Now, when my phone turns on (techn...
Gotta run, she's going in for her Echo and Heart Cath now.
To Be Continued.
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Sorry about that. Just as I was beginning to write up this post, I got a call from my Aunt saying that they were taking Mom in for her Echo. I dropped everything and went in to be with her (as much as you can be with someone during that particular exam. I am now writing this up on Tuesday the following day and she's had both the Echo and the Cath. The good news is that they found no new physical defects. Her cardiac arteries are fine (as fine as they can be on someone with a triple bypass and with three internal stents), and her ejection fraction is good. The bad news... they have no idea what caused her defibrillator to go off.
Being the next day, I don't have time to write up all that happened, but I do want to get some things down.
The short version of the story so far: Mom's internal defibrillator went off two times on Friday. She went into the ER, was put on amiodarone, and eventually moved her up to the Step Down Unit. Step down is technically just under Critical Care (think ICU), but still above a standard hospital ward. They monitored her, eventually performed an Echo and Heart Cath, and could find no cause for her heart going all wonky. So yesterday her new electrocardiologist decided to put her on Sotalol (an anti-arrhythmia drug). They will monitor her today and if nothing comes up she'll be coming home tomorrow.
I've already set up to be off work and be with her that day, so if time permits I'll get to tell you the whole story then. As for today, I'm going to visit her at the hospital and then head off to work.
Until next time....
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Talk about a post in pieces! I've already given you the short version and only have one thing to really add; Mom is now home again after a five day stay in the hospital. But let me give you the story of how all this went down while trying to cover my emotional ride over the last few days.
So I received quite the scare this past Friday night. Coming out of work I went about my normal routine... get into the car, start her up, grab my phone out of the storage bin, turn it on, and start to drive out.
Now, when my phone turns on (technically I'm just pulling it out of Airplane mode), it connects up to my car's bluetooth system. Once the phone is on, I settle into my seat, turn my fog lights on (I don't turn them on for additional visibility, I do it because I think the car looks cooler with them on!), put it into gear and get going. I've only pulled forward into the next parking space and am turning the wheel to continue out of the parking lot when my car announces that I have both a text message and a voicemail from my brother.
Now my brother doesn't often call or text me. So when I see that he has, I know it's important to listen to and read immediately. I cue up the car to read the text and get this:
"Hey, so they're keeping Mom overnight. She's OK, but they have her in the Step Down unit. I'll see you when you get home"
Who's keeping Mom overnight? Why does he feel it important to tell me shes OK? STEP DOWN UNIT!?I jab at the brakes, stop the car, pull the phone back out, and cue up the voicemail. Thankfully it starts playing over the car's speakers and I get a better understanding of what's going on. Mom's defibrillator went off. An ambulance was called. She went into the ER. They performed several tests. Her heart rate while at the ER went up to 190bpm. They put her on moderation. They've admitted her and are monitoring her. She'll be seen by a cardiologist in the morning to discuss what happened and what will happen going forward.
I call my brother up and confirm these facts... especially that she's currently OK... and rush home. This is one of my biggest fears. Mom's heart going out. I know I've discussed it a bit before, so I'll just cover some of the facts involving my Mom's heart.
- After my father's death my mom started experiencing headaches and chest pain. Eventually she went to a cardiologist and in for some testing (heart echo and cath).
- Her heart echo showed she was at reduced capacity... basically an echo measures how much blood the heart is pumping out, measured in a percent like number. "normal" is around 60 (60 percent of the blood in the ventricle being pushed out and into the body). Mom was at 50.
- They expected to find some kind of blockage in her heart using a heart cath (snaking a camera up from her thigh into her heart), and fix them using either angioplasty (pumping up a balloon inside the arteries) or stents (putting up a mesh wall to hold open the arteries).
- They found four major blockages, any of which could be causing the problem. All of the blockages were at hard to angioplast/stent areas, so they recommended a triple CABG (Cardiac Artery Bypass Graft).... a triple bypass surgery.
- She got the surgery. They put her on amiodarone as part of the surgery to keep her heart beating regularly. She recovered in the hospital, but not as much as they liked, and they sent her home.
- She didn't continue recovering. If anything, she got worse.
- She went in for further testing a few weeks later and it was found that all three bypasses failed. They had all clogged up and she was now back at her reduced capacity.... all while trying to recover from major surgery.
- Her new echo showed 27. Only 27 percent of the blood in her ventricle was leaving moving into her body.
- They went back in with stents and repaired what they could.
- A few weeks later her echo was up to 33.
- A few months later she was having trouble breathing. Tests showed she had one of the known side effects of amiodarone; pulmonary fibrosis. Her lungs could no longer work at anywhere near 100% capacity. They took her off the amiodarone, but her lungs didn't recover.
- Now her lungs can't get as much oxygen as he needs, and her heart can't transport that oxygen around her body.
Ever since then, Mom has been on a roller coaster of cardiac visits, meds, and procedures. All of them trying to keep her heart from degrading further. The cardiologist says that there isn't any hope of mom returning to the health she had before the surgery. She eventually got a pacemaker that included a defibrillator. It turns out that last decision has now saved her life.
You see, my biggest fear is that mom will suddenly and without warning start to degrade. Her heart will get worse. There just isn't much room for her hear to get worse, so any move in that direction is a short trip to her heart completely failing. To her passing away.
So getting that message from my brother sent my mind in a spiral that I just couldn't stop. What if this is it? What if Mom is going to die? I tried to push the thoughts away, but it has been a struggle to do so until yesterday when she was released from the hospital.
Mom being her normal Mom-self actually called from her hospital bed that night... just to make sure I got home and had a good day at work.
Over the next few days there were several tests, but none showed any new problems. No new blockages, and her Echo actually showed improvement... up to 45. I know I should be happy that her heart is doing better, but keep in mind that they wanted to improve that number when it was 'down' to 50. Without a new problem to fix, they decided to put her back on an anti-arrhythmic drug. The last anti-arrhythmic drug was amiodarone. Knowing her previous problems with that her electrophysiologist (a specialized cardiologist that deals with heart rhythms) put her on sotalol. It's a generation behind amiodarone, but doesn't have the same possible side effects. The biggest problem with sotalol is that it's also a very effective blood pressure medicine and mom is already on three effective blood pressure medicines. So this new drug that needs to be there for it's anti-arrhythmic properties will throw off her previous balance.
Every day Mom was in the hospital I went in to visit her before work. I had a day off (Monday) and I spent that whole day up at the hospital. So today is the first day that is normal for me. I have two days of work, then the weekend off. I have to still keep an eagle eye on mom though. With all the changes to her BP meds, she has a real chance of going too low. This probably won't kill her, but it could make her quite dizzy.
I set up two demands for Mom. 1) She doesn't hide any of her problems. She has a long history of not telling me or my brothers about her physical problems.... chest pain, shortness of breath, heart racing. So for the next week she promises not to hold those back, and we promised not to over-react and want to send her back to the ER. 2) she doesn't go downstairs. I just think the risk of her possible dizzy spells along with the current neuropathy in her feet (from her diabetes, she can't hardly feel her feet), could lead her to falling down the stairs. Hell... she did that before without the new BP meds. Once I got her home, I went off to the local pharmacy to get her supply of sotalol (future supplies will come from a mail order pharmacy... WAY cheaper and more convenient). While I was gone... she went downstairs.
I'm almost sure Mom will be fine. At least for the time being. They still don't know what caused this current episode, but if the same circumstances happen again her sotalol should prevent her heart from going into VTach (ventricle tachycardia), which of course will prevent her internal defibrillator from firing off again.
But it's just one more safeguard. One more thing that is holding back the eventual outcome....
One day all the medicines in the world, along with the best technology in the world, won't prevent my Mom's heart from completely failing.
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I was going to post some other notes.... work, music, movies... but to be honest I'm just not in the mood now. I'm glad that I've gotten this story of my chest, but it's really brought me down. Hopefully I'll be in a better mood this weekend and I'll post again then.
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