7/22/15 update

7.22.15

Today, John, Colleen, Jen and Mick were back at the UW Medical Center for four appointments and a tour of the ICU.

We started at 11AM with a meeting with Palliative Care.  Their goal is to be supportive care for patients with serious illnesses.  There were lots of questions about fears, depressions, goals, Health Care Directives, touchy-feely stuff, an emotional time, especially for the wife. 

After that, we met with one of the LVAD coordinator, a nice man named Clifford.  He walked us through all of the paperwork, and schedule.  There were lots of documents to sign listing all of the dangers, etc. of the LVAD.  Procedural, necessary stuff.  He gave us and walked us through a schedule of John's time in the hospital.  We are to check in on Sunday between 3PM and 4PM.  Monday will be full of tests, both physical, for example,  a right heart catherization, and a mental test.  The mental test is for a base line to monitor in the future.  The surgery is set for 7:30AM Tuesday morning and is expected to take most of the day.  The nurse said 7-8 hours and the surgeon said all day.  He did not want to commit to a specific time frame.  Then the schedule listed all of the usual goals, sitting in a chair, liquid diet, then solid foods, walking farther day by day.  The expectation is to be released in 10 days after the surgery.  At home, John will be expected to weigh himself daily, which he already does, and to take his temperature daily.  Changes to either could be a sign of infection.

Between meetings there was another echocardiogram for John while the others took a tour with Clifford of the ICU (5SE) and heart inpatient unit (5NE).  John will definitely have a private room in both.  He will be expected to be in ICU for at least two days, where the patient/nurse ratio will be 1:1, then 2:1.  They expect to start weaning him from the breathing tube on Wednesday morning and remove his neck line on Thursday.  We found that they are currently following about 90 LVAD patients, which we thought was low.  The others have moved from LVAD to transplant, which is what we want to do. 

The last meeting was with Dr. Mokadam, the surgeon.  He gave us a brief description of the three available devices and explained the benefits of each.  There is also a clinical trial that is randomized that we opted to be in if we qualify.  The oldest of the devices is the Heartmate II and the newest is the Heartmate III.  If we qualify for the clinical trial, we hope to receive the Heartmate III.  If we don't qualify, we will opt for the Heartware device, the second newest device.  We hope to know tomorrow.  Since John has a mechanical Mitral Valve and needs to be off his blood thinners (warfarin), Dr Mokadam said he wanted John to come in on Saturday to start the Heparin IVs.  Colleen let him know that we have an injectable, Lovenox, which John uses prior to colonoscopies.  They basically do the same thing as Heparin, so we bought ourselves an additional day at home.

So, now we are trying to get all of the little chores around the house done, lawn mowing, laundry and all of that.  A blog entry will be posted when we find out if we are eligible for the clinical trial, Sunday after admittance and so on.

Colleen and John