes staring at the clock...waiting for it to say 2:30 so I could leave and go pick Harrison up from day care. 2:28 I was out the door.
While I was spending some time alone, Kristi had all kinds of visitors. Her friend Jen came by with her sister Shellie. Her fellow Aestician Melissa and her co-workers Karessa and Shannon came with some flowers. Her friend Ryan and his Dad came by for a while and she got some lunch from a tasty sandwich shop (Jen brought it). Her brother Jeff and his fiancée Tiffany flew in from CT this afternoon and came directly here to see her. Her cousin Cheri, who lives close by came as well. The highlight of the day was that Kristi got to get up out of her bed, walk to the conference room in the CCU and hold Hudson for the first time since Sunday. She really needed it. They both needed it. He cuddled right into her and slept in her arms for a nice, long time.
Dr. Jutzy also stopped by to speak with her about her surgery. He explained to her in detail what the replacement they decided on will be. I will try to get the complete story out of her, but she doesn't listen like I do. 8 years ago when they did the replacement they only replaced a "part "of the valve. I can only assume that this means they replaced the part with the cuspids only and not the entire thing. This time, it's the whole thing. Kristi tried to explain it to me in a way I can understand and type it for you but I still don't get it. Dr. Jutzy will come in tomorrow morning and I will have him explain it to me. Sorry 'bout that.
I picked up Harrison at school at 3:45. He wanted to show me everything. The slide, the pushcar, his basketball and of course...the sandbox. I stuck with him there for a while, playing and running and talking with his teacher. We left and headed back to Phil and Kathy's house 'cause he had a runny nose and a cough. I hope he is not getting really sick. If he has some sort of upper respiratory infection we have to be really careful about bringing him around Kristi. And then I went back to the Hospital. We ate dinner together...hugged a lot and cried a lot.
Tonight I decided to go to Phil and Kathy's house and try and sleep for a while. Something tells me that if I can't, I am going to get back in the car and stay in her room again. On the way home I talked with Shawn about how things were going at Atlas and it was nice to talk about something other than Kristi's illness for 20min. Sounds horrible to say.... But I have been thinking about it all day and night for 5 days. The thing that is killing me is the waiting. Waiting for the results of the cultures and then waiting for the surgery.
After dropping Harrison off at school this morning, I headed back to the Hospital to give Kristi a kiss goodbye before I went to our house. I needed to get her some more pajama pants, tank tops and some toothpaste. Going home was hard for me. Being 40mins away felt like I was on the other side of the country. Walking into the house when it was empty...quiet...just the sound of the central heat blowing in the background. I gathered up the things she requested, luckily they were all folded on the dining room table as Karen had done some laundry when we were at the ER on Sunday. Got some clothes, toys, a favorite book for Harrison, some diapers, socks and a blanket for Hudson. Took a long hot shower and brushed my teeth. I ended up emptying and running the dishwasher with the 5 dishes that were in the sink and then I just kind of wandered around. Looked at old bills that were due, cleaned up some stuff, got some clothes for me...sat on the couch for 10 minutes staring at the clock...waiting for it to say 2:30 so I could leave and go pick Harrison up from day care. 2:28 I was out the door.
While I was spending some time alone, Kristi had all kinds of visitors. Her friend Jen came by with her sister Shellie. Her fellow Aestician Melissa and her co-workers Karessa and Shannon came with some flowers. Her friend Ryan and his Dad came by for a while and she got some lunch from a tasty sandwich shop (Jen brought it). Her brother Jeff and his fiancée Tiffany flew in from CT this afternoon and came directly here to see her. Her cousin Cheri, who lives close by came as well. The highlight of the day was that Kristi got to get up out of her bed, walk to the conference room in the CCU and hold Hudson for the first time since Sunday. She really needed it. They both needed it. He cuddled right into her and slept in her arms for a nice, long time.
Dr. Jutzy also stopped by to speak with her about her surgery. He explained to her in detail what the replacement they decided on will be. I will try to get the complete story out of her, but she doesn't listen like I do. 8 years ago when they did the replacement they only replaced a "part "of the valve. I can only assume that this means they replaced the part with the cuspids only and not the entire thing. This time, it's the whole thing. Kristi tried to explain it to me in a way I can understand and type it for you but I still don't get it. Dr. Jutzy will come in tomorrow morning and I will have him explain it to me. Sorry 'bout that.
I picked up Harrison at school at 3:45. He wanted to show me everything. The slide, the pushcar, his basketball and of course...the sandbox. I stuck with him there for a while, playing and running and talking with his teacher. We left and headed back to Phil and Kathy's house 'cause he had a runny nose and a cough. I hope he is not getting really sick. If he has some sort of upper respiratory infection we have to be really careful about bringing him around Kristi. And then I went back to the Hospital. We ate dinner together...hugged a lot and cried a lot.
Tonight I decided to go to Phil and Kathy's house and try and sleep for a while. Something tells me that if I can't, I am going to get back in the car and stay in her room again. On the way home I talked with Shawn about how things were going at Atlas and it was nice to talk about something other than Kristi's illness for 20min. Sounds horrible to say.... But I have been thinking about it all day and night for 5 days. The thing that is killing me is the waiting. Waiting for the results of the cultures and then waiting for the surgery.
A NEW DAY
3/12/09 - 9:30am
Last night was pretty uneventful. Aside from the man next door screaming at 4am we slept rather soundly. I got about five or so hours in so I am feeling much better. Kristi slept a little bit longer than me, but the nurses check on her every hour and the blood pressure cuff checks her every 15 minutes it is hard to get into a deep sleep. But she is feeling a little more refreshed. Her body hurts from lying in bed for so many days...
I was up at 5, took a walk and got some breakfast. Got Kristi a plate of fresh fruit and a blueberry muffin. She was still sleeping when I came back up so I left it for her, gave her a kiss and went to Phil and Kathy's house to surprise Harrison when he woke up. We had breakfast together and I took him to his school (day-care place). Although this is such a horrible thing for his mommy to go through, I am really thankful that he is so little and can't understand what is going on.
While I was gone, Dr. Razook came in to see Kristi and talk with her. He basically recapped the discussion we had with him yesterday. Aortic valve needs a full replacement, Pulmonic will probably not be done. The tube that connects the aortic valve to the coronary artery will most likely be replaced as well due to the dilation of the natural one that is currently there. He explained that this is what makes this surgery complicated and is the reason why they won't do the Pulmonic valve. He said that since they have to do so much already, and because the surgery is going to be so difficult (his words), there is no reason to add anything to something that is already going to be hard to do. Although Kristi does not want to come in again for another procedure later in life, she gets it. Dr. Razook will be discussing her case in more detail with her other doctors over the coming days and will most likely be coming to us with more information.
The great news is that Dr. Bailey, her pediatric surgeon that worked on her when she was 15 is not only going to consult with her current doctors, he is going to scrub in for her procedure. He is a world-renowned, ground-breaking, extraordinarily technical cardiothorasic surgeon who's claim to fame is being the surgeon that did the baboon heart transplant back in the 80's. Although he is now semi-retired, he is making a point to be there for her operation. He was paramount in making LLUMC one of the top hospitals in the nation for heart care. As the nurses say, she has the A-Team in terms of doctors working on her.
Last night was pretty uneventful. Aside from the man next door screaming at 4am we slept rather soundly. I got about five or so hours in so I am feeling much better. Kristi slept a little bit longer than me, but the nurses check on her every hour and the blood pressure cuff checks her every 15 minutes it is hard to get into a deep sleep. But she is feeling a little more refreshed. Her body hurts from lying in bed for so many days...
I was up at 5, took a walk and got some breakfast. Got Kristi a plate of fresh fruit and a blueberry muffin. She was still sleeping when I came back up so I left it for her, gave her a kiss and went to Phil and Kathy's house to surprise Harrison when he woke up. We had breakfast together and I took him to his school (day-care place). Although this is such a horrible thing for his mommy to go through, I am really thankful that he is so little and can't understand what is going on.
While I was gone, Dr. Razook came in to see Kristi and talk with her. He basically recapped the discussion we had with him yesterday. Aortic valve needs a full replacement, Pulmonic will probably not be done. The tube that connects the aortic valve to the coronary artery will most likely be replaced as well due to the dilation of the natural one that is currently there. He explained that this is what makes this surgery complicated and is the reason why they won't do the Pulmonic valve. He said that since they have to do so much already, and because the surgery is going to be so difficult (his words), there is no reason to add anything to something that is already going to be hard to do. Although Kristi does not want to come in again for another procedure later in life, she gets it. Dr. Razook will be discussing her case in more detail with her other doctors over the coming days and will most likely be coming to us with more information.
The great news is that Dr. Bailey, her pediatric surgeon that worked on her when she was 15 is not only going to consult with her current doctors, he is going to scrub in for her procedure. He is a world-renowned, ground-breaking, extraordinarily technical cardiothorasic surgeon who's claim to fame is being the surgeon that did the baboon heart transplant back in the 80's. Although he is now semi-retired, he is making a point to be there for her operation. He was paramount in making LLUMC one of the top hospitals in the nation for heart care. As the nurses say, she has the A-Team in terms of doctors working on her.
Wednesday, March 11, 2009
THE CONSULT
Dr. Razook came in at 6:30 to talk to Kristi about her surgery. He has performed her last 2 operations, so he's very familiar with her heart. He had a quick meeting with Dr. Bansal and Dr. Jutzy before coming up. They looked at the films, the Echo's of her heart from yesterday, the images from the T.E.E. that was just performed and her chart.
He started the conversation with "You are going to be OK." He agreed, obviously, that her Aortic valve needed to be replaced. He said that although it will be difficult, it is nothing out of the ordinary for that part of the surgery. The one thing that may be tricky about this operation has to do with her coronary artery. In the place it attached to the heart, the measurement is 4.7cm. The maximum size of the opening they can operate on is 5.0cm. So she is very close to that. He said that if it was that size, they would have to do something more "major." They may put something around the artery to prevent it from getting larger in the future.
After talking with the other doctors they are leaning towards not replacing her Pulmonic valve. There is no calcification on it, there are no signs of leaks or distress...so they are thinking why fix it if it's OK. The bummer part is that it may, some day, wear out again...and we will be going through this all over again. I do trust these doctors and they are looking out for her best interest, but the decision is still up to her.
He wants to do the surgery on Monday or Tuesday afternoon. He wants her to continue on the Lasix and lose all that excess water in her system. She needs to eat, get stronger, continue to heal from her C-section and stabilize her blood chemistry. That way she will have a greater chance of survival.
So for the next 4 days we will all rest, spend lots of time together and try to have as much fun as possible. Kristi is moving to another room that has portable telemetry equipment so she can go just outside the CCU to spend time with Harrison and Hudson.
He started the conversation with "You are going to be OK." He agreed, obviously, that her Aortic valve needed to be replaced. He said that although it will be difficult, it is nothing out of the ordinary for that part of the surgery. The one thing that may be tricky about this operation has to do with her coronary artery. In the place it attached to the heart, the measurement is 4.7cm. The maximum size of the opening they can operate on is 5.0cm. So she is very close to that. He said that if it was that size, they would have to do something more "major." They may put something around the artery to prevent it from getting larger in the future.
After talking with the other doctors they are leaning towards not replacing her Pulmonic valve. There is no calcification on it, there are no signs of leaks or distress...so they are thinking why fix it if it's OK. The bummer part is that it may, some day, wear out again...and we will be going through this all over again. I do trust these doctors and they are looking out for her best interest, but the decision is still up to her.
He wants to do the surgery on Monday or Tuesday afternoon. He wants her to continue on the Lasix and lose all that excess water in her system. She needs to eat, get stronger, continue to heal from her C-section and stabilize her blood chemistry. That way she will have a greater chance of survival.
So for the next 4 days we will all rest, spend lots of time together and try to have as much fun as possible. Kristi is moving to another room that has portable telemetry equipment so she can go just outside the CCU to spend time with Harrison and Hudson.
SHE'S SLEEPING
3/11/09 - 5:15PM
The T.E.E. is over.
Dr. Jutzy found me in the waiting room and explained the results of her test. He said that they confirmed what they thought they saw yesterday. One cuspid of the Aortic valve is completely disintegrated. There is barely anything there anymore and it is amazing that she is doing as well as she is. It needs to be replaced urgently. If it wasn't for the possibility of her having an infection, they would have probably already wheeled her into the OR. He did said that her Pulmotic valve is holding up remarkably well for it's age. There is no clear answer as to how long those valves will last. If the surgeon studies the test results and feels that we may have to replace that valve in 3 or so years, he will most likely want to replace it at the same time. They did discover that she now has a small leak in her Mitral Valve. I don't know where that is because this is something new. Both Dr. Jutzy and Dr. Bansal agree that this is probably due to the enlarging of the heart and they suspect that it will correct itself when the heart contracts to it's normal size again. Let's hope so.
Her surgeon will be coming by shortly to talk to me about what he feels the best option will be in terms of when to schedule her operation and what exactly we are going to do.
The more I learn about this, the more I discover what an amazing machine the human body is. How such a critical part can fail and how the body compensates to keep itself alive.
The T.E.E. is over.
Dr. Jutzy found me in the waiting room and explained the results of her test. He said that they confirmed what they thought they saw yesterday. One cuspid of the Aortic valve is completely disintegrated. There is barely anything there anymore and it is amazing that she is doing as well as she is. It needs to be replaced urgently. If it wasn't for the possibility of her having an infection, they would have probably already wheeled her into the OR. He did said that her Pulmotic valve is holding up remarkably well for it's age. There is no clear answer as to how long those valves will last. If the surgeon studies the test results and feels that we may have to replace that valve in 3 or so years, he will most likely want to replace it at the same time. They did discover that she now has a small leak in her Mitral Valve. I don't know where that is because this is something new. Both Dr. Jutzy and Dr. Bansal agree that this is probably due to the enlarging of the heart and they suspect that it will correct itself when the heart contracts to it's normal size again. Let's hope so.
Her surgeon will be coming by shortly to talk to me about what he feels the best option will be in terms of when to schedule her operation and what exactly we are going to do.
The more I learn about this, the more I discover what an amazing machine the human body is. How such a critical part can fail and how the body compensates to keep itself alive.
THE T.E.E.
3/11/09 - 4PM
I'm down in the cafeteria right now eating some White Chocolate Macadamia Nut frozen yogurt with multicolored sprinkles while Kristi is going thorough one of the most horrible tests I can imagine. It really didn't hit me until I heard the doctor explain what he was going to do.
First they are going to administer I.V. medication to keep her from vomiting while they do the scan. Then they will have her gargle with viscous lidocaine to numb the back of her throat. After that they inject her with a sedative and try to keep her on the edge of consciousness. And finally they take a 3 foot metal rod with a sensor at the end and put it down her throat for 15 to 20 minutes. She needs to swallow to help them get it down there..that is why they keep her on the edge of consciousness.
And then he asked me to leave to room.
So I am down here...eating frozen yogurt...gonna go back up at 4:45.
I'm down in the cafeteria right now eating some White Chocolate Macadamia Nut frozen yogurt with multicolored sprinkles while Kristi is going thorough one of the most horrible tests I can imagine. It really didn't hit me until I heard the doctor explain what he was going to do.
First they are going to administer I.V. medication to keep her from vomiting while they do the scan. Then they will have her gargle with viscous lidocaine to numb the back of her throat. After that they inject her with a sedative and try to keep her on the edge of consciousness. And finally they take a 3 foot metal rod with a sensor at the end and put it down her throat for 15 to 20 minutes. She needs to swallow to help them get it down there..that is why they keep her on the edge of consciousness.
And then he asked me to leave to room.
So I am down here...eating frozen yogurt...gonna go back up at 4:45.
LOTS OF WAITING AND WATCHING
3/11/09 - 9AM
LOTS OF WAITING AND WATCHING
So I am still having trouble with the internet access here. So who knows how many days of updates you all will get at once.
Last night Kristi and I slept pretty well. Early in the evening we kept getting woken up by the monitors...seems that every time she dozed off, some kind of alarm would go off. So they put her on some oxygen and that helped keep them from freaking out. Her blood pressure, heart rate, oxygen level and respirations all look good...and her heart is pumping away the best it can.
This morning we woke up to a radiology tech who came in to do a chest X-Ray. They want to make sure that the meds are are working and removing the excess fluid in her lungs. She has lost almost 15 pounds in the last 6 days, so I think it is pretty safe to assume it is working. She also had another round of intravenous Lasix. She can't eat today until she has her Trans-Esophageal Echocardiogram (T.E.E) in an hour or so. Which she is not happy about, but she's getting through it.
I will get you an update when her test is over and let you now how it went.
Oh...on a positive note, we were able to figure out how to change channels on the TV.
LOTS OF WAITING AND WATCHING
So I am still having trouble with the internet access here. So who knows how many days of updates you all will get at once.
Last night Kristi and I slept pretty well. Early in the evening we kept getting woken up by the monitors...seems that every time she dozed off, some kind of alarm would go off. So they put her on some oxygen and that helped keep them from freaking out. Her blood pressure, heart rate, oxygen level and respirations all look good...and her heart is pumping away the best it can.
This morning we woke up to a radiology tech who came in to do a chest X-Ray. They want to make sure that the meds are are working and removing the excess fluid in her lungs. She has lost almost 15 pounds in the last 6 days, so I think it is pretty safe to assume it is working. She also had another round of intravenous Lasix. She can't eat today until she has her Trans-Esophageal Echocardiogram (T.E.E) in an hour or so. Which she is not happy about, but she's getting through it.
I will get you an update when her test is over and let you now how it went.
Oh...on a positive note, we were able to figure out how to change channels on the TV.
Tuesday, March 10, 2009
THIS IS GOING TO BE A MESSY SURGERY
3/10/09 - 11:30PM
Today, Kristi was evaluated by her Cardiologists, Dr. Jutzy and Dr. Bansal. Both of them are the best there are. They have been treating her since she was a little girl (when her murmur was discovered) and care about her very deeply. Dr. Jutzy is the Chief of Cardiology here at LLUMC. She had a Echocardiogram (Ultrasound of the heart) and they discovered that she has a ruptured cuspid in her Aortic Valve. A cuspid is another term for the part of the heart valves that open and close. The Aortic valve is under tremendous pressure when the heart contracts, so a tight seal is key. At her last "Echo" which was 5 months ago, they noticed a small leak in the same place and they decided to re-evaluate her after she had the baby. This leaking is typical of a valve that is reaching the end of it's useful life. At the time, it was not an emergency and they would usually try to plan another surgery a year or so from finding something like that. So although we were counting on having another surgery within the next year, we never imagined that it would happen this way.
Compounding this problem is the possibility that she may also have an infection in her heat muscle that is also causing some other issues. She had multiple (8 in all) blood cultures done today that will test for various bacteria in her bloodstream. Unfortunately those results won't be back for 3 days, so we are here...waiting...watching her monitors.
Tomorrow she is going to have a Trans-Esophageal Echocardiogram. That is when they insert a ultrasound device in her throat and take a look at the back side of her heart. It is very uncomfortable, as you can imagine, but is necessary. Dr. Bansal wants to make sure that there is no abscess behind her valves or in a place that he can't see using the other machine. He explained that it is important to find out all there is to know before they open her up. They don't want any surprises that will complicate the surgery. Kristi is not looking forward to this...at all...and is telling everyone she sees here that this test is pretty much the worst thing ever. Although they sedate you, you are wide awake for the whole thing.
If it turns out that she does have an infection they will treat it with antibiotics until it clears up and then they will operate. If she does not, they will proceed with the surgery. If for some reason she does have an infection and there is no time to wait, they will give her massive doses of broad spectrum antibiotics and do the operation.
Either way, she is most likely going to have surgery before the week is out. They are definitely going to remove her damaged biologic Aortic valve and replace it with a mechanical one. This mechanical valve should last her for the rest of her life. She will need to be on blood thinners and now that we have 2 babies she is OK with that. The question is weather or not they will replace her Pulmonic valve at the same time. It is older, 13.5 years but seems to be holding up well. This valve does not have to deal with the same pressures that the Aortic valve has to deal with so it lasts longer. Kristi feels like if they are going to open her up, they might as well do both. But doing 2 replacements will be more traumatic on her system and the doctors are unsure if it is worth the risk to replace a valve that is working, just because the patient does not want to go through another surgery down the line. This surgery will be more "messy" as the last 3, says Dr. Bansal. Since she has scar tissue from past operations and since the heart is enlarged the surgery will require more time, more blood transfusions and possibly more complications.
In the meantime, she is resting, watching the one channel we get here (CBS) and thinking about her boys. Harrison and Louise (our pug) are resting at Phil and Kathy's house. Hudson is with Ron and Karen. They will get the chance to see their mommy for a short time tomorrow afternoon. They will not be able visit her much in the CCU because there are people here with some pretty bad infections and we wouldn't want them to get sick.
I am going to try to get some rest tonight...although it seems unlikely. My eyes are glued to the blood pressure, blood O2 sensor and pulse monitor. It beeps when the O2 level goes below 90...or when her BP is too low.
She is taking calls when she can, getting text messages and emails. I can also relay messages to her for you.
Today, Kristi was evaluated by her Cardiologists, Dr. Jutzy and Dr. Bansal. Both of them are the best there are. They have been treating her since she was a little girl (when her murmur was discovered) and care about her very deeply. Dr. Jutzy is the Chief of Cardiology here at LLUMC. She had a Echocardiogram (Ultrasound of the heart) and they discovered that she has a ruptured cuspid in her Aortic Valve. A cuspid is another term for the part of the heart valves that open and close. The Aortic valve is under tremendous pressure when the heart contracts, so a tight seal is key. At her last "Echo" which was 5 months ago, they noticed a small leak in the same place and they decided to re-evaluate her after she had the baby. This leaking is typical of a valve that is reaching the end of it's useful life. At the time, it was not an emergency and they would usually try to plan another surgery a year or so from finding something like that. So although we were counting on having another surgery within the next year, we never imagined that it would happen this way.
Compounding this problem is the possibility that she may also have an infection in her heat muscle that is also causing some other issues. She had multiple (8 in all) blood cultures done today that will test for various bacteria in her bloodstream. Unfortunately those results won't be back for 3 days, so we are here...waiting...watching her monitors.
Tomorrow she is going to have a Trans-Esophageal Echocardiogram. That is when they insert a ultrasound device in her throat and take a look at the back side of her heart. It is very uncomfortable, as you can imagine, but is necessary. Dr. Bansal wants to make sure that there is no abscess behind her valves or in a place that he can't see using the other machine. He explained that it is important to find out all there is to know before they open her up. They don't want any surprises that will complicate the surgery. Kristi is not looking forward to this...at all...and is telling everyone she sees here that this test is pretty much the worst thing ever. Although they sedate you, you are wide awake for the whole thing.
If it turns out that she does have an infection they will treat it with antibiotics until it clears up and then they will operate. If she does not, they will proceed with the surgery. If for some reason she does have an infection and there is no time to wait, they will give her massive doses of broad spectrum antibiotics and do the operation.
Either way, she is most likely going to have surgery before the week is out. They are definitely going to remove her damaged biologic Aortic valve and replace it with a mechanical one. This mechanical valve should last her for the rest of her life. She will need to be on blood thinners and now that we have 2 babies she is OK with that. The question is weather or not they will replace her Pulmonic valve at the same time. It is older, 13.5 years but seems to be holding up well. This valve does not have to deal with the same pressures that the Aortic valve has to deal with so it lasts longer. Kristi feels like if they are going to open her up, they might as well do both. But doing 2 replacements will be more traumatic on her system and the doctors are unsure if it is worth the risk to replace a valve that is working, just because the patient does not want to go through another surgery down the line. This surgery will be more "messy" as the last 3, says Dr. Bansal. Since she has scar tissue from past operations and since the heart is enlarged the surgery will require more time, more blood transfusions and possibly more complications.
In the meantime, she is resting, watching the one channel we get here (CBS) and thinking about her boys. Harrison and Louise (our pug) are resting at Phil and Kathy's house. Hudson is with Ron and Karen. They will get the chance to see their mommy for a short time tomorrow afternoon. They will not be able visit her much in the CCU because there are people here with some pretty bad infections and we wouldn't want them to get sick.
I am going to try to get some rest tonight...although it seems unlikely. My eyes are glued to the blood pressure, blood O2 sensor and pulse monitor. It beeps when the O2 level goes below 90...or when her BP is too low.
She is taking calls when she can, getting text messages and emails. I can also relay messages to her for you.
Monday, March 9, 2009
THE BACKSTORY
As many of you know, Kristi has had three heart surgeries in her lifetime. The first was when she was 15, which was a reconstruction on her Aortic Valve. Unfortunately the reconstruction did not work and 11 months later she had a Ross Procedure. That's where they replace the Aortic Valve with her own Pulmonic Valve and put a Homograph in where her Pulmonic valve was. And finally one when she was 22 where they replaced her Aortic valve again with another biologic valve. The typical lifespan of these tissue replacements is 8 years in someone of her age and it has been 7 years and 5 months since her last procedure.
Starting 1 week before the delivery of our second son, Hudson, Kristi developed a slight nagging dry cough. It was nothing too spectacular and since everyone in the house was coming down with a slight cold, we though nothing of it. When Hudson was born the cough got a little bit worse and Kristi noticed some swelling in her ankles. Since she just had a C-Section we figured that it had something to do with the surgery that caused some slight water retention. She also was drinking almost a gallon of water a day because she was breast feeding, so we naturally thought her swelling had something to do with that as well. We went about our business for the next 10 days enjoying our new baby, all the while trying to get over our colds.
And then last Sunday afternoon, after she was unable to sleep the night before because she could not stop coughing, we took the boys for a short walk. We got about 2 blocks away and she began to feel fatigued and short of breath. That is when she realized that something was wrong. That evening we went to the Emergency Room in Glendora and she was diagnosed with congestive heart failure. Her lungs were filling with fluid (which was causing irritation and thus her cough) and her heart was enlarged. Instead of being admitted to the Hospital in Glendora, Kristi decided to go to Loma Linda University Medical Center to get treatment. She has a history with them (all her prior surgeries) and felt that she would receive the best care there. So they stabilized her and sent her on her way.
Since then they have been monitoring her. She has been on Lasix to remove the excess water in her body and lungs and has been taking potassium supplements to replace what the Lasix removes.
Starting 1 week before the delivery of our second son, Hudson, Kristi developed a slight nagging dry cough. It was nothing too spectacular and since everyone in the house was coming down with a slight cold, we though nothing of it. When Hudson was born the cough got a little bit worse and Kristi noticed some swelling in her ankles. Since she just had a C-Section we figured that it had something to do with the surgery that caused some slight water retention. She also was drinking almost a gallon of water a day because she was breast feeding, so we naturally thought her swelling had something to do with that as well. We went about our business for the next 10 days enjoying our new baby, all the while trying to get over our colds.
And then last Sunday afternoon, after she was unable to sleep the night before because she could not stop coughing, we took the boys for a short walk. We got about 2 blocks away and she began to feel fatigued and short of breath. That is when she realized that something was wrong. That evening we went to the Emergency Room in Glendora and she was diagnosed with congestive heart failure. Her lungs were filling with fluid (which was causing irritation and thus her cough) and her heart was enlarged. Instead of being admitted to the Hospital in Glendora, Kristi decided to go to Loma Linda University Medical Center to get treatment. She has a history with them (all her prior surgeries) and felt that she would receive the best care there. So they stabilized her and sent her on her way.
Since then they have been monitoring her. She has been on Lasix to remove the excess water in her body and lungs and has been taking potassium supplements to replace what the Lasix removes.
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