Matters of the Heart, Part 30

As I said in Part 29, I didn’t expect to have a Part 29 of this series, let alone a Part 30. But here we are.

Looking back, Ben and I have been dealing with his heart issues for 36 years. We’ve been married for 37 years. What does that tell you?

Deciding on having the Watchman procedure done was easier than the steps involved to actually get the procedure itself approved. And it certainly wasn’t his doctor’s fault.

There were several tests he had to have first, including a new EKG, and echocardiogram. Those were simple and of course showed he was a good candidate for the procedure. 

Then he needed a second opinion from another cardiologist in his group. Time was ticking until the end of the year, and we were getting a bit antsy. 

But that appointment was finally scheduled and the doctor confirmed that with his history he was definitely a good candidate for the procedure 

Now to get it approved and scheduled before the end of the year. With Thanksgiving and Christmas affecting schedules as well.

But our doctor assured us we’d get it done by the end of the year, and we’d get a call from the office as soon as it could be scheduled.

We just didn’t realize we’d get the call just five days before the surgery date, with two of those days being a weekend. It was scheduled for TWO DAYS before Thanksgiving! And we found out on Thursday which was the Thursday before Thanksgiving Day!

He’d be the first surgery of the day, which meant we had to be at the hospital at 5:30. In the morning! And I am NOT a morning person, which meant we’d have to get up at 4 am to get ready and be there that early. Ugh.

Well, we’d take what was available. Which meant frantically rearranging both his and my work schedules, as well as finishing putting up all the Christmas decorations! Fortunately we’d started early, and if you followed the stories about our 8+ Christmas trees, plus the Christmas ledge in our two story foyer, well you can imagine how much we needed to get done since we were having Thanksgiving dinner at our house.

I finished all the big trees, and he finished the ledge. Boxes for the decorations were still sitting around which needed to be put away, but I figured our daughter and son-in-law could do that since Ben wouldn’t be able to lift anything for several days after the procedure. Talk about rushing around…!

But plans don’t always go as planned, shall we say. The night before his surgery he got a call from his doctor around 6:30 PM. From his doctor’s personal cell phone. (Yes, we have that number.) That’s a call you don’t ignore.

And you guessed it. Surgery was postponed. The insurance company still hadn’t approved it. We weren’t happy at all. However, as Ben told the doctor, “my wife will be happy she doesn’t have to get up at 4:00 in the morning.” He said the doctor laughed himself silly over that comment! After apologizing profusely, the docotr promised they would reschedule as soon as they got the word from the insurance company, and it would definitely be before the end of the year.

Things did work out for the best, though, because not only did I not have to get up before the crack of dawn, we were able to put all the decoration boxes away, and I didn’t have to beg for extra help from our daughter to get Thanksgiving dinner ready. And Ben was able to play with the grandkids on Thanksgiving without being concerned about his incisions. 

But how was this going to affect our Christmas plans? Would we have to scramble to change other things?

Fortunately, the next week we got a call rescheduling the procedure, for the following week. Our doctor must’ve remembered Ben’s comment about early mornings, though, because the new surgery time was 1:00 in the afternoon and we didn’t have to be at the hospital until 11:00 am. That worked really well, at least for me.

Then we found out the insurance company had actually approved the procedure at 4:30 pm the day before the original surgery date. They just didn’t notify the doctors in time.

Go figure. But it did all work out for the best, since Ben had a week’s vacation already scheduled for the following week after the surgery to make recuperation easier.

Surgery went perfectly. In fact our doctor told him he’d done hundreds of these procedures and usually he had to do a little maneuvering to get the device precisely where it needed to be, but this one went in perfectly the first time! Thank goodness!

Ben will now be on blood thinners for 45 days after the surgery while the tissue grows over the device to seal it in. He will then have a CT scan to be sure everything is going well, which we’re sure it will. Then he will be on a different blood thinner plus baby aspirin until 180 days after the procedure and then no more blood thinners; just a daily baby aspirin.

Naturally we’re all pleased with the results, and so glad he made the decision to do it.

What’s ahead in this saga now? Hopefully only 6 month follow up visits that will show everything is still doing well.

After three heart valve replacements, two pacemakers, and now the Watchman, I think he’s had enough.

We are so thankful for all the great doctors and nurses he’s been fortunate enough to have over the years, and I do have to say that the last two cardiologists that have been caring for him have been the absolute best!

If any of you reading this have any heart issues, or have loved ones with these issues, please be encouraged. It’s not always as bad as it seems. Yes, it’s scary, but look what we’ve been though over the years. And if you have questions please feel free to message me with questions.

And Ben is still going strong after all of this!

Matters of the Heart, Part 29

I really didn’t expect to be writing another installment of this series. After all there’ve been 28 installments so far, the last one being in September of 2019. A little more than two years ago.

Certainly enough stories, right?

Well, you would think so.

But after the last heart valve procedure, which is still doing very well, thank goodness, both of Ben’s doctors determined that he was a very good candidate for a device called the Watchman. This device is implanted in an area of the heart called the left atrial appendage. It permanently closes off that area of the heart in which blood clots can form for patients like Ben who have a history of atrial fibrillation or AFib (which can lead to a stroke).

AFib patients, even those with pacemakers, like Ben, are on blood thinners daily to prevent blood clots from forming. This particular device prevents such clots from forming, thus eliminating the need for patients to take blood thinners daily, which in Ben’s case have also caused a number of blood vessel ruptures in his left eye, which has had numerous recurrences of iritis, which is another story altogher.

Naturally we had a lot of discussions on this procedure, as it’s only been around a little over ten years, and we’d never heard of it. But we did a lot of reading about it, and after several talks with his doctor, we decided that it was the right thing for him to do. Particularly since it was a non-invasive procedure in which the device was inserted into his heart through an artery in the groin, much like his last heart valve replacement. An overnight stay would be required, which was no big deal.

There were several tests that had to be done prior to getting final approval by the cardiology team (not to mention his health insurance, but that’s another matter entirely).

But before we could start the process, Covid hit, and although we’ve been extremely fortunate and neither of us or his medical professionals have contracted it, all elective surgeries were put on hold until further notice.

Of course the Watchman is an elective procedure. So we were on hold. For quite awhile. About 18 months or more.

We kept checking with the hospital and his doctors and finally the restrictions on elective surgeries were lifted. We made an appointment as soon as we could with his doctor to discuss the next steps.

When we were finally able to get the appointment  with his doctor we all quickly decided this was the best way for him to go, and proceeded to schedule the testing involved to be able to apply for approval not only within the cardiology group, but also with his insurance company for their approval.

Nothing is ever simple, though. And we also needed to do the surgery by the end of 2021 to avoid a huge out of pocket expense, since he’d already met his deductible for that year. And it was already early in October 2021.

So the process began…but not without a few complications along the way. Of course.

Read the next installment of “Matters of the Heart, Part 30″, to be published on January 24.

Matters of the Heart, Part 25

This Friday is supposed to be the day. Hopefully it will be Ben’s last heart procedure for some time.

It’s been a long five weeks since the last one…you know, when he was supposed to get his new upgraded pacemaker. And didn’t.

Although he received a double ablation in preparation for the new pacemaker, these last few weeks haven’t been all that easy. There have continued to be problems, which are still going on even as I write this.

It actually began the night he came home from the ablation. Walking up the stairs that night the shortness of breath was back. And his heart rate was up to 90, although it was at 70 when we left the hospital. His weight was up to 171 and it had had been 167 when we were at the hospital. How did all that fluid that come back so quickly???? And his fingers were so swollen he couldn’t get his ring back on. And it hadn’t been like that at the hospital. The on-call PA said it was all normal and if it weren’t any better the next day to let them know.

And it was ok. UntilFriday morning when his Kardia app told him he was back in Afib….

It was back and forth like that for the next week, but he was at least able to go to work. He was terribly tired when he got home, but he did it.

Then on a Saturday 20 days after the procedure he got in the pool for the first time and tried to swim. He only went 1/4 of the length and was so short of breath we thought we were going to have to help get him out.

We went to an early dinner and when we got home he leaned over to pet the dogs and got extremely dizzy and lightheaded. We took his BP several times and it was 66/46!

Fortunately when we called the doctor’s office the PA on duty was his doctor’s PA, who knew all about his case. She emphasized his heart was still adjusting to the ablation and since his heart rate was fine, we shouldn’t panic. (Right!!) She told us to cut back on two of his meds because they tended to lower blood pressure. And to eat some salty food! Salt on a low sodium diet?

But we fixed him some salty popcorn which helped and his BP was up to 83/77 when we went to bed. The next morning it was normal.

It’s been back and forth like this for the last two weeks. He’s very tired when he gets home from work and still has to take a nap. The shortness of breath hasn’t gone away, and some days is worse than others. He still gets swelling in his abdomen even though he’s on double doses of fluid pills. His feet are swollen off and on.

Fortunately his heart rate has stayed fairly constant, with no signs of Afib. That’s a positive.

And of course with all of this going on, even though he’s been told by the doctor’s assistant that the new upgraded pacemaker will take care of all of this, he’s still not sure it will. And I don’t blame him.

There’s just been so much….

So this Friday is the day. So far. And hopefully the beginning of a calm period in our lives. A time to

start going places again without worrying if he’ll get too tired to enjoy himself. A time to only take his vital signs once a day instead of four. A time to be able to lift his granddaughters and our little dogs without shortness of breath.

Thank you for sharing this journey with us. And may there only be one or two more chapters of updates about heart surgeries and other cardiac procedures!

Stay tuned for Matters of the Heart, Part 26.

Matters of the Heart, Part 24

I really had hoped this would be our last installment of the series, at least for a few months. However, as I’ve said before many times, you just can’t make this stuff up! Even if you try.

When we woke up the morning of Ben’s scheduled pacemaker upgrade and ablation procedure, all we could think about was, it was finally going to be over, at least for several years. He’d finally be saying a permanent goodbye to Afib, shortness of breath, and fatigue. It was going to be the end of a long and difficult journey.

We were so looking forward to getting this all behind us.

But still I had this nagging feeling in the back of my mind, and I ignored it. After all, what could go wrong? We’d been though enough already.

The surgery was scheduled for 9:00 and we got to the hospital right on time at 7:30. Although the Heart Center was packed, we were taken back fairly quick to begin the pre-surgical prep. After all of the various procedures we’d gone through, we fairly well knew the routine and were able to mentally check off each step in our minds.

One difference this time was having the pacemaker specialist come in to check Ben’s current pacemaker and download the information from it to put into the new one. (Never thought about that!) We asked questions about the new device and how it basically worked, since we hadn’t had the opportunity previously.

The tech said that like the one Ben currently had, it monitored the heart to keep it in rhythm, but also would monitor when he went into Afib, and would deliver a shock to the heart to put it back in rhythm when necessary. Yes, he would feel it, but most likely he could tell when it was going to happen because he’d feel somewhat light headed already from the Afib. And it wouldn’t be anything like the shock of the paddles that are used when the patient is unconscious or needs to be resuscitated, since this one shocks directly through the heart and doesn’t have to go through clothing, chest muscle, etc. to get to the heart itself.

He told us, “It’s sort of like going from a car to a diesel truck!” Well, I think we could relate to that. At least it gave a good visual.

When Ben’s surgeon came in for a final discussion before surgery he explained again that he was going to do the pacemaker change-out and would then do a complete ablation so that the pacemaker would be totally in charge of the heart keeping a proper rhythm.

The new pacemaker would also communicate its daily activity via WiFi through a monitor on his night stand and the readings would go to the doctors’ office daily. He’d have regular 6 month checkups to be sure it was working properly. And that it would require a battery change about every 5 years. We’d know in advance when it needed changing with the monitoring and the regular checkups.

Well, he’d had his current one for five years and it was still working properly, so that sounded fine.

The doctor explained he would also be doing a venogram before they started so as to be sure the veins were clear and open so the pacemaker could be properly installed in place of the other one. If the veins weren’t in good condition he would have to install the new one on the other side of the chest, a somewhat different procedure. For that reason, Ben would be awake during the venogram so they could discuss any change of plans necessary, as he would have to consent to the change in procedure.

So we were ready. Time to get it all done! By that time our daughter had arrived and we said goodbye and good luck to our patient, and went out to wait the two hours or so it would take.

And as planned, the first thing done in the OR was the venogram, and the doctor was pleased with the results. Ben remembers hearing him say everything looks good to go, so let’s get started! That’s the last thing he remembers til he woke up a few hours later.

And I got the phone call from the nurse two hours later that the surgery was over and went well; Ben was in the recovery area; and the doctor would be out in 15-20 minutes to talk to us. I was relieved, to say the least!

Finally all this was behind us.

Or so we thought.

Until I talked to the doctor.

The first words out of his mouth were “we weren’t able to put the new pacemaker in.” And he looked very upset.

What?

He quickly went on to explain that although the venogram was fine, once they opened Ben up and got ready to put the new device in, he discovered because of the way the old pacemaker had been put in, he wasn’t able to run the wires properly for the new one without risking the veins breaking.

So they had to re-implant the old one. Ben would now require another surgery in 30 days in which the new pacemaker would be inserted on the right side and then the existing one on the left would be disabled. Since Ben was already under anesthesia, he wasn’t able to give consent to the different procedure at that time. and they also had to allow time for healing before they went back in.

The good thing, though, was that the doctor had been able to do the ablation, so the Afib should be gone, at least until the new pacemaker was implanted. And I will say, the doctor did not look happy about the change in plans for his patient.

Neither was I, and I knew Ben wouldn’t be either.

I really didn’t know what to say, and I’m sure I haven’t explained all of this properly. I was too shocked to completely take it all in. All I could think was, after all this…we still had to wait…

More to come in Matters of the Heart, Part 25.

Matters of the Heart, Part 23

Spending three nights and two and a half days in the hospital hadn’t exactly been in our plans for Ben just a month after a very easy and successful heart valve replacement procedure.

But unfortunately the Afib decided it was much more dominant than a new heart valve, and if you’ve read our installment of Matters of the Heart, Part 22, you’ll know exactly what I’m talking about.

Although we were so sure our hospital stays were over, once the Afib came back just three weeks after the cardioversion two days after the valve replacement, it was unfortunately a matter of time. At the emergency room he was hooked up to IV’s once again, given stronger meds to steady his heart rate, and IV injections of lasix to reduce the fluid buildup which had put him in a serious state of congestive heart failure.

And as nice as the new cardiac wing of that hospital was, and as friendly and caring as the nurses were, it still wasn’t the place he’d planned to be that week, and it wasn’t fun trying to get his body back to some semblance of normalcy so he could come back home and be able to function normally until the next cardiac procedure to hopefully eliminate the Afib once and for all!

Which was still over three weeks away.

When he finally came home he was somewhat better. The meds were helping the Afib a little, although it still didn’t go away, but the shortness of breath continued. Some days were worse than others, and he still didn’t have the energy to go back to work.

The next week was Fourth of July. We always had a cookout with friends over. This year it was extremely modified. Just a couple of close girlfriends and I were in the pool that afternoon, and Ben did manage to grill burgers for us, but he was mostly confined to staying inside in the air conditioning and watching baseball on TV. Not much excitement over a long holiday weekend, since he really didn’t feel like going anywhere. We even missed a birthday party for one of Ashley’s friends’ daughter, something we’ve never missed.

Increasing the lasix helped a bit, and he was able to go back to work the next week, although in the office rather than his regular courier routes. But at least he was able to feel productive and get out of the house!

For those of you who cannot really imagine what this is like, let me try to explain. For Ben, it’s a day by day ordeal, wondering each morning how he’s going to feel. If his heart rate will be jumping all over the charts, which makes him exhausted. If his blood pressure will stay in the normal range or drop dangerously low requiring another hospital visit. If the fluid accumulation will become worse which causes difficulty breathing and shortness of breath, making it a chore to go up stairs, lift anything over about 7 pounds, or even go for a walk. Some mornings he’s ok for a while, and some mornings he says he felt like he didn’t get any sleep when I know he did.

It’s no fun living like that, and he keeps saying he’s just waiting for something else to happen to cause another trip to the emergency room. He checks his heart rate 3-4 times a day as well as his blood pressure, and makes sure to text me the results.

For me…I worry. I can’t help it. I still wake up at night and listen to be sure he’s breathing. If he has to get up during the night, I immediately wake up as well and can’t help but ask if he’s ok. I take notice of the swelling in his abdomen and his feet and ankles and remind him to put his feet up every chance he gets. I watch his facial expressions and have learned to tell when he’s not feeling right, or getting short of breath again.

And yes, I probably nag him too much to take it easy when I think he’s overdoing it. He tells me he knows his limitations, but to me, it seems he stretches them a bit because he just wants to do what he normally does. Which worries me as well. But it’s difficult watching your husband go through this struggle, and not being able to fix it.

Fortunately his ablation and upgrading his pacemaker will be done shortly. All we can do now is wait, and pray it will correct this situation once and for all.

It’s a journey, although not one we chose. But we’re getting through it with the help of good friends, family, and understanding co-workers. And some excellent doctors.

More to follow, in Matters of the Heart, Part 24.