Monday, April 6, 2009

Day + 18 -- more heart problems, pacemaker

Doug is still on the ventilator, deeply sedated and not aware of anything. It is hard to see him like that, hooked up to all the machines. His body is bloated with fluids, but he does have some urine output. I stroke his hands, feet and forehead and talk to him on the chance that he is aware on some level.

The cardiologist decided today to put in a permanent pacemaker. They had turned down the temporary one but Doug's heart could not sustain a rythym, so it appears he will need a permanent one. The plan was to then get him off the ventilator.

The pacemaker procedure took about two hours, longer than they had told me. When the cardiac doc came out to talk to me he said that he had found something very unusual. The normal electrocardiac voltage for the right atrium should be 3 to 5 mv. Doug's was only .2 and they couldn't get it above that. Doug's upper chamber is "severely diseased". The cardiac doc is very experienced and he said he doesn't know why that is. He is going to call in some other experts to get more ideas. He shared with me what he doesn't know, and I appreciate his honesty. He doesn't know yet if it is permanent or temporary; if it is caused by a virus, or some allergy or toxicity (chemo anyone?) or it could be cardiac amyloidosis which is not good. I'm not going into detail on that until we see what happens. A biopsy of the heart muscle is a possibility.

Meanwhile the permanent pacemaker has only one wire, into the lower chamber instead of two. This is the way all the old original pacemakers were - the doc said it should work well, except Doug might be short of breath on exertion.

The plan is to extubate (take off the ventilator) Doug in the morning. I want to be there for that since they stop the sedation first and I think it could be a scary uncomfortable feeling to wake up with that tube in his throat and not be able to speak. Hopefully it will be a quick procedure.

For now there are more questions than answers. We can only take it one day at a time.

1 comment:

childoflight said...

Dearest Pat,we are all praying for both you and Douggie.He would benefit from being sedated right now so that he does not have to exert his mind or body in any way. If this is a toxicity with time it should resolve.The electrolyte and mineral balance is really important. Do what you can and let the Great Spirit do the rest. God Bless.xoxoxoo