Matters of the Heart, Part 31

Just when we thought we were clear and weren’t going to have anything else happen relating to Ben’s heart for a while, life comes up with something else. 

Guess why that’s why it’s called “life”. 

Because you never know what’s next.

You may not know this, but every person who has a pacemaker has a routine yearly checkup on the pacemaker itself. The technician has a device that is put on top of the area where the pacemaker is located and it gives out readings on how the pacemaker is functioning, checking that the settings are still correct, and reviewing its remaining battery life.

Yes, you may remember that Ben has two of them, because when the original one was put in, for some reason it was implanted in such a way that tissue had grown over it so that it couldn’t be replaced. Therefore, when he needed a new one with a defibrillator it had to be implanted on the right side instead of the left, which is the normal location for pacemakers.

Should we have expected anything less?

After two pacemakers, we figured now he was done for a while. The “bionic man” could take a break. For at least 7 years or so until he needed a new battery in this newest one. Well, this will be about five years since the new one was put in.

We never really thought about that, though, and what it entailed.

Until several weeks ago when he had his annual pacemaker checkup.

Everything checked out fine. Until he was told he had about 15 months of battery life left on it.

Uhhh…what?

Then what?

And how would we know when it needed replacing? Since the technician told him the pacemaker was keeping him alive, that was a fairly important question.

“Let me show you how you’ll know,” she said. And she hit a button on the machine and a beeping noise went off. And it was definitely audible.

“That’s what will happen about 4 months before we need to replace the battery. It’ll do that for about two minutes. And it’ll keep doing it every day until you call our office and come in for us to turn it off. And you’ll make the appointment for the replacement then.”

When I told the story to a friend of ours, he said he could just picture Ben being at a client’s business when it went off and saying, “Excuse me while I take this call” as his chest is beeping! And knowing Ben, he may do just that.

The technician also demonstrated how important it is for the pacemaker to be in good shape by turning it down just for a few seconds. Ben said his whole body suddenly felt limp and exhausted. It was a weird feeling, and one he doesn’t want to experience again.

We assumed he’d just have a simple battery change. But we didn’t know how that would work because we never really thought about it. But we discovered it wouldn’t just be a simple battery change. It was a total pacemaker replacement! And we remembered that last time his doctor tried to replace the one he had, which ended up not being possible because of the way it had been installed, so he ended up with a second device on his right side. 

Well, since the same doctor would be doing the replacement, we can only assume he did it so that it’ll be simple to change out.

I guess we’ll find out in about twelve months though. 

So stay tuned, because there’s probably going to be more to come before this next procedure.

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 27

As I said in Part 26, you know there’s always an extra story… nothing is ever as simple as we think. It’s always an adventure! And you just can’t make this stuff up!

Ben’s pacemaker surgery was to have been 2-2 1/2 hours. And true to the estimates, it took just a little over 2 hours. Not bad. Maybe he could even go home that night?

His doctor came in to the waiting area shortly after the attendant had told us it was over and he was in recovery. Dr. I immediately came over to us, telling us the surgery had gone very well; the new pacemaker was in and working perfectly. He’d decided to leave the other one in and set it at a lower rate as a backup, just in case something happened to the new one, which he had no expectation of happening. Sort of like a back up emergency generator, to my way of thinking.

But there seems to always be a but…

And there was. He then said when they finished the procedure and started bringing Ben out of the anesthesia he noticed his left eye was quite red. He’d taken a picture of it and showed it to us, and explained he’d sent it over to a colleague who’s an ophthalmologist to get his opinion. As well he should have.

Ashley and I looked at it, and told him that happens from time to time because of the iritis he’s had for over twenty years, so we really weren’t overly concerned. Usually just a tiny broken blood vessel or a flare up which is handled with eye drops. And you could tell Dr. I was relieved to hear that.

And in typical Ashley to doctor conversation she made sure Dr. I sent her the picture because she thought it was “cool”. Which led to them discussing what he’d done for his daughter’s third birthday that morning, and ended up sharing pictures of his family trip to Dubai and riding camels in the desert!

As you can tell, we do have a great doctor here! In fact, after he left, one of the women in the waiting room asked for his name and contact information because she was so impressed with him!

And we weren’t real concerned about Ben’s eye. Until we saw him.

By that time, even though he was still pretty much out of it, and his eyes weren’t opening a lot, the eye looked visibly swollen on the outside. It had never looked like that before when this happened. And since it was the eye that he’d had the cornea transplant in several years ago, I started to get very concerned.

And when Ben came to enough to talk to us he said the eye felt like it had something in it, and he couldn’t really see out of it very well. We explained what the doctor had said, but how much he heard at that point I have no idea.

But when he finally stated opening his eyes, that left one looked the worst I’d ever seen it. Almost black-red. The bottom part of the eyeball was actually swollen out a little over the bottom eyelid. It was scary looking. And the area on his face around it was turning black as well. Ashley of course was concerned then, but took more pictures and sent them to several of her friends who are nurses and surgical assistants to get their opinions.

And of course, I was a wreck. I could tell from the monitors his pacemaker was doing exactly what it was supposed to do. But that eye…all I could think of was that somehow something had happened to the transplant!!!

Because of our doctor contacting his colleague it wasn’t long until two doctors, a resident and an intern, came over from the EVMS ophthalmology department with a pack of equipment to take a look at him. I was so glad to see them!

They spent almost an hour looking him over. Testing his vision (which in the left eye wasn’t good!), dilating his eyes and checking the transplant and his retina. At one point I was so upset all I wanted to do was go out in the hall and cry! Thankfully a couple good friends were texting me and keeping me focused.

They finally told us the transplant was fine and it appeared to be just a broken blood vessel from the blood thinners he was on, but they needed to go back and consult with their team to be sure. Relieved? Yes. Still worried? Of course.

And all the while, his eye was looking worse and worse.

Dr. I came back in and told us he’d talked to the ophthalmologists and agreed that it was a broken blood vessel from the blood thinners. And fortunately it wasn’t a retina bleed which would’ve left him blind in that eye. Another doctor would be in later to double check him, though.

He also mentioned there was something called a Watchman that he had used for other patients as an alternative to taking blood thinners which could be implanted in the heart to prevent clots. And we could discuss that later. In the meantime Ben was to stay off the blood thinners until his follow up appointment.

That Watchman sounded like a good possibility to me! But as Ben said, it would mean another surgical procedure, even though it was done through the groin like his last valve replacement. And he’d be the one having to go through another surgery!

So much to think about. And we thought this was the end of it all…

Later that afternoon as I was getting ready to leave after 12 long hours at the hospital, another ophthalmologist came in to see him and check his eye. And she confirmed it was definitely a broken blood vessel from the blood thinners, and that it would most likely look worse before it got better…in about two weeks. And let me tell you, by then it looked really bad!

It’s now been a little over a week since the surgery. His eye is finally starting to look better. He still has one more week of not driving, which is making me crazy. His heart rate is normal, but he still has shortness of breath, although not nearly as bad as it was. And he’s still a bit sore off and on from the procedure.

Life is starting to return to normal. Somewhat. We are looking ahead to him being totally back to normal.

And to an answer concerning other alternatives to the blood thinners, as we don’t want to risk anything happening to his vision.

As I’ve said many times, never a dull moment.

Stay tuned. There’s more to follow….

Matters of the Heart, Part 26

You know there’s always an extra story… nothing is ever as simple as we think. It’s always an adventure!

Friday morning started way too early. We were at the hospital at 6 am. Mind you, that’s the time I’m usually getting up! I’d told Ben several times I was going to call an Uber to take him, but I got up and took one for the team, as the saying goes!

When we arrived the waiting area for surgery check in was packed! Obviously Fridays are as heavy a surgery day as the rest of the week. We were prepared for a long day, but not nearly as long as it turned out to be.

Check in was as smooth as ever, although Ben wasn’t called back til almost 7:00 for pre-op preparation, which meant I didn’t go back with him til 7:30. Two of the nurses remembered us from our previous visits, and although they were happy to see familiar faces again, they did say they hoped it was a long time before we were back.

Yeah, we felt the same way!

Everything progressed as usual until one of the nurses came in to go over post operation procedures for pacemaker surgeries. Not a big deal, right? This wasn’t his first one.

But things had obviously changed from five years ago, because one of the first things we were told was that he couldn’t drive for four weeks!! Excuse me? That’s 90% of his job, and no one ever told us that, nor was that the protocol the last time. Of course, Ben told her that wasn’t going to happen. I was afraid he was going to cancel the surgery!

She nicely explained he would have to talk to his doctor when he came in, and that certainly was his plan! He also would have to wear a sling at night to keep his arm stabilized in order to minimize the possibility of the pacemaker wires being dislodged. Good point. And he would have a new monitoring device to take home so that the new pacemaker could transmit information at night back to the monitoring station at the doctors’ office.

I guess because the last time we went through this it was an emergency procedure, we didn’t have all these instructions beforehand. Nor would we have had very many questions, since he had no choice that time but to have the pacemaker installed.

But this was a new device, one which would not only prevent his heart from going into Afib and hopefully eliminate his fluid buildup and shortness of breath, but would also deliver a shock to his heart if it started going too far into Afib again. As the nurse told us, patients who’ve experienced such an event said it felt like a horse kicking them in the chest. And then she proceeded to give us further instructions on what to do if the device did deliver a shock, including calling 911 immediately.

We knew she had to tell us these things, but that didn’t sound promising. However, we were told that possibility was not very likely in his case, since his device would be set to only go off to shock him if his heart rate went above 180, and normal rhythm is around 70.

Ok. That sounded hopeful. Of course, I wasn’t the one having surgery…

At one point I was worried that Ben would decide not to get the new pacemaker and just leave the hospital.

But when the doctor came in to talk to us, he told us the driving restrictions were only for two weeks, and explained that was because they didn’t want to risk the wires being dislodged or pulled out due to any sudden driving moves. Or because his shoulder would likely still be sore from the surgery, and his driving reactions might be slower than usual.

That made sense.

Of course he’d have the usual restrictions on not lifting or carrying anything over ten pounds, not walking the dogs with that arm, etc. that we already knew.

The doctor also added that he would be leaving the old pacemaker in and merely disabling it, rather than making another incision and disrupting the chest again, so fortunately there would be an easier recovery and less chance of infection.

So Ben was finally more at ease, kidding around with the nurses and technicians like his normal self. Our daughter had arrived earlier with our 3 month old granddaughter and she’d put little Ryleigh on the bed beside her dad. So of course he was telling everyone he’d come in for heart surgery and had a baby instead! And a really cute one, too!

We even told the doctor how my coworker had said they should just leave the old pacemaker in and make it a USB port or a warning light that would blink if there were a problem. Funny how our minds work sometime. But it helps distract us from the stress of what’s going on around us. (And the doctor thought those comments were great!)

So after all this we were finally ready. Or as ready as we’d ever be. We were ready for Ben to be back to his normal self. To be active again. To climb stairs without getting winded. To be able to go bike riding again. And on walks with our two dogs. To play with our granddaughters and not be worn out.

When they came to get him this time we believed it was finally going to be the end of a long journey.

But suddenly I had this little feeling of unease. Nothing I could really put my finger on. I dismissed it. And after we told him goodbye, Ashley and the baby and I went to the waiting room once again while he was wheeled off to surgery.

Another two hours or so and it would be over, and all would be good! Right?

More to follow in Matters of the Heart, Part 27.

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.