Mom has been feeling more and more lethargic and short of breath over the past 6 weeks. This is due to the heart-valve calcification condition she was diagnosed with several years ago. The prognosis was that the condition would continue to get worse over time, leading to congestive heart failure where breathing simply becomes more and more difficult until total heart failure.
Up to 6 weeks or so ago, the situation has been getting slowly worse, but not to a point where life was very seriously curtailed. In the past 6 weeks, however, the situation has become precipitously worse. It has gotten uncomfortable enough for her that when mom heard about a heart-valve replacement study at Emory hospital in Atlanta, Georgia that involved using a catheter to do the replacement rather than full blown open heart surgery, she decided to go for it. So she and Julie packed the car and they drove up to Atlanta.
I spoke to my boss about taking time off to go to Atlanta, and he agreed. I spent as much of the weekend as I could with Pam, and then drove down to Atlanta Sunday to meet Julie and Mom at the Emory Conference Hotel about 3 blocks from the hospital.
We all three spent the night in the hotel, Julie and I had a pleasant dinner outside the hotel restaurant, and in the morning went to the hospital.
Plan was to get some tests to evaulate if she was a good candidate for the Study's catheter-from-groin surgery. Turned out she was not. Calcium buildup in her aortic arteries in her groin was too excessive and the arteries were too small to support the size catheter needed for the replacement procedure.
This was disappointing, and we had to evaluate what next to do. There were three options offered: (1) valvoplasty - temporary (4 to 6 months) fix using a balloon inflation to clear the valve of calcium buildup; (2) full open heart surgery; (3) Trans-Apical procedure - enter through lower ribs with catheter tool.
Because option (3) was also part of the study and not FDA approved, the choice between options 2 and 3 had to be randomized.
Long discussions and deliberations ensued. Chosen stragegy: If option (3) was selected, she'd do it. If option (2) was selected, then do option (1) and go home to think on what to do.
Doing the latter makes sense from a "don't rush foolhardy into something" perspective, but makes for rather an emotionally stressful decision process that needs to be made going forward.
As luck would have it, the randomization selected option (3), the TransApical procedure. Mom seemed somewhat relieved about this, as were we all. Now the sweat of decision making was basically resolved.
Numerous tests followed this afternoon to ascertain Mom's fitness level prior to surgery. It seems that other than the heart valve problem and the congestive heart failure that it brought on, her health was really quite good.
The various doctors on the surgical team, one by one, showed up for introductions and pre-surgical consultations. Questions and answers. Getting to know each other personally and get comfortable with the physicians involved.
Surgery is scheduled for Wednesday. She is the 2nd patient of the day, and they said she'd probably go in at around Noon time. Probably she'll get taken for 'prep' an hour or so before that.
I asked the cardiac surgeon (Dr. Babaliomos) various technical questions regarding the heartvalve and replacement procedure:
o) The new valve is bovine valve (bio-material).
o) The old valve is simply pushed out of the way.
o) The new valve is inside a stent. This is how the old valve is pushed out of the way. The stent is placed inside the old valve and then 'sprung' open, pushing the flaps of the old one to the edges.
o) The new valve is not sutured into place, but rather stays in place by heart-action/blood-flow pressure. The new valve is slightly larger than the aortic artery aperture. Pressure of blood flow holds it pressed against the aortic exit.
o) The stent/valve combo are compressed very small, placed inside the catheter tool, and fed through the incision on the lower chest, and to the heart.
o) The heart is not stopped for the valve insertion. Rather, it is "galloped" up to 200 or so beats per minute for 15 to 30 seconds. This results in 0 efficiency in pumping, therefore 0 blood flow, and therefore no pressure to get in the way of the insertion. Once in place, the heart resumes it's normal rate and blood flow/pressure take part in holding the valve where it belogs.
The anesthesiologist stopped by earlier this afternoon while Mom and I were away on a test, so we missed him. He left message that he'd stop by in the morning. I'd like to speak with him to specifically ask "how will they know that she isn't doped and unable to move but still conscious"? Usually these days they have some kind of monitor (brain activity monitor or something) to see the expected brain-wave pattern of unconsciousness.
I may not be in yet when the anesthesiologist shows up, so I'll tell Julie to ask about this in my stead if that's the case.
Tomorrow is a big day. Many people are offering prayers and well wishes.
Tuesday, June 16, 2009
Thursday, May 21, 2009
TIME GETS BETTER WITH AGE
TIME GETS BETTER WITH AGE
Read it through to the end, it gets better as you go!
I've learned that I like my teacher because she cries when we sings "Silent Night".
Age 5
I've learned that our dog doesn't want to eat my broccoli either.
Age 7
I've learned that when I wave to people in the country, they stop what they are doing and wave back.
Age 9
I've learned that just when I get my room the way I like it, Mom makes me clean it up again.
Age 12
I've learned that if you want to cheer yourself up, you should try cheering someone else up.
Age 14
I've learned that although it's hard to admit it, I'm secretly glad my parents are strict with me.
Age 15
I've learned that silent company is often more healing than words of advice.
Age 24
I've learned that brushing my child's hair is one of life's great pleasures.
Age 26
I've learned that wherever I go, the world's worst drivers have followed me there.
Age 29
I've learned that if someone says something unkind about me, I must live so that no one will believe it.
Age 30
I've learned that there are people who love you dearly but just don't know how to show it.
Age 42
I've learned that you can make some one's day by simply sending them a little note.
Age 44
I've learned that the greater a person's sense of guilt, the greater his or her need to cast blame on others.
Age 46
I've learned that children and grandparents are natural allies.
Age 47
I've learned that no matter what happens, or how bad it seems today, life does go on, and it will be better tomorrow.
Age 48
I've learned that singing "Amazing Grace" can lift my spirits for hours.
Age 49
I've learned that motel mattresses are better on the side away from the phone.
Age 50
I've learned that you can tell a lot about a man by the way he handles these three things: a rainy day, lost luggage, and tangled Christmas tree lights.
Age 51
I've learned that keeping a vegetable garden is worth a medicine cabinet full of pills.
Age 52
I've learned that regardless of your relationship with your parents, you miss them terribly after they die.
Age 53
I've learned that making a living is not the same thing as making a life.
Age 58
I've learned that if you want to do something positive for your children, work to improve your marriage.
Age 61
I've learned that life sometimes gives you a second chance.
Age 62
I've learned that you shouldn't go through life with a catchers mitt on both hands. You need to be able to throw something back.
Age 64
I've learned that if you pursue happiness, it will elude you. But if you focus on your family, the needs of others, your work, meeting new people, and doing the very best you can, happiness will find you.
Age 65
I've learned that whenever I decide something with kindness, I usually make the right decision.
Age 66
I've learned that everyone can use a prayer.
Age 72
I've learned that even when I have pains, I don't have to be one.
Age 82
I've learned that every day you should reach out and touch someone. People love that human touch-holding hands, a warm hug, or just a friendly pat on the back.
Age 90
I've learned that I still have a lot to learn.
Age 92
I've learned that you should pass this one on to someone you care about. Sometimes they just need a little something to make them smile.
Read it through to the end, it gets better as you go!
I've learned that I like my teacher because she cries when we sings "Silent Night".
Age 5
I've learned that our dog doesn't want to eat my broccoli either.
Age 7
I've learned that when I wave to people in the country, they stop what they are doing and wave back.
Age 9
I've learned that just when I get my room the way I like it, Mom makes me clean it up again.
Age 12
I've learned that if you want to cheer yourself up, you should try cheering someone else up.
Age 14
I've learned that although it's hard to admit it, I'm secretly glad my parents are strict with me.
Age 15
I've learned that silent company is often more healing than words of advice.
Age 24
I've learned that brushing my child's hair is one of life's great pleasures.
Age 26
I've learned that wherever I go, the world's worst drivers have followed me there.
Age 29
I've learned that if someone says something unkind about me, I must live so that no one will believe it.
Age 30
I've learned that there are people who love you dearly but just don't know how to show it.
Age 42
I've learned that you can make some one's day by simply sending them a little note.
Age 44
I've learned that the greater a person's sense of guilt, the greater his or her need to cast blame on others.
Age 46
I've learned that children and grandparents are natural allies.
Age 47
I've learned that no matter what happens, or how bad it seems today, life does go on, and it will be better tomorrow.
Age 48
I've learned that singing "Amazing Grace" can lift my spirits for hours.
Age 49
I've learned that motel mattresses are better on the side away from the phone.
Age 50
I've learned that you can tell a lot about a man by the way he handles these three things: a rainy day, lost luggage, and tangled Christmas tree lights.
Age 51
I've learned that keeping a vegetable garden is worth a medicine cabinet full of pills.
Age 52
I've learned that regardless of your relationship with your parents, you miss them terribly after they die.
Age 53
I've learned that making a living is not the same thing as making a life.
Age 58
I've learned that if you want to do something positive for your children, work to improve your marriage.
Age 61
I've learned that life sometimes gives you a second chance.
Age 62
I've learned that you shouldn't go through life with a catchers mitt on both hands. You need to be able to throw something back.
Age 64
I've learned that if you pursue happiness, it will elude you. But if you focus on your family, the needs of others, your work, meeting new people, and doing the very best you can, happiness will find you.
Age 65
I've learned that whenever I decide something with kindness, I usually make the right decision.
Age 66
I've learned that everyone can use a prayer.
Age 72
I've learned that even when I have pains, I don't have to be one.
Age 82
I've learned that every day you should reach out and touch someone. People love that human touch-holding hands, a warm hug, or just a friendly pat on the back.
Age 90
I've learned that I still have a lot to learn.
Age 92
I've learned that you should pass this one on to someone you care about. Sometimes they just need a little something to make them smile.
Sunday, May 3, 2009
Mom visit - update, and Julie comes home
Mom is not feeling too great today. She said she had a difficult night sleeping, and kept waking up with her cough. She breakfasted with me, she took a shower, we talked about me and Pam, and she's now getting on her stationary bicycle to try to "clear her breathing".
She asked me if I was ok with letting go of my apartment? Letting go of the freedom to 'get away' to my place if I wanted to. I said I was afraid of the move-in, but was ok with it. Pam too is afraid, and we've discussed that with each other. Pam says she's not as good at starting up those intimate-feelings conversations. But once I start them and make 'safety' primary, she is quite good at going there with me. That is one of the most important things to me in a relationship now, and it's so good to have that with her.
Julie is back in Miami this morning, and will be back home towards late afternoon. She's had a really nice time, and I hope she got a chance for a *most* well deserved bit of relaxation.
She asked me to wash the dogs if I got the chance. But I'm just not enough of a dog-person to do that yet :). Patches has been great this time around. And Bessie, poor thing, is a sweetie. Each morning when she went outside for her morning consitition, I would follow it with a good brushing out of her undercoat - Wow that's a lot of hair!!!! I think she really liked it, and she seemed to be happier when I'd come and go. I also swept most of the floor at Julies place this morning and washed up the dishes to try to make it so she didn't come home to a complete mess of work. If she wants to wash Bessie (and this morning, I agree that she definitely needs it), I'd be happy to help her do it. But with Bessie in the condition she is in now and Julie not present, I don't think I want to do it myself. Julie knows how much to push Bessie, what her wimpers mean, and how much she can take. I don't.
She asked me if I was ok with letting go of my apartment? Letting go of the freedom to 'get away' to my place if I wanted to. I said I was afraid of the move-in, but was ok with it. Pam too is afraid, and we've discussed that with each other. Pam says she's not as good at starting up those intimate-feelings conversations. But once I start them and make 'safety' primary, she is quite good at going there with me. That is one of the most important things to me in a relationship now, and it's so good to have that with her.
Julie is back in Miami this morning, and will be back home towards late afternoon. She's had a really nice time, and I hope she got a chance for a *most* well deserved bit of relaxation.
She asked me to wash the dogs if I got the chance. But I'm just not enough of a dog-person to do that yet :). Patches has been great this time around. And Bessie, poor thing, is a sweetie. Each morning when she went outside for her morning consitition, I would follow it with a good brushing out of her undercoat - Wow that's a lot of hair!!!! I think she really liked it, and she seemed to be happier when I'd come and go. I also swept most of the floor at Julies place this morning and washed up the dishes to try to make it so she didn't come home to a complete mess of work. If she wants to wash Bessie (and this morning, I agree that she definitely needs it), I'd be happy to help her do it. But with Bessie in the condition she is in now and Julie not present, I don't think I want to do it myself. Julie knows how much to push Bessie, what her wimpers mean, and how much she can take. I don't.
Saturday, May 2, 2009
Teddy Stern
I also got a chance to talk with mom's friend, Teddy Stern, today. That was so nice. She (and Sigy) have been such a vivid and warm part of our family life. It is always wonderful to get a chance to chat with her.
Mom is making her famous Liptauer bread-spread for my trip back up to Raleigh Monday. Don't know if it will last until then :).
Mom is making her famous Liptauer bread-spread for my trip back up to Raleigh Monday. Don't know if it will last until then :).
Merenge!
Browsing around YouTube this morning on my mother's computer. Looking at various Latin-dance lessons. Came across some Merenge stuff for which the basic-step looks dirt simple! Thought of Pam while watching it, and thinking how much we're both looking forward to getting some lessons down and doing some fun dancing together once were done with all the medical junk.
It's just a simple left-right step, over and over again. No pauses, no extra repeat stepping. It's like the shuffling dance I saw once at a Haitian wedding I went to years ago. At that time, I didn't understand and couldn't quite get it. But now I think that must have been some form of Merenge.
With the stuff I've learned from all the Mambo classes I've taken, some of the added fun-stuff - turns, swings, shifts in directions - looks pretty easy to add in.
I emailed a YouTube video to Pam that I thought was pretty good in it's lesson-combo: basic step, simple direction-changes, simple turns, etc. I think she'll get a kick out of it!
Friday, May 1, 2009
Visit while Julie goes on Vacation
Mom and I went to the doctor (scheduled appt) on Tuesday to have a check up on the leg injury she got from the dog. It was doing well. We did not go swimming that day due to all the doctor and chasing-around activity of the day. Wednesday, was a good day for her, and in the late afternoon we went swimming. Thursday, Mom was feeling poorly, and had developed a persistent cough. It does not seem infection related, and is maybe more of a talking-too-much kind of thing? Something is irritating her chest, so she coughs. Also she was feeling tired and run down all day, so we did not make it into the pool at all. Goulash for dinner!!!
Today (Friday) she's still got the cough, but it seem much much less. We're planning on the swim later and hopefully it will work out. If not, I'll try to get her to at least come down with me to the poolside. Perhaps being there will motivate her to get in.
Patches has been incredibly well behaved, I'm super impressed with him!
Today (Friday) she's still got the cough, but it seem much much less. We're planning on the swim later and hopefully it will work out. If not, I'll try to get her to at least come down with me to the poolside. Perhaps being there will motivate her to get in
Patches has been incredibly well behaved, I'm super impressed with him!
Wednesday, April 29, 2009
Visit while Julie Takes Vacation
Julie went on her well deserved vacation cruise with Ellen this week. Due to the goings on with Pam at present, I was initial not planning on coming down. But Julie called me a couple weeks prior and said Andrea, my standin, had a family in NY to go to herself. Julie had no other backup. So I arranged for train tickets and came down last Sunday for the week. Pam is on the Gemcytoven chemo this week, and that seems to be pretty mild, so it's actually good timing as well.
I'm enjoying time to share with mom. Today I conjured up some Hungarian Goulash for us, and she gave a few small pointers. Planning on a swim in 20 minutes or so.
Bessie is having quite some diffficulty these days, even to the point where I sometimes need to hand feed her. Julie has me give her some oral medications (hidden in liverwurst) for her joint pain, and that seems to help some.
Patches has been such an incredibly good dog. He has not jumped up on me a single time, with out me asking him to first. I'm so very impressed! He's such a HAPPY-DAWG!
I'm enjoying time to share with mom. Today I conjured up some Hungarian Goulash for us, and she gave a few small pointers. Planning on a swim in 20 minutes or so.
Bessie is having quite some diffficulty these days, even to the point where I sometimes need to hand feed her. Julie has me give her some oral medications (hidden in liverwurst) for her joint pain, and that seems to help some.
Patches has been such an incredibly good dog. He has not jumped up on me a single time, with out me asking him to first. I'm so very impressed! He's such a HAPPY-DAWG!
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