Heart History: Phil’s father died at age 32 of a weak heart, an unknown cardiomyopothy, where it was explained that the pump of his heart wasn’t strong enough. Phil, 41, had a very low resting heart rate of 30 or 28 beats per minute, with atrial fibrillation. They put him on blood thinners–since atrial fibrillation puts you at an increased risk of stroke–and shocked his heart back in August, and then realized he was in complete heart block (meaning the chambers weren’t on speaking terms with each other–nothing to do with diet or a clogged artery), so they put in a pacemaker. Through several echo cardiograms, and one MUGA, they saw that his ejection fraction was trending down, from 60% to 40% to 23.5% in a relatively short time, so he now wears an external defibrillator. A biopsy of the heart was taken, where Amaloid was ruled out. Genetic testing was performed, specifically LMNA testing, but of 100 people who have the genetic abnormality, only 50 of them will actually test positive for it, so it’s not the greatest test. His results came back negative, but again, 50 people who actually have it also get negative results. So who knows. All that said, yesterday, Phil came in hoping to lose the atrial fibrillation, which has nothing to do with his pacemaker or his ejection fraction, and now, one day after his "procedure" he’s in atrial flutter.
Today: Dr. Andrea Natale (from the Cleveland Clinic, now at Saint David’s in Austin) performed the ablation procedure. People keep making a point of calling the surgery a "procedure," so I know what’s next. Phil will soon be muttering to a Jamaican woman, whom I can’t stand but whom he’ll call mama. This is Billy Crystal logic, and quite frankly, we could use a little humor right now.
A surgical operation was performed on Phil’s heart, where many of the vessels of his heart were burned, hoping to stop the atrial fibrillation (which increases risk of stroke and causes the heart to enlarge). The larger the heart, the harder it becomes to repair it. And eventually the quality of life you experience can change, causing you to be fatigued, with chest pains, shortness of breath, etc.
He no longer has Atrial Fibrillation, but this morning he is in atrial "flutter," which is more erratic that fibrillation, and not as fast– which isn’t ideal, but we need to wait two weeks to see if it’s still there. Dr. Natale said that when he went in, he saw that the upper left chamber of the heart was "highly diseased." I don’t know what this means exactly, but I do know no one wants to hear those words. He said he monitored the whole heart, reading the electrical output of the heart, and there were certain parts of the heart that were not registering on the monitor. There were parts of the heart that the pulse was very weak. His left Atrial appendage was thick, so it was hard to get to the current, hard to locate it, to burn it away. So that’s the area where the a-fib might come back.
All that said, here are the next steps: he’s being discharged today, where he’ll be on close watch with his man vest and on some heavy diuretic. No lifting anything over five pounds: so no masturbating for him. No climbing stairs… which means we’re sleeping in THE DREADED GUEST ROOM! Poor poor Phil! In two weeks, he might need to come back for a cardioversion (where they shock his heart like you see on TV when someone says CLEAR). In three months, they’ll know if they need to go back in there and do more ablating. In five months–the whole time wearing the 3 lb. modem and man bra–they’ll see if he needs a new pacemaker (a bi-ventrical pacemaker with a built in difibrulator). His Ejection Fraction, last checked, was at 23.5%. So now he’s on beta-blockers, hoping the medicine will help. That’s where we are. I have no idea how we’re going to keep the sprouts from crawling all over their papa (whose eyes are also all bloody thanks to anesthesia and oxygen). As for me, I’ve got nausharhea.