Wednesday, June 1, 2016

Heart (Ablation) Study scheduled. Working together re shunts

The Heart Rhythm Study (Ablation ) and Heart Cath are scheduled for July 20th, 1st case.
We do have the same Cardiac Anesthesia dr., the 2nd EP Dr and my Heart Rhythm dr. with arguably the Anesthesia part being most important and Heart Rhythm dr being familiar with my issues now so should be ok.
I hadnt thought of this to ask last wk (emailed earlier this wk) but it is scheduled now as just an over night stay - as long as all goes well. As a friend said "a sleep over", lol.
These (direct) tests and procedure are being done to directly measure pressures in heart and between heart and lungs as well as to visualize  the  mechanical valves.
Most importantly the goal is to try to ablate (rid) the abnormal signal (overly fast) heart rate coming from the sinus node and thus slow heart rate down.
As I think I mentioned in earlier blog posts re  this the risks can include the ablation causing a to slow heart rate and thus need for a Pacemaker but there to honestly I feel like I did far better with all 3 Open Heart surgeries then was expected so yes I know the risks  but I also am looking at it as 1. We may have no problems or 2. It may or may not even help heart rate slow down enough (to get off some meds) or honestly 3. If it did cause to slow of heart rate well then we deal with that and manage.
I can't worry about every thing that 'could' happen when we may in fact make things a lot better...
 I also see Cardiology (not prior planned, they want an Echo done now and Chest Xray) later this coming wk due to symptoms that I to be perfectly honest figured where related to the head/humidity but my Cardiologist at the Appt the wk before wanted me to let them know if it did not improve and/or changed symptoms wise and the NP  and Dr.E this wk felt they should look at more closely just to be sure. Why not, what's another appt? Sigh, never ends. <--- It is what it is, good that they are cautious I guess but boring wouldn't be a bad thing... 
I saw my Primary Dr  earlier in the wk just for overall given all things going on which we talked about the shunt stuff/Dr.Bragg having left and the interim period amongst a few other things.
She knew what the mngmt plan was but was happy to know what Dr.Bragg had helped put in place for managing the headaches now (work w Peds Neurosurgery NPs) and Dr.Simpson (PCP) and I  came up with a few other possible ideas we're  looking in to.
Given things are up in the air between the plan we did have in place we're looking at other options at the time being so we'll see?
Her seeming concern was/is the   changes in the last quick brain MRI done (done a few wks ago, last time I saw Dr.Bragg) in fact shunt related (what else would it be?
That MRI report  noted change in ventricle size from prior imaging which I knew from Dr.Bragg
A new MRI is being done in a few wks, my concern is ventricles rarely enlarge as it is so seems unlikely they'll enlarge even more but there's definitely something going on given symptoms keep changing.
 My PCP wondered if given symptoms if that ventricle size change especially given my ventricles almost neve change size (rare occasion ) if that wasn't pointing to a shunt issue.
I talked to Dr.Bragg re this and my PCP wondered if a Neurology consult to could  perhaps help in this interim few mo's (till new Nrsgn comes Aug./ Sept.).
We'll work to figure this out, I  talked to the Peds Neurosurgery Secretary and NPs and have a few names but even with their talking to that Team the quickest would be Sept. so doesn't do us a lot of good.
 Dr.Bragg has said when the new Neurosurgeon comes later in summer she'll talk to him about my case so hopefully that can help  and most of all just keep praying when the new Peds Nrsgn comes in late summer he is open to looking more closely in some way at the shunts.
I truly think and have thought it's the LP Shunt given symptoms there replicate symptoms we've had in the past when we weren't sure it was in fact a shunt issue but then would have to do something directly with the shunts and indeed would find 1 of the shunts, usually the spine one wasn't working well.
Lastly the NP today had written up all the  surgeries Dr.Bragg has done over the past 5yrs - 36 to be exact  with my having 3 shunt surgeries prior to Dr.Bragg (so 39 total). 
Definitely grateful to Sue for putting that together!

Coumadin (blood thinner) wise my Cardiologist brought up last wk, almost as a passing remark/question did I think I was resistance to Coumadin (I don't)  and we also talked about (both of my Cardiac drs - Cardiology and Heart Rhythm dr.) brought up the heart rate control and it's resistance to cardiac meds. This is the reason we're going ahead w the procedure (ablation) though my Heart Rhythm  dr did say he would stop the Ivabradine for  a short while after the study to see how HR has reacted. If it helps but not enough may still have to use Ivabradine after but  will depend. This particular study is one that can either not work effectively enough or cause to slow of heart rate (thus need for pacemaker) or work very well and do exactly as we hope.
The Heart Rhythm test was coord. between Dr.Kovach (my Heart Rhythm dr), Dr.Dhala (1 of the other HR docs) and  with the Cardiac Anesthesia dr. we've used for all 3 open heart surgeries (valve replacements) and the 2 prior Heart procedures/tests. That past especially (having an anesthesia dr familiar w airway issues) make me not worry much about any of it.

God knows his plan, right?
Thanks for stopping by,


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