Saw him in ICU

Saw Michael finally about 3pm briefly. Doing ok. He'd already been taken off the breathing tube & was talking. Good stuff. He was in pretty good deal of pain & they started his pain pump while I was there. Hope it helps. Poor guy!!! All he wanted was for me to keep rubbing his head.

He was happy about surgery results when I told him. Hasn't yet asked for coffee with his dilaudid but probably will tomorrow. ;-)

I'll take his folks up next. We had to wait for nusing shift change. Maybe meds helping by now.

Peace
J
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Still waiting

Went to check in with ICU for 1st visit. Still not ready yet. Said check back in 30 min. So I wait some more.

The waiting part is harder now I think than earlier. Huh. Or maybe its cuz I've been up since 4, all caffeine no longer working or working too well & I'm antsy.

Peace
Jenn
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Sorry for few updates -- blame the surgeon

I know you were all hoping for fresher info and more real time blogging. Oops. Sorry. 
The good news is that Jen and all distracted me really well until nearly 9am and the first update. And then the nurse doing the completely mostly redundant and CYA presentation (mandatory -- ugh) on what to expect when expecting a patient in ICU distracted me further -- but most distracting was needing a pit stop badly and being stuck in that damn presentation.  And then there was waiting and waiting. And no news.
Finally bugged the coordinator to get me news from surgeon around noon -- talked to him and you have the results of that talk in the prior brief post. I'll try to get more info and post later, especially after I get to ICU the first time.

Peace
Jenn

Done!! All's well

Talked to surgeon - he was happy how all went. Took good portion of the enlarged septum (middle wall). Also did some tweaking to mitral valve area but valve is good. May have been part of papillary muscle reorientation. Goal was to get gradient as low as possible (the thing that makes him feel awful). Got it from highs of around 160 now to 13!!!!!! YAY!

More later. Will see in ICU ~ 1-2 hrs.

Peace
Jenn
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Update #1 -- Major part underway

Just got my first page from the CC update alert pager system ... the blinking buzzing pager that tells you your table is ready.  ;-)

No, really -- it was to alert me that as of 9am the "major portion of the surgery is underway". They've done the prepping and apparently probably done the opening and cracking. And so I assume the real work of Dr Smedira the surgery guru to cut and sculpt is underway.

Thanks for all your best wishes.

Peace
Jenn

Aaaand we're off!!

The Sitting & Waiting Championships have begun!!

They've taken Michael up for surgery prep & booted me out. Surgery itself likely to start approx 1hr or so - 7am hour sometime I think. More info will come as I know it.

Commence the good thoughts, karma, mantras or whatever you believe. And we feel your hugs here already.

Peace
Jenn

One more thing

See my September 2009 postings for the FAQ about hypertrophic cardiomyopathy and the myectomy procedure.

Also, for a treasure trove of information on HCM, go to the Hypertrophic Cardiomyopathy Association (HCMA) website. Better yet, become a member and support this terrific organization dedicated to providing accurate information to HCMers and their families.

And away we go

Final appointments were today: anesthesiology, clinical research (they want my excised heart tissue to study, as well as to enter me in a randomized study of the merits of fresher-than-standard blood should I need a transfusion; I said yes to both), pre-op nurse, and the surgeon, Dr. Smedira. For Dr. Smedira, this will be a simple and relatively unchallenging procedure given his expertise and my age and general condition.

Ultimately the day yielded no real news to speak of, just a lot of tedious instructions.

Thanks to everyone who has voiced their support via comments or e-mail, and to the lurkers who haven't but who are with me spiritually. It means the world to me.

Jenn will take over status updates for the next few days. See you on the other side!

Take care,

Michael

Gettin' religion

When I woke up this morning, I had strange markings on my feet:















Jenn and I have 2 competing theories on this.

Hers: A nurse marked them yesterday for some clinical use (a road map for finding pedal pulses, perhaps)

Mine: Stigmata. I am the chosen one. Expect to hear from me about how you and everyone else should live their lives.

(Kidding, folks.)

Cath update

Fortunately, there's not much to add to Jenn's posting, as all went well (ie, no surprises). My coronary arteries are "pristine."

The first person to thread a tube into an artery (his own brachial, as it turns out ... the femoral artery in the groin is generally the preferred approach today), snake it up to the heart, and snap an X-ray was a physician by the name of Werner Forsmann, sometime in the first half of the 20th century. Crazy SOB, if you ask me. Flash forward to 2010, and this procedure is on par, experience-wise, with a trip to the dentist. This was cath #2 for me, lifetime, and I can safely say they're not worth sweating over. (You can't anyway - the cath lab is typically kept around 60 degrees.)

In addition to the arterial assessment, the cardiologists take some other measurements, and again there were no surprises here. My heart muscle overall is quite stiff, which is common in HCM. The resting gradient was 30, in line with what we've seen before on echo (remember folks - normal is zero). It spiked to 120-200 after he generated a premature ventricular contraction (a PVC, like a skipped heartbeat) by "tickling" the inside of the ventricle. This is called the Brockenbrough-Braunwald-Morrow sign, and it's just really cool how they do this: they place a catheter with 2 lumens, one in the left ventricle and one in the ascending aorta; force a PVC; and take pressure tracings. Differences in pressure after the PVC = gradient = obstructive HCM. It's what confirmed the HCM diagnosis in October 2008, and I made the cardiologist do it again today just to be sure.

Tomorrow is the last set of pre-op appointments, but no procedures or tests that I'm aware of. Both sets of parents arrive in Cleveland tomorrow afternoon.

Take care,

Michael