Date is set

07.01.2015

Hello all,

We went to the UW Medical Center today and John had two CT scans, one of the head and one of the chest.  The transplant department wants to be sure that there are no problems that would delay or terminate the chances of a transplant.  Then we met with Dr. Mokadam, the head Cardiac department surgeon.  He told us that the CT test results were fine. 

Then he started giving us information on John's condition and on the three heart pumps available.  John's problem has always been an enlarged left ventricle, but now the right ventricle is enlarging and as a result of that, the tricuspid valve is leaking.  This enlargement and leakage just showed up in John's last echocardiogram in April 2015. It did not appear to be there in the 2014 echo.   It is the reason that he has started feeling so bad and weak so suddenly.  Dr. Mokadam was very clear that the jury is out on whether that valve needs repair since the LVAD is being implanted.  Some cardiologists say yes and some say no.  He is in the group believes that it should be repaired.  We agree but there is a bit of a problem with that.

If the valve is repaired, the chest needs to be opened.  We had hoped for the new pump that does not require cutting the sternum, but that is not possible if the valve is to be repaired.  So we had to make a choice, but before we did, Dr. Mokadam gave us a third option to consider.

There is now a third pump that is being implanted.  It is being implanted now as a clinical trial, a blind trial/study.  The blind trial is such that we would not know prior to the surgery if we got the new pump, the Heartmate 3 or the older Heartmate 2.  Even the surgeon will not know until we are admitted.  John may not qualify for the study because of his mechanical valve that was implanted in 1996.  The doctor was not able to show us the newest pump as the UWMC is still a few days away from officially being part of the study.

There are known advantages to each of the  earlier pumps.  One has longer battery life, but a bit higher risk of bleeding.  The other is smaller, without the bleeding risk but with a bit higher risk of stroke.  The newest one hopefully eliminates most of both of these risks. 

We have decided to be a part of the study if John qualifies, but we won't know if he qualifies until our next appointment on July 22nd at which time John will have another echocardiogram and a tour of the floor where John will be cared for.  He will be screened on that day to see if he qualifies for the trial.  But the surgery has been scheduled for July 28th.  John will be admitted on July 26th for two days of tests and preparations.

Things are getting real busy around here.  John had a physical this past Monday, and is getting ready for his colonoscopy next Monday.  We have decided to cruise to Alaska one more time, so will be leaving on John's birthday, July 11th.  We return on July 18th, then a one day trip to Yakima for the McLean family picnic on July 19th.

Colleen and John