Sunday, September 1, 2013

The Big Decision

Well~ today the decision has been made to do the LVAD on Thursday (9/5). Danny has been vomiting for the past 4-5 days, which is a sure sign that his heart failure is worsening. There is also something they check through blood work called a BNP that is skyrocketing. The BNP is a hormone released by the heart when someone first goes into heart failure or who has worsening heart failure.

I know many of you have asked what an LVAD is, so here goes the lesson as best as I understand!! LVAD stands for left ventricular assist device. It's a pump that is attached to the left side of the heart and takes over the function of the pumping of blood. The left side of his heart will not work--the pump will instead. An interesting tidbit about the pump is that Danny will no longer have a pulse, because there will not be a heartbeat...just a steady machine through which blood flows. His right heart must still function on its own and just to be safe, he will keep the ICD (pacemaker & defibrillator) he already has on his heart to help out the right side if necessary. Now for the spooky part...the doctors will cut open his chest and pull apart his rib cage to have full access to the heart. They will use something to basically prop open the ribs while they are working. The surgery to attach the pump and change the blood flow to go through the pump will take at least 8 hours. I've been told that no one will come out during the surgery to give us updates. After the LVAD is attached and functioning, the doctors have to leave his chest propped open until the right heart decides to accept the foreign object. In very simple terms, the right side won't like the LVAD at first and so the doctors have to "caress" (their own words) it into being friends. Sometimes the right heart takes only a few hours to accept the LVAD, but sometimes it can be as long as a couple of days. Regardless of how long it takes for the right side of Danny's heart to become friends with the LVAD, his rib cage will remain propped open until the doctors feel confident it will work. The reason they don't close him up before then is because if the right heart rejects the LVAD, doctors will not have time to reopen Danny to save his life. He will stay in a sterile environment and from what I understand right now, I will be able to see him through a window. Once he is closed up, he stays in an ICU bed for about a week or two, until he is stable enough to go to the step down unit. The ICU has visiting hours, therefore I won't be able to stay with him 24 hrs/day as I have been doing (he doesn't want me to leave his side). I will be able to stay with him again once he's in the step down unit. He will be there for another week or two and will then be discharged to New Orleans for about 6-8 weeks. Ochsner has an attached hotel called Brenthouse that is designed for families and patients in this situation and there are also very basic apartments available within a couple of blocks of the hospital. When doctors feel he is ready, Danny will go back to Baton Rouge and back to life as before--but hopefully feeling much better. 

The upside to the LVAD is that it is a way to save his life while waiting on a heart transplant...it's known as a bridge to transplant. Danny should have energy again and be able to breathe without struggling. There are a couple of negatives...as I said, the LVAD is a mechanical pump that is attached to his heart. The pump runs on batteries, which need to be charged. He will have a power cord that runs from the pump through a hole in his abdomen that he will plug in at night or when at home. He will have to carry around a controller (the computer that runs the pump) in some type of bag or vest. He cannot get wet (rain, swimming, etc...). Once the hole in his belly has healed, Danny will be able to use a shower bag to keep all components dry while he showers. We all know that it rains all the time in Louisiana, so he must always have a raincoat and umbrella handy to not risk electrocution. 

As you can see, the LVAD will take a lot of getting used to and will definitely be lifestyle altering, but the benefits of staying alive and probably feeling pretty good while he waits for a donor heart definitely outweigh the negatives. 

This is scary...it's a very serious surgery and recovery. I will have to be thoroughly trained on how to take care of him and clean the area where the cord comes out. Before he is released to Baton Rouge, Danny and I will have an outing day (8 hours) at Ochsner where I will be required to complete different scenarios while the doctors and staff are nearby watching. Sounds a little stressful, but we will do just fine. 

That's all my knowledge about the LVAD, I think. Feel free to post any questions or text/email me...I'll do my best to find the answers!

Thanks for reading and praying...Some have asked for our address because they aren't comfortable using Paypal and that's OK! If that's you, please email me and I will give you our address. 

tasauer@cox.net 

Here's a very recent of my family--please don't forget to pray for Maggie and Charlie. I can't even imagine how scary this is for them. I've also taken a picture of this brochure I have that gives good info about the LVAD if you're interested. 









~Tricia


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