Drama Mama

Carlos had a bit of drama.  They started him on a medication called thymoglobulin that he really didn't like.  I wrote this whole long post and this stupid program didn't save it.  So here's the short version.

He had some unpleasant side effects that are common so things were feeling a little intense.  Blood pressure dropped, there was projectile vomiting with something that looked like blood at first glance, etc.  It was exciting to say the least.  He was stable again when I left.  He was nauseous but communicating more, not liking the lying flat on his bed, and the tube in his throat.  They have him back on minimal vemt settings so hoping maybe he will be ready to be extubated this evening as originally planned.

Then I'm going home to sleep.  Its been a lot of hours since I last slept.  Its like working a busy weekend!

Deja Vu

Kim and I are sitting here chilling with Carlos.  He got into his ICU room about  1050 this morning but we didn't get back here until about 1215, once they had him tucked in.

One of the transplant doctors came and talked to us after surgery.  They had a tough time getting in and getting the old heart and LVAD out.  There was a lot of scar tissue which, considering how he keloids on external scars, didn't surprise me.  Because of the that, he had quite a bit of bleeding.  He received a bunch of blood products.  See picture below :-)   They got the new heart in and it immediately started beating.  In fact, its right where they want it and he's not requiring any pacing.  They removed his BiV pacemaker as well.

He's already breathing spontaneously on the lowest vent settings.  They want him to wake up a little more before extubating but sounds like it will be by tonight if not sooner.  He has lots of other stuff hooked up as you can see in the picture...chest tubes, various lines, and the event.  His kidneys got a little ticked off so creatinine went up to 1.9 from 1.6, but output is great and they aren't concerned.

I love watching his heart rate.  Not a single PVC or other arrhythmia.....just very steady beat.  Unfortunately, I did not get a picture of his old heart.  They wouldn't let me have it in a jar either :p. The nurse said it was pretty amazing to look at the difference between the two hearts though.  She said his old heart was big and floppy while the new was tight and smaller.

We don't know anything about the donor at this point.  I think there will a lot of time later to think about that but I'm so incredibly thankful that despite someone else's suffering we can have this gift.

The Call part two

9:30. Beth arrives.  The inappropriateness reaches new levels.

10:15. My mom arrives.  We keep cracking jokes at Carlos' expense.  But it keeps the mood light.

10:35. The nurse comes to take Carlos to pre-op.  We follow like groupies then head to the waiting room to set up camp.  We'll get to see him once more before he goes back.

12:00. The witching hour.  We go back to sit at his bedside until it's time.  Carlos is a little woozy from his visit with Dr Feelgood.  He now has a Swan Ganz catheter in his neck and an arterial line.  He's in good spirits so we continue with the inappropriate jokes.  

12:40. They took him back and now the wait begins.  We have heard anything from 6 to 12 hours.

The Call

3:07pm. Carlos comes walking into the bedroom crying and hands me his cell phone.  The girls follow behind asking what's going on.  Two of the nurse transplant coordinators are on the phone and tell me they have a heart for Carlos.  I accuse them of playing a joke.  This really felt out of the blue for both of us.  We really had resigned ourselves to a two year wait and it's not been a year and a half yet. 

4:20. Arrive at Mayo to check in.

4:40  Someone finally checks him in.

4:55. We get to the room.  And stuff starts getting done.  Chest X-ray, bloodwork, etc. 

7:55 The chaplain comes in to chat.  That's disconcerting when you are waiting for open heart surgery.  We pray holding hands.  Then we burned some incense and chanted.  Haha.  We did pray though.

8:00 Kim's mother , who passed away 6-7 months ago, sent a message that all would be well and don't take the fentanyl (inside joke involving hallucinations and fentanyl).

8:45   I put the nurse through the third degree regarding surgery length of time, did the surgeons sleep today, etc.

8:50. Heidi arrives with supplies (Powerade, Xanax -lol, and food).  We are laughing our asses off. 

Latest info - he heads to preop at 1030 and surgery at 1130.  More to come....

INR Drama

Remember when Carlos had INR drama?  It was too high and he had a GI bleed.  Now he decided to do the opposite...his INR is too low.  It's been dropping the last few weeks despite increases in his coumadin.  So tomorrow we had to Mayo.  If it's increasing then they will continue to monitor.  If it's not, hello hospital admit for heparin.

Keep your fingers crossed it looks better tomorrow.  Liberty's birthday is on Tuesday and we are celebrating tomorrow night.  Last year, Carlos was in the hospital for her birthday.  Here's hoping no admit!

One Year Vadiversay

One year ago today, Carlos had open heart surgery and LVAD implant.  When I look back at the past year, I am amazed at where we are now.  It was a rough couple months at first.  In the Facebook LVAD groups, we've seen LVADers who have passed away over the past year.  This is always a sad thing to see but we take it as a reminder to live life and don't sweat the small stuff.  We expect that this will be Carlos' year for transplant!

Almost One Year

Time is flying by and they tell us 2013 is his year!  That narrows it done to 12 months :p  In the meantime, he has been doing well.  He's walking for exercise, keeping any additional weight off - whether fluid or otherwise.  He keeps the weight between 226-229.  I think the walking more regularly has really helped this - keeps them kidneys perfused and working better.

His INR has been a little wonky this past week or so.  It shot up to 4 a few days ago so had to adjust his coumadin a bit.  Mayo gets concerned about clots in the pump or GI bleeds when they start seeing this happen.  He hasn't had any other symptoms to indicate a problem.  After some adjustment, it's back to a normal range.