It's hard, I'm sure, to anticipate another procedure when the only two in recent memory were vascular surgery on a major artery and open heart surgery with mitral valve replacement. Sarah was understandably apprehensive though bravely willing to go forward. Fortunately, she had an early AM date in the cardiac electrophysiology lab allowing her to get it finished before noon.
The EP cardiologist did a great job of explaining the procedure. Small 1 inch long incision below her left collarbone, catheter inserted through a nearby vein to advance the pacemaker wire to the inside of the right side of her heart, pacemaker slipped in (about the size of a stack of 3 or 4 silver dollars), and wound closed with super glue (!). Turns out, of all the elements of this gentle explanation, Sarah keyed most on the absence of stitches. However, she gave the cardiologist a raised eyebrow and skeptical glance when he said "super glue."
In the US and the world, there are three major manufacturers of pacemakers - Medtronics, Boston Scientific, and St. Jude. The good news is that they are all good, and we don't have to do the shopping. DHMC rotates brands to avoid favoritism. The vendor representative attends the procedure to assure the latest equipment and accessories. Since Sarah has good electrical beats in her small chambers (atria), the pacemaker will stimulate her larger ventricles to contract just following each atrial beat. This will allow her heart to respond naturally to variations in activity with a slower and faster rate dictated by her own atrial heart rate. Her situation also means that she has only one wire instead of two - one less piece of hardware to malfunction or cause trouble.
So, Sarah's pacemaker procedure was completely uneventful. I was able to attend her awakening in the recovery room. The only stressful moment arose when Sarah returned to her room, and her mother noticed her blue lips. Before she could turn up the oxygen to 100%, I was able to mention the grape popsicle I had fed her in the recovery room. She has a small dressing, and the EP cardiologist said that he was able insert the pacemaker close to the surface but still in a way that it is not easily visible.
Now Sarah will begin a five to seven day process of anticoagulation with Coumadin. With an artificial mitral valve, she will need to continue Coumadin for the remainder of her life. It still seems better to think day to day, but the prospect of getting home within a week is tantalizing at this point.
Thank you all for your supportive comments and messages here and on Sarah's Facebook page. Today she asked for her laptop for the first time, so her feisty voice should soon be heard again in Facebook nation (or should that be world? or universe?).
The EP cardiologist did a great job of explaining the procedure. Small 1 inch long incision below her left collarbone, catheter inserted through a nearby vein to advance the pacemaker wire to the inside of the right side of her heart, pacemaker slipped in (about the size of a stack of 3 or 4 silver dollars), and wound closed with super glue (!). Turns out, of all the elements of this gentle explanation, Sarah keyed most on the absence of stitches. However, she gave the cardiologist a raised eyebrow and skeptical glance when he said "super glue."
In the US and the world, there are three major manufacturers of pacemakers - Medtronics, Boston Scientific, and St. Jude. The good news is that they are all good, and we don't have to do the shopping. DHMC rotates brands to avoid favoritism. The vendor representative attends the procedure to assure the latest equipment and accessories. Since Sarah has good electrical beats in her small chambers (atria), the pacemaker will stimulate her larger ventricles to contract just following each atrial beat. This will allow her heart to respond naturally to variations in activity with a slower and faster rate dictated by her own atrial heart rate. Her situation also means that she has only one wire instead of two - one less piece of hardware to malfunction or cause trouble.
So, Sarah's pacemaker procedure was completely uneventful. I was able to attend her awakening in the recovery room. The only stressful moment arose when Sarah returned to her room, and her mother noticed her blue lips. Before she could turn up the oxygen to 100%, I was able to mention the grape popsicle I had fed her in the recovery room. She has a small dressing, and the EP cardiologist said that he was able insert the pacemaker close to the surface but still in a way that it is not easily visible.
Now Sarah will begin a five to seven day process of anticoagulation with Coumadin. With an artificial mitral valve, she will need to continue Coumadin for the remainder of her life. It still seems better to think day to day, but the prospect of getting home within a week is tantalizing at this point.
Thank you all for your supportive comments and messages here and on Sarah's Facebook page. Today she asked for her laptop for the first time, so her feisty voice should soon be heard again in Facebook nation (or should that be world? or universe?).
Sarah Glad to hear that today went well. we are thinking of you. Donna Matt and Sara
ReplyDeleteSarah, I hope you are home next week and back on your feet quickly.
ReplyDeleteMay those laps around the floor go quickly and a diet coke with ice is waiting for you! The great escape to back home is coming soon...count down ahead! hugs, Patti
ReplyDeleteSuper glue rules! It's what it was originally invented for during either Korea or Vietnam! It allows the skin to heal much better than stitches do and it gives less of a chance of infection. I'm so happy to hear that Sarah is well on the road to recovery. Best wishes in continued healing!
ReplyDeleteHi Sarah and family, You are that much closer to going home....Hurray for you!!!
ReplyDeleteYou remain in our thoughts and prayers
Mary
Glad things are progressing and that Sarah's been able to enjoy grape popsicles! It's nice to see the photos you've added on the side too. The two of her as a child especially make me smile!
ReplyDeleteSince you're providing such excellent medical detail, can I ask what type of valve was used?
Thanks again for keeping us up to date here. You're doing a really nice job. I hope Sarah gets to go home soon ...
Sarah we are so delighted to hear your positive progress. each day you will get better and better!
ReplyDeleteour daily prays and healing thoughts are with you
carol
Saraha, met you once awhile ago. Good luck in you recovery. Been through heart surgery myself. Things will get better each day. Take care.
ReplyDelete