The Heart Of It

A week ago I knew very little about picc lines, infusions, various kinds of catheters, or “hospital time.” I had never heard of Milrinone or an LVAD. It’s amazing how much one week can change your life. I’ve spent at least part of (almost) every day this week at the Meijer Heart Center in Grand Rapids, MI, where my father was admitted after a heart catheterization on Monday showed his heart has severely weakened. I’ve spent every spare minute researching the LVAD after the team of heart doctors mentioned this as a possible treatment, while my dad underwent a multitude of tests to see if he qualified for this procedure. What I learned amazed me on an analytical or theoretical level – technology can do amazing things! It also overwhelmed me and my parents on a practical level – living with this device requires a tremendous amount of care and lifestyle change; could my dad and our family really do this?

An LVAD (Left Ventricular Assist Device) is a mechanical pump that is implanted just below the diaphragm during open-heart surgery. One end is attached to the heart’s left ventrical. It continuously pumps blood out of the heart, through the titanium pump, to the other end (connected to the aorta), where it carries the oxygen-rich blood to the rest of the body. A driveline (tube going through the skin) connects the pump to a system controller, a small computer worn outside the body. The controller is the “brain” of the LVAD as it displays messages and warnings if there are any problems. The LVAD is powered by two batteries during the day and a wall unit at night. The batteries last around 10-12 hours, so you always need to be charging extra sets of batteries. Electricity is vital for the LVAD to work! The LVAD has primarily been used on patients waiting for a heart transplant, but during the last several years it has started to also be used as a “Destination Therapy” (which would be the case for my father, as he didn’t qualify for a heart transplant).

photo from Thoratec, HeartMate ll

this is the model they showed us in the hospital,

this type of pump would be implanted

After the surgery, the patient recovers in the hospital for 2-4 weeks. Once they return home, someone needs to be with them at all times for at least 90 days, in order to change the dressing and in case there are any problems with the device. There are also weekly (later monthly) visits to the LVAD clinic to make sure the device is working. The family and caregivers are also trained to know how to live with it and troubleshoot any possible difficulties. When leaving the house, a bag carrying extra batteries and other supplies must always be brought along.

My research showed many good results – most people have a much better quality of life and heartily recommend it. Complications can occur, however, due to infection or blood clots or issues with the device not working properly. The mechanical heart pump can extend someone’s life for 3-7 years.

We had lots of questions for the doctors; they were very helpful and patient as we struggled to decide whether this would be beneficial for my dad and our family. It is a huge step as life would change drastically. But we realized that life would change even if he didn’t have this procedure, as he would just continue getting weaker for the next 6-16 months.

After a lot of discussion, thinking, and prayer, we decided to proceed with the LVAD. My dad was released from the hospital today and has a small portable pump, which continuously infuses Milrinone, a heart medication, into his heart to strengthen it. He’ll remain on this for the next 2-3 weeks as we make preparations for the surgery, build a care support team (if anyone in the Grand Rapids area is willing to stay/visit with him for 1-3 hours per week from Oct-Dec, please let me know), and become more educated on life with the LVAD.

This week has been a whirlwind with lots to process. I feel like our lives are on hold. And yet, we’ve prayed for God’s clear direction and wisdom in our decision-making, and we feel God’s presence. We are so thankful for our Christian community – in Michigan and beyond – which has been upholding us in prayer. As I’ve listened to the radio on my drives to and from Grand Rapids this week, I was struck by how many Christian contemporary songs have the word heart in them. And how the heart of God is filled with love for us. In some ways, we are apprehensive about this impending surgery and life change. But we also know that God is with us and will continue to give us what we need each step along the way. And that is really the heart of it.

Cousins

Question: Can two dogs – large and small, male and female, adult and puppy-ish, get along?

Answer: Yes - with patience, watchfulness, and separate rooms.

Toby met his “cousin,” Daisy, as she spent the past week with us. Daisy is a three-year-old “shichon” (shih tzu & bichon cross) and is much smaller than Toby. She’s used to her family (my sister and brother-in-law and their kids) and loves people. Other dogs – not so much. Of course it didn’t help that I had her in a travel crate during the car ride to my house when she’s used to being free in the car. Toby was excited to meet her: tail wagging, barking, sniffing, and jumping all around. Daisy, however, was not impressed and wanted nothing to do with him. For the first couple of days she stuck pretty close to me and avoided Toby completely. I guess when you’re a little 10 pound dog Toby seems like a giant.

Gradually the two dogs got used to each other and Daisy tolerated Toby’s sniffs (eventually sniffing back). Daisy had her room with her crate and food and Toby had his room, so they each had their private space (although Toby kept trying to get in Daisy’s room to get her food). When I was home, Daisy’s spot was on top of the couch right behind me. Toby was either on the floor, next to me on the couch, or at his favorite lookout spot.

By the end of the week they had learned to get along and share each other’s water bowls. We even managed a walk outside all together! They each had their hyper times (never at the same time, thankfully), so we got plenty of playtime in. Daisy loves pulling things out of the trashcan and Toby still enjoys shredding things (his nice patriotic bandana is gone), so I kept doors closed and things up high. It’s like having toddlers around! 

Overall it was a fun week. I loved having a little dog who likes to cuddle and sleep by me (take note Toby!!). It was also good for both dogs to learn how to deal with each other. We’ll see if they remember each other at Christmas time.

Hopefully Daisy is showing Toby how to go in his crate as Toby is still afraid of it.

Yes, they are both on the bed at the same time! (Toby didn't stay for long, though.)

Love this picture of them both keeping a lookout.

I never could have gotten them this close to each other at the beginning of the week.