Tag Archives: PFO closure

Speak to the Man

After yesterday’s shock news that the Amplatzer Septal defect occluder although seated properly seems to be ‘leaking’ we have obviously been concerned as to what exactly this means.

Liz has discussed with a number of her friends but none have sufficient depth of knowledge in what is obviously a highly specialised area to really be able to offer more than rudimentary comfort and support, which although welcome has not really been sufficient to allay her fears of what might happen, especially after being told worst case it could mean open heart surgery 😯

Liz managed to get a call through to Mr Ward’s secretary and left a message with her explaining that she needed to speak with him and needed to discuss her situation. As he is clearly a busy man, Liz wasn’t really expecting a response.

However, at 6:00pm she received a call back from the man himself.

He explained, firstly, that he did not understand why the doctor had asked for the scan at this time, only a month after the procedure to close the PFO, since he would not expect the heart muscle to have fully sealed around the device until at least 3 months after the operation, so everything was as he would have expected at this stage.

He stated that Liz should be doing everything that she felt she needs to do, in terms of her ongoing physical therapy and that he would see her in a month or so, as planned, to discuss and review her case, but a further scan would not be carried out until the three month mark. He confirmed that having reviewed her notes she had nothing to worry about at all 🙂

I went for a run today and my ankle / foot still seems no better than it was three weeks ago after 8km round the city.

I hope I get similar good news after my next visit to the physio on Monday.

 

Update from the heart

We had a visit back to the hospital yesterday, for another echo cardiogram, as it is now a month since Liz had her operation.

It is routine to apparently check on these things, and although there was some confusion over whether the check would be a normal ultrasound or the more unpleasant trans-oesophageal echo (TOE), fortunately only the former was required.

The appointment was for 11am and luckily we were a little early as they were running to schedule. I accompanied Liz into the room for the scan, although the doctor was not keen and throughout the procedure consigned me to a chair in the corner, and warned me of the pain and suffering I would experience, for all eternity, in the event I moved from this position. Her caring NHS attitude clearly didn’t extend to mere husbands, and she quite obviously felt she could do a better job of supporting my wife than I could!

Cardiac Ultrasound

The procedure itself involves the injection of an agitated saline mixture into the bloodstream while monitoring the heart with an ultrasound probe from just underneath the left ribs. The view of the pumping heart, with the valves in perfect detail is remarkable. This was also the first view we had had of the Amplatzer device that had been fitted and the view, thankfully, was that it looked secure and perfectly positioned.

After another couple of injections with the saline and a manoeuvre Liz had to perform to tense up to put additional pressure on the heart for a second or two, it was all over.

The doctor then proceeded to inform us that she had seen 20 bubbles pass from one chamber to the other, indicating a ‘leak’ around the device. Given she had earlier explained that the sealing process for the device would probably be complete but in rare cases there was a problem (and in even rarer cases open heart surgery is required to correct the issue), this came as a bit of a shock.

She further explained that David Ward does not normally see people before 6 weeks and 3 months is the normal case for review, so we were at least comforted by the fact that we are still at an early stage.

So, we are back to the stage where we are waiting, anxiously again, to see what the future holds.

Life seems to be throwing everything it can at us at the moment, what with Liz’s stroke, then the Operation and now our house chain is looking decidedly shaky and my foot problem is refusing to show any signs of reacting positively to my regime of rest and icing for the past few weeks.

I wonder what is going to happen next to throw us off our charted course!

Sleepovers, Ketchup and Kites

Morgan had had a sleep over with a very brave parent overnight, so after breakfast the first thing to do this morning was to pick him up. However, as we had a party to go to at 11am, to which all of the children were invited, and a present was still required, there was no time to really think first thing. The morning seemed to disappear into a haze of toy shopping, traffic jam frustration and children’s party entertainment – no surprise I relinquished the usual desire for a coffee to see me through the morning and I has a beer in my hand just before midday.

Liz has still been resting today and although she came along to the party, she was very tired by the end of things and so we had a quiet afternoon.

Well, Liz did, at least.

Barnstormer Bi-Plane Kite

Col was very kind to look after the children while they were making the most of the warm weather with a water fight outside on the front lawn, before trying some kite flying with the numerous kites we have around the house; for a full 3D biplane kite, to the normal box kite and seagull impersonations to a simple mini pocket kite. Ironically, the large biplane provided the most fun, but it’s ascension into the lower atmosphere was achieved largely through the motive force of our youngster’s legs rather than the movement of any air from one point to another. Plenty of energy expended. Tick!

Chicken satay for dinner was welcome, but Liz had a quick trip to the hospital to check out some ‘bruising’ around her groin.

Everything was fine with her though. It is apparently quiet normal to have bruising after the operation, given the ‘manipulation’ the surgeons carry out during the operation, and it is also quiet normal for the bruises to show up when any swelling goes down, but the visit was necessary to ensure her confidence in her recovery is increasing.

Rest Day….for some!

We arrived home mid evening yesterday and really didn’t do much else before crashing out, but when we arrived, the children were all still up and wildly happy to welcome their mother home.

Today was more of a normal day, with the school run to do and so on. Liz was under strict instructions to rest which she complied with for most of the day, although clearly had done too much (?) by 2:30 as she had to sleep for the rest of the afternoon.

Liz has been restricted from doing any heavy lifting, walking up too many stairs or hills – so the school run is out for a couple of days!

The main concern is still the slit that was made in her groin, in order to insert the sheath for the catheter. While there is little chance that it is going to bleed now, there’s a chance of a haematoma or bleeding beneath the surface which would be a worry.

Fluffy Friday May 2012

Colleen and I walked the children to school first thing, but after dropping them off for their ‘fluffy Friday’, where they wear civvies to school and have a day where they have prearranged ‘fun’ activities, we then stopped off for a couple of croissants for breakfast, which we took back to Liz at home.

After that I had some time to spare, so decided to get a quick run in.

It was hot outside and I was prepared for an easy run. The last time I’d run in the heat was mid-April when in America (see here!) but today turned out to be better.

I ran easily around the level ground of Bramley, Wonersh and Shalford, but surprised myself with a turn of pace with which I was happy. It was definitely hotter than recently though (I wore a sleeveless vest for the first time in probably 30 months) and even with the wind, I was still a trifle warm.

Run done and lunch over, Liz had to rest for a bit, so Col and myself walked back up to school to pick up the little one’s from their fluffy day. Luke had been to ‘Spain’ doing all sorts, and Savannah proudly handed me a pot with her planted rocket (presumably salad leaf) in it. Joshua had been outside all day playing cricket and other sports, which he had enjoyed, but was clearly tired and hot as well, so an ice cream on the way home was in order.

A quiet day otherwise, with Morgan dropped of for his party and sleepover with a friend.

Liz has been tired, but is fine otherwise, so the recovery continues and everyone has been very kind with their thoughts and concern for her well being. They have also been amazed the procedure was so fast and she was already back home.

The Day Of Reckoning

The day had arrived.

Coleen had very kindly offered to come down from Wales and help with the children during Liz’s procedure to close her PFO, or patent foramen ovale, aka ‘hole in the heart’, so we said our goodbyes to our kindly saint before getting on our way – thanks Col; you’re a star!

The travel to St. George’s Hospital in Tooting at 6:15 in the morning was easier than we had anticipated, so we arrived just after 7:00 o’clock. The ward was not yet open, and unfortunately neither was the coffee shop (bad planning on their part, as I’m sure they could make a killing from people arriving early for their day ops!)

Anyway, marketing opportunities aside, we reported to the Belgrave Ward where we had a momentary scare when they said we were ‘not on the list’ but we were quickly restored to ‘A-list’ authorised to proceed status, after they found an ‘updated’ schedule’.

However, we still had to wait.

PFO closure

They had a day room with comfy chairs, but because they are refurbishing the kitchen next door, all the white goods seemed to have migrated to the day room, so we sat for some time staring at a couple of fridges, while the ward porridge was warmed up in the microwave. A bizarre start to the day. Still, after impromptu repairs to the television (aerial and source problem!) we were sufficiently distracted and were called just before 9:00 for pre-op checks.

Liz has always had trouble when giving blood, seemingly irrespective of the experience and prowess of the medical staff. Today was to be no different. The nurse, struggled apologetically for some minutes with the veins in her wrists, which she ultimately declared as having swelled up as no blood was forthcoming. Eventually a successful insertion of the cannula, just to take blood, was managed in Liz’s right elbow.

The increasingly apprehensive patient was moved to bed 4 on the ward and after a touch more waiting, and a few more normal tests, she was whisked off. That was about 10:30.

And so the medical science was left in the hands of the miracle workers…..

Gore Septal Occluders

Left on my own for a couple of hours I visited the coffee shop again and updated a few bits and pieces of my training plan and records, but before I knew it a groggy Liz was being wheeled back into the ward.  She had apparently been ‘conscious’ for the last 30 mins or so having come round about 11:45.

The whole process, from application of the anaesthetic, insertion of the cannula sheath for the catheter and trans-oesophageal echo equipment for the ‘camera’, the actual insertion of the device (which apparently takes 20 minutes, and the revival from the anaesthetic only took 1 hour 10 minutes. The device which has been inserted is known as a Gore septal occluder.

The rest of the day was spend with Liz resting and drifting in and out of her world of drowsiness, during a succession of post-op ECGs, blood pressure and stats monitoring and finally the removal of the cannula ‘sheath’ from the femoral vein – a procedure which itself involved successive reduction of the pressure applied to the puncture in the leg, after extraction of the  needle, but which luckily no longer requires the nurses to apply said pressure manually, as it was in days of old. Ironically, this process took longer than the procedure to insert the device in the first place!

As I write this, we have just heard that Liz will be allowed home! 🙂

Pre-Op

As Liz has her operation booked in for next Thursday, we had a pre-op discussion planed for today.

Or so we thought.

When we originally spoke to David Ward in the Royal Surrey a month or more back he said that they do the PFO closure operations in ‘batches’. Presumably this make sense not only economically, as the overheads with having the right equipment and staff available are less, but the risk aspects are also minimised by carrying out repetitive procedures which staff will be familiar with. He also said that they carry them out on a Thursday towards the end of the month and that Liz would be booked in for either April or May.

St Georges, London

A few weeks back, as the end of April was approaching and we still had no date for the procedure, Liz phone to discuss with the admission people at St George’s, at which point they confirmed, as we had begun to suspect, that the end of May was a more likely candidate. The gent she spoke to said she was on the system and booked in for the procedure on the 24 May and that the pre-op would be the 18 May, to do ECG and blood pressure, and discuss the finer detail of the procedure with the consultant. He said he would follow up with paperwork

Some weeks after the call, Liz had searched for the paperwork, but couldn’t find it and we assumed we had lost it.

So this morning we duly travelled up to just past Wimbledon, leaving at around 8:30 as our friend Natasha was kindly taking the children to school. The journey was on the whole quite simple, but I took a wrong turn at one point, or rather I didn’t turn off the A3 soon enough. Still, on this occasion there was no stress as we had plenty of time, so the dress rehearsal, was not to be entirely wasted.

We found our way to the hospital, and the right annex, in plenty of time and even afforded ourselves the luxury of a coffee before going to the appointment.

When we arrived at reception though, we were met with blank faces.

There was a predictable rushing around of staff trying to determine what had happened to our 10:00am appointment booking, and we suddenly found ourselves not in a pre-op clinic, but the administration room where the booking should originally have been registered.

I have to say, and I’m sure Liz would agree, they were very helpful, apologetic and caring all at the same time; Liz’s worst case expectation was that she would have to wait for another month, but they explained that would not be the case as she was still booked in for the 24th May.

In the end they said they would carry out the checks on the morning of the procedure, so the journey ended up being predominantly to find the place and see what the traffic was like.

Not a very auspicious start to the whole process, but a start, nonetheless.

Operation Date

Another quiet and pretty normal day.

Liz made oat waffles for us this morning as we are trying to get back into a term-time routine for a few weeks, at least until her operation, which we have now had confirmed dates for, so at least that is positive; 18 May for pre-op checks and 24 May for the actual operation.  Colleen has said she will come down to help, but there is still a lot of unknowns around this whole thing, although it appear she is unlikely to be in hospital (St George’s, London) for more than a day – she was actually informed that if she is first in the ‘morning batch’ she may well be allowed home the same day, which is absolutely incredible.

Operation Date

So many people have offered to help already, and I have no doubt they will continue to offer, so I’ll be baking lots more goodies in thanks for all the assistance to come. Some of the most recent batch of ‘treats’ went out today, and they have been ‘well’ received 🙂

The Boys have Judo on a Tuesday, so it is always busy for Liz, but she had asked Cecilia to take the children to school in the morning, so she rested for a bit after midday.

I on the other hand only had interviews, pre-project and team meetings to contend with, and even managed to fit in some cross training (cycling) and physio exercises at lunchtime.

Nevertheless, my life is still physically easier than looking after 4 children, irrespecive of how many calories I rack up during a day!