UPDATE
The lead anesthesiologist just let me know that Colleen's procedure will not be finished until about 7:00. Before the procedure could begin, in addition to the usual prep, a venous scan needed to be done, that is, they wanted to ensure that the veins in the area of the pacemaker are nicely open. I'll keep posting.
Monday, May 13, 2013
UPDATE . IN PROCEDURE ROOM
Colleen is in the procedure room. Her cardiac electrophysiologist is Ronald Berger, MD, Ph.D., Professor of Medicine, who came by Colleen's room this morning, introduced himself, and went into more detail about the particular plan for giving her new pacemaker. (Dr. Ishigawa, the doctor who would have done Colleen's procedure had it happened last Friday, is out of town today.) Colleen's CP anesthesiologist is Ramola Bhambhani, MD.
MINOR TIME CORRECTION
A staff member just explained the digital monitor more completely to me. GREEN represents Pre-Op/Prep as well as the Procedure itself. Colleen clocked into Green at 2:25. No way of knowing exactly when the Prep finished and the Procedure itself began, but we can assume it's underway. Remember three to four hours for the procedure is projected.
Colleen is in the procedure room. Her cardiac electrophysiologist is Ronald Berger, MD, Ph.D., Professor of Medicine, who came by Colleen's room this morning, introduced himself, and went into more detail about the particular plan for giving her new pacemaker. (Dr. Ishigawa, the doctor who would have done Colleen's procedure had it happened last Friday, is out of town today.) Colleen's CP anesthesiologist is Ramola Bhambhani, MD.
MINOR TIME CORRECTION
A staff member just explained the digital monitor more completely to me. GREEN represents Pre-Op/Prep as well as the Procedure itself. Colleen clocked into Green at 2:25. No way of knowing exactly when the Prep finished and the Procedure itself began, but we can assume it's underway. Remember three to four hours for the procedure is projected.
MONDAY AFTERNOON . COLLEEN ON HER WAY
About an hour ago, "Transport" came with a rolling stretcher to pick up Colleen to take her down to the 5th floor of the Sheikh Zayed Tower, the newest Hopkins building that houses the EP procedure room. Two EP nurses and two EP anesthesiologists surrounded Colleen in a holding room with their kindness, evident expertise, and obvious familiarity with Colleen and her case. The lead anesthesiologist unhurriedly talked with Colleen about the anesthesia option(s) they are hoping to use in lieu of general anesthesia, which is highly problematic because of Colleen's fibrotic lungs. They are going to do everything they can to avoid it.
Just gave her a kiss a few minutes ago as they wheeled her from holding to the Pre-op/Prep room. I got the auspicious impression that she's the second EP procedure of the day. By the time "Transport" knocked on the door, Colleen and I were in full readiness mode again, readiness laced with apprehension, especially for Colleen. May this procedure make a difference.
As in Pittsburgh, the waiting room has a digital wall monitor that indicates the status of each patient by patient number and color. Green for in-Procedure Room and Red for Recovery/Procedure Over.
Colleen's status, Patient No. 902053, is Green.
About an hour ago, "Transport" came with a rolling stretcher to pick up Colleen to take her down to the 5th floor of the Sheikh Zayed Tower, the newest Hopkins building that houses the EP procedure room. Two EP nurses and two EP anesthesiologists surrounded Colleen in a holding room with their kindness, evident expertise, and obvious familiarity with Colleen and her case. The lead anesthesiologist unhurriedly talked with Colleen about the anesthesia option(s) they are hoping to use in lieu of general anesthesia, which is highly problematic because of Colleen's fibrotic lungs. They are going to do everything they can to avoid it.
Just gave her a kiss a few minutes ago as they wheeled her from holding to the Pre-op/Prep room. I got the auspicious impression that she's the second EP procedure of the day. By the time "Transport" knocked on the door, Colleen and I were in full readiness mode again, readiness laced with apprehension, especially for Colleen. May this procedure make a difference.
As in Pittsburgh, the waiting room has a digital wall monitor that indicates the status of each patient by patient number and color. Green for in-Procedure Room and Red for Recovery/Procedure Over.
Colleen's status, Patient No. 902053, is Green.
MONDAY MORNING . HOPKINS . DAY 6
A new day begins in Baltimore. I grabbed the 7 AM shuttle. Sun shining. Colleen awake and reading email on her iPad when I get to her room. No food for her until after the pacemaker procedure scheduled for 2:45 this afternoon in the EP (Electro-Physiology) lab. The EP lab, we've been cautioned more than once, is notorious for its shifting schedules. Nevertheless, given getting bumped on this past Friday, we expect some rectification, unwise as that expectation might be.
About being rudely bumped last week, we've come to see we were told the truth about the reason--for the best outcome, the doctors wanted Colleen to lose more fluid. We thought she'd been emptied to the max. We discovered over the weekend, however, that wasn't so.
And now? Colleen just wants this upcoming, 3-4 hour surgery to be over. BTW, the bi-ventricular pacemaker Colleen is getting today is no ordinary pacemaker. Her existing pacemaker regulates her heart's right ventricle only. Her new pacemaker will regulate both the right ventricle and the left ventricle, the lower muscular chambers of the heart responsible for pumping blood into and out of the lungs. Right now, her left ventricle pump is weak. Nor is it mping in synchrony with the right ventricle. If successful, the new pacemaker will strengthen the left ventricle, as well as bring the right and left ventricular action into synchrony. The cost of this state-of-the-art pacemaker? $70,000.
A new day begins in Baltimore. I grabbed the 7 AM shuttle. Sun shining. Colleen awake and reading email on her iPad when I get to her room. No food for her until after the pacemaker procedure scheduled for 2:45 this afternoon in the EP (Electro-Physiology) lab. The EP lab, we've been cautioned more than once, is notorious for its shifting schedules. Nevertheless, given getting bumped on this past Friday, we expect some rectification, unwise as that expectation might be.
About being rudely bumped last week, we've come to see we were told the truth about the reason--for the best outcome, the doctors wanted Colleen to lose more fluid. We thought she'd been emptied to the max. We discovered over the weekend, however, that wasn't so.
And now? Colleen just wants this upcoming, 3-4 hour surgery to be over. BTW, the bi-ventricular pacemaker Colleen is getting today is no ordinary pacemaker. Her existing pacemaker regulates her heart's right ventricle only. Her new pacemaker will regulate both the right ventricle and the left ventricle, the lower muscular chambers of the heart responsible for pumping blood into and out of the lungs. Right now, her left ventricle pump is weak. Nor is it mping in synchrony with the right ventricle. If successful, the new pacemaker will strengthen the left ventricle, as well as bring the right and left ventricular action into synchrony. The cost of this state-of-the-art pacemaker? $70,000.
Sunday, May 12, 2013
SUNDAY NIGHT . HOTEL . LOMBARD ST
I'm staying in an older hotel whose rooms have windows that open out to the cool night air. I need no other luxury that this tonight.
I said goodnight to Colleen after we watched "60 Minutes" together. Oh, does she ever want to get out of the hospital and go home, even though physically she's feeling decidedly better. Today was simply one day too many; for me as well. Our mental readiness for tomorrow's procedure is a pale cousin to the readiness we arrived with last Wednesday. This is simply fatigue, however. We feel a confidence in the new pacemaker that wasn't quite there for the cardioversion. The stops and starts, the waiting and days of preparation, all the blood sticks and IVs, the potassium and magnesium drips that burn, the constant interruptions and random intercom noise that makes sustained quiet impossible, the sedentary hours spent day after day in a bed no longer crisp, the indignities of having to use a commode so your every output can be measured, the confinement, the stale air, the hospital room windows that can't open to the outside--all this, in spite of the kindest of nurses and hospital staff--all this, is simply wearing to the hardiest of spirits.
I'll keep you posted as tomorrow unfolds. Know that Colleen has not just one but two Hopkins teams at her back. Dr. Hiroshi Ashikaga is the cardio-electrophysiologist who will perform tomorrow's procedure. He's come to Colleen's room to speak with her more than once and other members of his team have stopped by as well. Colleen's pulmonologist Dr. Mathai, about whom you've heard much by now, is the primary architect of her care. Members of his team have come by every day to see her.
Postscript on Dr. Mathai: This is one tall, dark-haired, handsome dude. On Friday, he walked into Colleen's room wearing, under his white coat, the most amazing pair of bright green pants; I also noted he wore no socks.
I'm staying in an older hotel whose rooms have windows that open out to the cool night air. I need no other luxury that this tonight.
I said goodnight to Colleen after we watched "60 Minutes" together. Oh, does she ever want to get out of the hospital and go home, even though physically she's feeling decidedly better. Today was simply one day too many; for me as well. Our mental readiness for tomorrow's procedure is a pale cousin to the readiness we arrived with last Wednesday. This is simply fatigue, however. We feel a confidence in the new pacemaker that wasn't quite there for the cardioversion. The stops and starts, the waiting and days of preparation, all the blood sticks and IVs, the potassium and magnesium drips that burn, the constant interruptions and random intercom noise that makes sustained quiet impossible, the sedentary hours spent day after day in a bed no longer crisp, the indignities of having to use a commode so your every output can be measured, the confinement, the stale air, the hospital room windows that can't open to the outside--all this, in spite of the kindest of nurses and hospital staff--all this, is simply wearing to the hardiest of spirits.
I'll keep you posted as tomorrow unfolds. Know that Colleen has not just one but two Hopkins teams at her back. Dr. Hiroshi Ashikaga is the cardio-electrophysiologist who will perform tomorrow's procedure. He's come to Colleen's room to speak with her more than once and other members of his team have stopped by as well. Colleen's pulmonologist Dr. Mathai, about whom you've heard much by now, is the primary architect of her care. Members of his team have come by every day to see her.
Postscript on Dr. Mathai: This is one tall, dark-haired, handsome dude. On Friday, he walked into Colleen's room wearing, under his white coat, the most amazing pair of bright green pants; I also noted he wore no socks.
SUNDAY AFTERNOON . SAME PLACE
After five days, Colleen busted out of her room today. She got a one-hour hall pass from Nurse Liz, who took pity on us and tacked on an extra 15 minutes, which we were strictly instructed not to exceed. We used every minute and got back just before curfew. Col wanted to see the "old" section of the hospital--which includes only three standing buildings of the original twelve that were built in the late 1800s. We both remarked the beauty of the dark wood wainscotting and doors, the marble floors, framed oil portraits of Johns Hopkins and the earliest medical staff, a five-story balconied rotunda with a domed glass ceiling, ornate brass lamps polished gold, and green-patina copper ornamentation on the upper exterior windows and roof. It wasn't difficult at all to envision doctors and nurses dressed and coiffed in 19th century style walking briskly down these very halls. I wished I could time-travel back to see them with my own eyes.
We happened upon a patio with an ideal view of one of the three historic buildings and where Colleen got to sit in the sun until time was up. White clouds traversed blue sky above us. I turned my face upward
and wondered who was enjoying this more, me or Col, now sleeping.
5 PM . OMG . SAME PLACE
Eternity has nothing on this endless Sunday. It has rendered Colleen and me zombie-like, in spite of "getting out" earlier for 105 minutes. Colleen has just finished her upteenth Lasix IV--losing altogether since being here 4 quarts-plus of fluid. She still has a ways to go on a two-hour magnesium drip through her other IV port. And that's about it.
We should, I suppose, feel good that Colleen's Wagnerian Opera is on hiatus today. But we're both finding it difficult to read, to screen anything, to alight on any whisper of peace. Even Nurse Liz is soporific today. The entire ward is somnolent. The late afternoon sun outside the window fails to beckon. I deduce we have a case of the lonesome hospital blues.
We expect tomorrow will arrive like an inbound train, but no sign of anything on the length of empty tracks yet.
After five days, Colleen busted out of her room today. She got a one-hour hall pass from Nurse Liz, who took pity on us and tacked on an extra 15 minutes, which we were strictly instructed not to exceed. We used every minute and got back just before curfew. Col wanted to see the "old" section of the hospital--which includes only three standing buildings of the original twelve that were built in the late 1800s. We both remarked the beauty of the dark wood wainscotting and doors, the marble floors, framed oil portraits of Johns Hopkins and the earliest medical staff, a five-story balconied rotunda with a domed glass ceiling, ornate brass lamps polished gold, and green-patina copper ornamentation on the upper exterior windows and roof. It wasn't difficult at all to envision doctors and nurses dressed and coiffed in 19th century style walking briskly down these very halls. I wished I could time-travel back to see them with my own eyes.
We happened upon a patio with an ideal view of one of the three historic buildings and where Colleen got to sit in the sun until time was up. White clouds traversed blue sky above us. I turned my face upward
and wondered who was enjoying this more, me or Col, now sleeping.
5 PM . OMG . SAME PLACE
Eternity has nothing on this endless Sunday. It has rendered Colleen and me zombie-like, in spite of "getting out" earlier for 105 minutes. Colleen has just finished her upteenth Lasix IV--losing altogether since being here 4 quarts-plus of fluid. She still has a ways to go on a two-hour magnesium drip through her other IV port. And that's about it.
We should, I suppose, feel good that Colleen's Wagnerian Opera is on hiatus today. But we're both finding it difficult to read, to screen anything, to alight on any whisper of peace. Even Nurse Liz is soporific today. The entire ward is somnolent. The late afternoon sun outside the window fails to beckon. I deduce we have a case of the lonesome hospital blues.
We expect tomorrow will arrive like an inbound train, but no sign of anything on the length of empty tracks yet.
SUNDAY MORNING . COL'S RM 919
The hospital shuttle driver was late picking me up at the hotel this morning--he had a driving job for a high school prom last night that didn't finish until 3 am--so I was a half-hour late and missed the early morning routine doctor visit. Col said I didn't miss anything. When I arrived, she was sitting up on the window side of the bed, sun pouring through, writing in her personal medical journal and eating breakfast!
She slept last night too.
Yesterday, acting as my sister's personal Sherlock Holmes, I may have stumbled upon a key culprit in her sleepless nights--the 2 cans of supplemental nutrition, called "2-Cal," that she's been taking at night ever since the feeding tube was put in on February 28. Evidence: Wednesday and Thursday she had two good nights; she received no 2-Cal nutrition on those nights because of planned procedures on the following days that required fasting. Evidence: Friday was a bad night and when I saw her first thing in the morning, she looked exhausted the way she's been looking in the mornings since I arrived in New Jersey. Question: Why was Friday night a setback? Speculation: One glaring difference between Friday and the previous two nights was the presence or absence of the supplemental 2-Cal. Deduction: 2 cans of 2-Cal nightly is the prime suspect.
I offered my observation yesterday morning to the pulmonary team. One of the doctors, Dr. Boyle, took it seriously and ordered her prescription cut in half last night--to 1 can only of 2-Cal. Corroborating evidence: she had a good night's sleep.
10:15 AM
We're waiting for Colleen's nurse Liz to unhook her from her most recent IV dose of Lasix--the last one before tomorrow's procedure--so we can suit up a wheelchair with oxygen to take our trip around the hospital.
The hospital shuttle driver was late picking me up at the hotel this morning--he had a driving job for a high school prom last night that didn't finish until 3 am--so I was a half-hour late and missed the early morning routine doctor visit. Col said I didn't miss anything. When I arrived, she was sitting up on the window side of the bed, sun pouring through, writing in her personal medical journal and eating breakfast!
She slept last night too.
Yesterday, acting as my sister's personal Sherlock Holmes, I may have stumbled upon a key culprit in her sleepless nights--the 2 cans of supplemental nutrition, called "2-Cal," that she's been taking at night ever since the feeding tube was put in on February 28. Evidence: Wednesday and Thursday she had two good nights; she received no 2-Cal nutrition on those nights because of planned procedures on the following days that required fasting. Evidence: Friday was a bad night and when I saw her first thing in the morning, she looked exhausted the way she's been looking in the mornings since I arrived in New Jersey. Question: Why was Friday night a setback? Speculation: One glaring difference between Friday and the previous two nights was the presence or absence of the supplemental 2-Cal. Deduction: 2 cans of 2-Cal nightly is the prime suspect.
I offered my observation yesterday morning to the pulmonary team. One of the doctors, Dr. Boyle, took it seriously and ordered her prescription cut in half last night--to 1 can only of 2-Cal. Corroborating evidence: she had a good night's sleep.
10:15 AM
We're waiting for Colleen's nurse Liz to unhook her from her most recent IV dose of Lasix--the last one before tomorrow's procedure--so we can suit up a wheelchair with oxygen to take our trip around the hospital.
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