Post Ablation Day 1

I finally got to see Sam around 11:30pm with his mom. He was still very groggy and in a lot of pain. He said this ablation was more painful than the one in May. He had a great night nurse - Ramone who was in his room constantly to check his blood levels at this groin site. Once it dropped below 200 he was going to remove the tubes and apply a 10lb sandbag to clot the site.  I left the hospital in the early morning hours and came home to get some rest and his mom stayed with him. At around 6am he was able to get up and walk around and try and put some pressure on his groin. However, soon after walking around in his room he started to bleed and was sent back to bed for another 4+ hours.

[The sandbag that had to lay on Sam's groin to clot the blood at the site]

Dr. Wong came in to see Sam around 1:30p today and wanted to explain to him everything that he was able to do during yesterday's procedure. He drew on Sam's patient board and explained how he went in and worked on his heart. Looking at the photo below - the atrium with the arrows is the right side of his heart. This is the side that they fixed back in May and is still blocked and after testing isn't showing any signs of active signals. The side with the dots is his left side and that is the one where Dr. Wong spent 6 hours ablating. The total number of ablations done in Sam's heart was between 300-400!

[Dr. Wong's drawing to Sam as he explained to him what he did inside of his heart]

Dr. Wong was able to use a new devise that is able to chart while he is catheterizing. It shows him how effective the ablation is and measures the tissue to see if it was destroyed enough to build a block in his heart. This is something that wasn't available back in May for his procedure. The Dr was confident he ablated all of the triggers on the left side of his heart. On the right side everything was gone for good BUT he did see some Atrial Flutter after inducing his heart back into an arrhythmia and it came from the right side. However, it was mysterious and he couldn't find the source... with the left side being fully ablated there are no triggers to feed off of the flutter should it come back. 

Next Steps:

We have a follow-up appointment with Dr. Wong in January. At that time he will be taken off of all of his arrhythmia medications and placed on a 30 day heart monitor. If there are no issues seen on the heart monitor he will discontinue the medications for good. If for some reason there are still issues within his heart we will re-evaluate at that time. 

We agreed with the Dr today that the next time we are leaving Royal Oak Beaumont it will be with our baby in March/April 2013. 

For now Sam is shuffling around for the next week... 

 

Post Ablation Update

We arrived at Beaumont Royal Oak at 10am this morning. After checking in at the registration counter we headed up to the 8th floor central tower to the same waiting room as his other procedures - Schlafer Cardiology Center. They took Sam back right away to start his prep and came for his mom, dad and I to go see him after he was ready. They had taken blood work in the prep area and his potassium was elevated to 5.9 (a normal range is 3.2-5). Dr. Wong was concerned and ordered a redraw of his blood work. If Sam were to be under anesthesia and they were ablating with the elevated potassium level it could cause a lethal level of arrhythmia issues (his words not mine). After 7 pokes and 3 nurses the anesthesiologist was able to get his 2nd blood draw for his potassium level. It came back normal and at Noon they whisked him away to start. 

Around 3pm one of the nurses Kathy came out to update us - They had incubated him at 12:15pm and made it to the left side of his heart (again this wasn't an easy task and took about 30-40 minutes) and started to map out the left side. Dr. Wong was going to start ablating the heart using his 3D mapping while she was out talking to us.

[Image is of a heart being mapped... I couldn't obtain Sam's specifically but this google one gives a good idea]

At 7pm a familiar face came in to update Sam's mom, his cousin Jeff (in from Florida) and myself. It was Ann, the same nurse that we dealt with in May and it felt like deja vu. As like May, we were the last family in this waiting room and she was coming to give us an update and let us know it would still be a few hours... Dr. Wong had triggered Sam's heart into Atrial fibrillation/flutter and was trying to get it under control by continuing to ablate the left side of his heart where the hot spots were active. The spots that he ablated on the left in May were now active - hence causing this disruption in his heart. Again this is very common to have to undergo two ablations to get the actual arrhythmia issues corrected. Ann also mentioned that they are being very careful around his esophagus - as when they are ablating it can get too hot and they do not want a hole to form in his esophagus. 

At 8pm Ann came back out and said they have ablated the left side of Sam's heart and have now gone back over to the right side to map it to ensure that the flutter/fibrillation that should be corrected on the left goes to the right to become active. They did notice while mapping that the original ablation areas on the left are still doing great but they did find some activity in the top part of his right side that Dr. Wong was addressing. 

At 10:30pm Dr. Wong finally came in to see Sam's mom and I and talk about the procedure. After 10 hours Sam is in the recovery room and we are waiting to see him.. Dr. Wong said they spent most of their time on the left side of his heart  but he feels confident he got all of the signals. Dr. Wong even tested Sam's heart after completing the left side to ensure arrhythmia issues wouldn't occur after all the work he had just completed. However, while working on the heart he found something mysterious (he is really using some crazy words today)... all of a sudden his right atrium went into atrial flutter. It was very difficult to detect as it didn't appear in the same circut that they corrected in May (and it should have). However, After corrected and triple checking both sides he couldn't get it to replicate again - hopefully its left his heart for good!

I have filled my day with day time TV in the waiting room, stalking facebook, pinterest, work emails, texting/talking on the phone with friends/family, coloring and visitors... what a long day! Just counting down until I can see Sam and talk to him... more to come tomorrow!

Ablation #2 Scheduled for Tuesday.....

We met with Dr. Wong on Monday, August 27th for Sam's 3 month post-ablation update. Despite the fact he was running late and by late we mean almost 2 hours behind... the original plan for this appointment was for Dr. Wong to take Sam off all of his arrhythmia medications and put him on a 30 day heart monitor to see how his heart was doing after healing for 3 months. However, after we finally got to see Dr. Wong he decided against his original plan. Since Sam hasn't had too many episodes lately he didn't want to mess with his medications and cause something to go hay wire. Which we both appreciated.

Sam is having a 2nd ablation on Tuesday, October 9th at Beaumont. Dr. Wong is confident this should correct all of his arrhythmia issues once and for all. His plan of attack for this procedure is to successfully ablate the left side of Sam's heart. We are very hopeful he is right as this procedure comes about a month before his 1 year post-op mark. Dr. Wong mentioned the night before he plans to get 12 hours of sleep, eat a couple bowls of Wheaties for breakfast and be ready for another long day. I am looking forward to another hospital slumber party, hoping this one goes a little faster and we can finally put Sam's heart arrhythmia's behind us.

Stay tuned...

Cardioversion

Rewind....Last week Sam started to get atrial flutter again and this time it wouldn't go away. His heart rate was over 130 beats a minute and we went into the doctors office last Wednesday, July 18th. Usually an extra dose of medication would bring his heart rate back down but that hasn't been working. Sam had an EKG done and met with Dr. Wong's nurse - Carla (Dr. Wong was out of the office when we went in). She looked over everything, examined Sam and texted Dr. Wong with the details of what was going on with Sam. Dr. Wong believes the atrial flutter is coming from his left side of his heart since he had fixed the right side of the heart in May. Sam was advised to increase his motoporal - taking an extra does if needed and to come back for a cardioversion next week.

[Sam's rhythm and heart rate prior to cardioversion]

A cardioversion is when an abnormal heart rate is converted via electricity (being shocked). Doesn't sound very appealing and I did ask how many shocks one's heart could take in a day.... 12! Unreal right!? One pad is placed in the center of the chest and the other is placed in the center of your back. These are connected by cables to a machine which functions as a electrical defibrillator. A synchronizing function allows the cardioverter to deliver a reversion shock, by way of the pads, of a selected amount of electric current over a predefined number of milliseconds at the optimal moment in the cardiac cycle which corresponds to the R wave converting the heart back into a normal sinus rhythm.

Fast Forward to today... we arrived at Beaumont at 6:30am and checked in for Sam's cardioversion. I started to get flash backs when we entered the waiting room as it was the same waiting room I waited 11 hours in for his ablation back in May. They took him back for prep and I was finally called back at 7:45am to see him. Dr. Wong was running late so I sat their cracking jokes and filling him in on all the other people their and my people watching information from the waiting room. Dr. Wong came in around 8:15am to talk to us and explain what his goal was today and for the future.

They took Sam into the lab and did a TEE first to ensure there were no blood clots around his heart and then performed the cardrioversion (only once) and then he was back in recovery. I made Dr. Wong promise me it would in fact be this short of a procedure given his track record. I went back to the waiting room and after 15 minutes Dr. Wong was already back to see me.. I was shocked! He said he was back in a normal sinus rhythm and in recovery. Music to my ears. Now this is not to say this all happens again but I am remaining positive and calling in a favor to the big guy up stairs to give us a reprieve. We were discharged at 11am and headed home for Sam to nap all afternoon from the anesthesia.

We see Dr. Wong for a follow-up appointment on August 27th and are sticking to the 'original' plan of taking Sam off all of the arrthmya medications and monitoring his heart for a month on a heart monitor. However, Dr. Wong is being proactive and is already requested his 2nd ablation be done in October so that he can ensure the heart doesn't have any other arrthmyia triggers. He is confident

Stay tuned....the beat goes on.

Ablation Updates

Its been almost a month and half post ablation and I am sorry for the delayed update! This thing called life gets kinda crazy at times. Sam's first week home was spent taking it easy as he was very sore from the long procedure and was starting to feel the burning sensation in his chest from all of the ablations. What hurt him the most was his arms/shoulders - since in the operating room they have you flat on the table with your arms out straight the entire time. Dr. Wong had decreased Sam's arrhythmia medications prior to us leaving the hospital.

For a few weeks post ablation Sam didn't feel any arrhythmia issues like the atrial flutter or atrial fibrillation he felt before the procedure. Things didn't feel "normal" but that was due to the trauma his heart had been through and part of the healing process. However, a couple weeks ago Sam started to get atrial fibrillation again. Needless to say it was disappointing for him despite the fact we were told it may take several ablations to fully correct the issue. It was a speed bump in the healing process but luckily Sam was able to take an extra does of his medication and it stopped. Which is a VERY GOOD thing since before the procedure the medication wasn't working anymore and he was on the highest dose he could take.

The goal is for Sam to be on the decreased dose of the arrhythmia medications for 3 months and come in for a check-up at the end of August with Dr. Wong. At that time he will have an evaluation and some standard heart tests run. From there they are going to put him on a 30 day heart monitor (always enjoyable for Sam). They want to see how the heart is doing post-ablation but AFTER its had time to rest. If the monitor shows everything to be in good working order he will be able to stop taking all of the arrhythmia medications and the blood thinner. [Fingers crossed]

 

Sam's birthday is this Saturday so he is currently deeming it his 'Birthday Week'....we are going to enjoy our summer and we will keep you posted during the recovery process.

Day 1 - Post Ablation

Late last night and into this morning Sam and I were rehashing what Dr. Wong told us and going through all of Sam's aches and pains from being on the table for so long. The first thing to really bug him was his arms. His arms were extended and tied down during the procedure making them incredibly sore for him. I would periodically get up and try and massage them to keep them from cramping up. Sam had to lay flat all night in order for his groin to start to heal up before he was able to sit up or walk. 

Sam's nurse would come in every hour and check his catheter site for swelling, make sure a hematoma didn't start to form and checked his blood to see if his level had dropped below 190 in order for the tubes to be removed. He was able to get them removed at 3:45am. A few nurses came in to do this and after the tubes came out the charge nurse had to apply pressure on his groin for 30 minutes to ensure the 3 small holes would clot. However, since Sam was placed back on his blood thinner medication right after he woke up it wasn't that easy for the sites to clot. At 4:30am the nurse was able to alleviate her pressure (her fingers were numb) and place a sandbag on Sam's groin (sounds so great right?). The sand bag had to stay on for at least an hour and then he wasn't able to get up or move his bed until 8:30am.  Needless to say there wasn't much sleeping during all of this as they had to do constant vital checks and incision area checks. I finally fell asleep in my upright hospital chair in the most ridiculous position at about 6am - I think I was annoyed there was nothing going on with Facebook and had run out of things to do. Sam & I both got about an hour of sleep (it felt pretty amazing). 

Just before Sam was able to get out of bed I ran downstairs for some much needed Starbucks and got him some fruit and breakfast items from Papa Joe's. At 8:30am his nurse came in and he was FINALLY able to get out of bed and stretch - he was mad at the midnight nurse for not even letting him move just a pinch. Once he got to finally walk a bit he felt a lot of pressure off of his chest and started to feel a little better. BUT since he was flat on his back from 11:30am 5/31 to 8:30am 6/1 his right butt check was blessed with a sore from not being able to move. This currently hurts Sam more than his groin and made making him comfortable a real challenge.

We got home around 4pm and spent about an hour trying to find the right pillows and positions on the couch for Sam to be comfortable. He finally fell asleep after all of the adjusting and I was able to sneak in a few winks as well. We were told by the discharge nurse that tomorrow will be the peak of his pain - he will start to feel a burning sensation in his chest from the ablations and overall feel like he played in traffic. He isn't allowed to drive until Sunday and isn't allowed to lift anything over 10lbs for a few days. I on the other hand have been building muscle by assisting him up and down.

We have switched sides of the bed to make it easier for Sam to get in/out. His incision sites are occasionally leaking so I have been changing his bandages frequently. Its really difficult when he is on blood thinners and they want these small holes to clot but he has to keep moving... sigh. 

I am currently listening to him snoring so I am going to try and get some sleep before he needs help with something in the middle of the night. Good Night!!

Post Ablation Update

I am not even sure where to begin... I can start with neither of us anticipated what today turned out to be. We arrived at the hospital just after 9:30am and Sam went back for his surgery around 11:30am. It was supposed to be 4-6 hours but turned into 9+ hours of surgery. The staff was fabulous and came out and gave us updates every 1-1.5 hours. Dr. Wong himself even came out around 3pm after he had finished the right side of Sam's heart. Needless to say today has been longer than his open heart surgery was in November. It was just as stressful and I felt less prepared.

They went into the right side of his heart first to correct the atrial flutter that he was currently in. The Dr was successful in ablating part of the circuitry on the right side of his heart. He then continued the ablation until he formed an electrical block around the right side. They look for spaces within his heart (kinda like a where's waldo) and once they find them all they ablate, recheck and repeat.

Then things got tricky... what should have taken 30 seconds for the catheter to get from the right side of the heart over to the left side took 40 minutes!! Sam's heart is still very enlarged which made it difficult for them to go around his atrium along with his veins being very small. (common due to his surgery still being fresh and from the arrhythmia issues he has been having). Dr. Wong tried to use x-rays and other devices to see inside to assist in guiding his instruments however, they didn't give him the clear images he was hoping for. They did however see that his heart is contorted - this could be from being so enlarged or from the trauma of his open heart surgery in November. As Dr. Wong described it to us "I was lost with no map and had a foggy window".... scary to think about when you are talking to someone that was dealing with your husbands heart! Basically when guiding the catheter from the right to the left side he was completely blind and hoping for the best. If he went too far one way he would have made a hole in his heart, if he went too far the other way he would have gone into his aorta and thankfully he went just the right way and got through to the left side. 

Now that they finally made it to the left side....They checked his veins to see if they were the "triggers" for his atrial fibrillation and they all checked out normal. They did however find multiple "hot spots" on the back of his left atrium. Whenever they went over these areas his heart went "CRAZY". Dr. Wong was able to ablate all of the hot spots and also build fences around his veins in hopes he created blockages around them for the future. 

Both atrial flutter and atrial fibrillation can cause your heart to enlarge or stay enlarged until those rhythm issues are fixed. Dr. Wong said 1/3 of heart valve surgery patients have to undergo ablation surgeries. We are hoping in Sam's case over the next three months his heart will finally start to shrink in size and fix its contortion.

After we finally got to speak to Dr. Wong - Bonnie, David (a close family friend) and I headed down for some much needed food making phone calls/texts along the way. We were told Sam wouldn't be awake for at least an hour or so however, my cell phone rang in the elevator on the way up to his room and his little groggy voice was calling me from his room to see if we left him - I don't know if he will remember this later. 

Sam is in pain and still laying flat - we are hoping his catheter tubes can come out of his groin in the next few hours. I am hunkering down for a long night at the hospital in another uncomfortable hospital chair. 

Happiness is hanging out together ... even if its in the hospital on our anniversary :)

(I got the below figurine for Sam and gave it to him in his room after his surgery)

We appreciate everyone's thoughts and prayers - they mean so much to us. I will keep you all updated tomorrow!

Morning Update

This morning we were called and told that we could arrive at the hospital early as the first ablation was postponed. We arrived to Beaumont around 9:45am and they whisked him away the minute we got upstairs. They had to do procedure prep which included some shaving of his fur (i mean chest). His parents (Bonnie & Fred) and I are here today and were able to go back and see him prior to him being taken back.

He was hooked up to all of the monitors and was experiencing atrial flutter and a very high heart rate. Which I think is good in the sense that they can already see the issues he has been experiencing before they go in.

Dr. Wong came in to talk to us before the procedure and explained everything very nicely for Sam's parents and I. Dr. Wong showed us the heart monitor and how the lines were showing his atrial flutter which is like a dog chasing his tail (all I could think about was Baxter and how he LOVES to chase his tail daily).  Atrial fibrillation feeds into atrial flutter - so with that said they are going to do his procedure in a few parts. First they are going to go in and correct the atrial flutter. This will correct the fast heart rate and most of his day-to-day symptoms. The success rate of correcting this today is 95%. However, correcting his atrial fibrillation success rate is only 50-60% the first time. More than likely a second ablation is needed to fully correct the fibrillation. Commonly the second ablation will show flutter in the left upper chamber instead of the right (where his current issues are isolated to) and the success rate jumps up to 80-90%.

After the atrial flutter is corrected and they are working on the atrial fibrillation they can tell if they are correcting it by looking for extra signals through the catheter. These signals can't be seen on an EKG and are easy for the doctors to see through normal signals.

They ordered a TEE test prior to the procedure to ensure there were no blood clots around his heart since he has been off of the pradaxa since Tuesday. The doctors assistant (Scott) came in and told us that the TEE was clear and they were starting the ablation process. It will take between 4-6 hours and he will come back and give us updates throughout. Stay tuned...

Procedure Details

Sam received a call from Beaumont today with all the details for tomorrow's procedure. We need to report to the hospital at 10:30am (much better than the original 6:30am they had him down for). His procedure is slated to last between 4-6 hours and afterwards he will need to lay on his back for up to 8 hours. This is very similar to the catheterization he had done in 2009 at UofM. Unlike the catheterization they will go through a vein in his leg which should be less invasive  - the catheterization went through his groin which took longer to heal and caused some complications.

Sam also received a Beaumont video link with a very informational video for tomorrow - almost too much information! I can't share that one as its through their patient system but I did find one that was shorter and similar that outlines some of the key details.

As you can imagine tomorrow will be a very long day and with that I am off to bed...I will post updates to the blog throughout the day tomorrow.

We appreciate all of your thoughts and prayers!!

Ablation Update

Its been 6 months post-op and we are right around the corner from Sam's heart ablation. For the past few months Sam has been on a few different medications trying to keep his heart rhythm normal. With the right medication combination he has been doing pretty well but recently the medications have started to become less effective causing arrhythmia issues again. In order for this to be corrected and for Sam to get off all of the medications he has to have a cardiac ablation done. Sometimes this procedure corrects the arrhythmia issues the first time and sometimes additional ablations are needed to correct it for good.

A couple months ago Sam met with Dr. Wong and discussed his options for all of his arrhythmia issues [see 4 month post] and set-up his ablation date. Before the ablation can be done he had to have a coronary CT scan and bloodwork done. Last Thursday morning Sam & I went to Beaumont for him to have the Coronary CT Scan to ensure his veins would be good in order to do his ablation this week. Out of all the tests and everything he has been through this was by far one of the easier ones. They took some blood work and after waiting 30 minutes he was ready for his 10 minute test. We even got to watch Ellen like old times while we waited in the prep area for his test.

This Thursday, May 31st (this day may ring a bell for some of you as its our 4 year wedding anniversary) we will be at Royal Oak Beaumont for his heart ablation. The hospital will call us Wednesday with the time of his procedure. Since Sam is only 6 months post-op he will have to stay the night in the hospital to be monitored for any complications. As you can imagine its not our ideal date for our anniversary but I have a feeling this was in our vows somewhere in the "for better or worse and in sickness and in health" part. So we will make the most out of our slumber party at Beaumont!

The past few months have felt like a ride at the fair with doctors appointments, tests, medications etc...hopefully all of this will be behind us soon.

More updates will come throughout the week...stay tuned!

4 Months Post-Op

Yesterday marks 4 months since Sam has had open heart surgery to fix two leaking valves in his heart. And 4 months to the day Sam went back to work again! I think he was happy to get back into a routine other than cooking, cardiac rehab and dog walking :)

It has been one heck of a ride and its not over yet. Sam went to Beaumont today to meet with Dr. Wong, Director Electrophysiology Research, to discuss the arrhythmia issues happening with his heart. Dr. Wong looked at his heart monitor records from the past 30 days along with reports from cardiac rehab and recommends Sam have a catheter ablation done on his heart. If the ablation is successful Sam can stop taking ALL of the medications (they have added up!) that are needed to keep his heart in a semi-normal state.

Dr. Wong feels this isn't associated with his recent heart surgery but something he may have been experiencing before surgery and just didn't notice due to his valves leaking so severely.  Sam is classified as having paroxysmal superventricular tachycardia (say that 10x fast)!  This is when his heart's electrical system causes his heart to beat very fast and cause other abnormal arrhythmia's.

(Instrument used to ablate the heart muscle)

Statics show that your first ablation is 90% successful and sometimes a second or third ablation is needed to fully correct the arrhythmia issues. When the catheter ablation is done they go in through a vein in his leg and induce his heart into its abnormal rhythm (see photo above of the instrument used)- whether that be atrial flutter/fibrillation or both. Once they see the abnormal rhythm they will destroy the abnormal pathway. (see image below)

Since Sam has had trauma to his heart with his recent surgery Dr. Wong feels Sam should stay the night in the hospital to be observed and take 2 days to lay low so his vein can heal from the catheter.

Ironically Sam's appointment was pushed up from the end of April and is on Thursday with U of M's Dr. Aman Chugh to discuss these issues. We will give an update on that appointment and try and get something scheduled in the next couple months either at Beaumont or UofM.

Heart Monitor + Arrhythmia Issues

It has been a trying few weeks.... between Sam's heart arrhythmia, medications, doctors calling, a heart monitor and just juggling everything it has been a little hectic to say the least. Sam's heart is STILL having arrhythmia issues. It has varied on the day/time but between the PACs/PVCs, SVTs and Atrial flutter/Atrial Fibrillation + 3o day heart monitor + increase in medications = tiring and trying times around the Bristol Recovery Estate.

[This heart monitor hangs around Sam's neck or clips to his belt. It beeps when the recorder is full]

Since Sam was calling the doctors office daily with updates they decided to put him on a  30 day heart monitor so that they could monitor his heart and see any/all arrhythmia's [and they may have been sick of hearing from him too ;)]. A 3rd party monitoring company closely watches Sam's heart 24/7 and whenever he has an "episode" or hits his button for the device to record something they call the house or he has to call them to download the data off the monitor. At that time they can talk to him to see what he was doing and how he was feeling when they recorded an "episode". The monitoring company then sends reports to Dr. Bach so that he can see everything as well. He was supposed to be living a "normal" life with the device however, he went to wash my car the other day and his heart rate jumped up to 190 beats/minute. The heart monitor company called Sam to see what he was doing and how he felt...needless to say they told him not to wash any more cars. So living "normal" isn't what the average person would see as normal. Extremely frustrating for Sam.

On top of this fabulous heart monitor the doctors office has increased his rhythmol medication to the maximum dose and increased his beta blocker (coreg). They were hoping with these two medications increased his arrhythmia issues should subside and after a 1-2 weeks of the increased medications he would be able to go back to cardiac rehab.

Today was Sam's first day back at cardiac rehab. He was THRILLED to leave the house and do something again. He made it through his whole session without an issue and in the cool down phase his heart went into atrial fibrillation where it is still currently. Cardiac rehab sent a report to Dr. Bach's office at U of M and the heart monitor company called Sam to verify his symptoms etc. Since his heart rate has remained normal during this episode we do NOT need to go to the hospital. However if his heart rate should increase or he gets any  symptoms we will have to make a trip to the ER.

Dr. Bach's office has recommended Sam to see a Cardiac Electrophysiologist at U of M. The first available appointment isn't until April so we are currently pushing back on Dr. Bach's office to pull some strings or we will consider going to another hospital. Since this issue just started with Sam in January - we don't want to waste anymore time when the issue could get corrected faster. Sam is eager to go back to work and be able to get back into his everyday routine + Baxter :) We are hoping this is like surgery... a minor speed bump that can get resolved soon and we will be able to laugh about this months from now. When we look at the calendar it seems like it has been longer than just 14.5 weeks since surgery!

For now I try to crack some jokes around the house... I usually sing something ridiculous to get a quick smile... currently I have been trying to find songs about beats, rhythm or faith. Something like a flash back to Gloria Estefan's Rhythm is Gonna Get you. ;)

A Day of Doctors..

This morning we headed out to U of M to see Sam's cardiologist Dr. Bach. You may remember Dr. Bach was the cardiologist that told us it was "GO TIME" for surgery last summer. This was Sam's first appointment with Dr. Bach post-op and his first echo.

Sam's echo showed his atrial flutter had stopped (Sam felt it subside overnight). It showed his heart had good working valves and that it looks like a heart that just had open heart surgery (no way!). Dr. Bach confirmed that Sam's atrial flutter doesn't affect his heart or the valve surgery. The left ventricle is still large but should decrease in time. His echo also showed a SVT (supraventricular tachycardia) episode.

Here is a great video example that shows everything Sam's heart has been through recently: SVT, atrial flutter, atrial fibrillation.

We met with Dr. Bach and discussed Sam's last week of atrial flutter/fibrillation. We discussed his recent hospital stay and what Beaumont suggested for treatment. His opinion is to start Sam on medication and if it shouldn't work or he starts to get these episodes more frequently then we will go to the cardiac ablation option. Sam and I agreed this is a safer and better option at this time. Dr. Bach started Sam on propafenone medication that controls his hearts rhythm. He also increased some of his blood pressure medications as his blood pressure has recently increased with these episodes. We are hoping with the new medication and other medication tweaks his heart will focus on healing.

It takes a few doses of the new medication to really take affect on Sam's body. In the meantime he needs to lay low and can resume cardiac rehab next week in hopes that when he goes back he isn't asked to get off the treadmill for atrial flutter/fibrillation again.

We called Dr. Hanzel on our way home from U of M so we could discuss everything we talked to Dr. Bach about. He was on board with the medication treatment and reserving the cardiac ablation if the medication doesn't work. We were relieved both doctors are on  the same page and working together on Sam's health. So needless to say all of the procedures for tomorrow are cancelled and Sam now has a week to relax and hang out with Baxter :)

I would like to end on a positive note (kinda like how Brian Williams does every night on the NBC Nightly News) So below you will see an adorable photo of Baxter taken by our good friends Chris & E'Lisa Campbell. Enjoy!

Atrial Flutter Options

After a sleepless night at Beaumont (well I shouldn't say sleepless...more like 2.5 hours of sleep) the Doctors and nurses started rounds and saw Sam first thing this morning. Dr. Hanzel's office sent their fellow Dr. Hansen and they recommended three options to Sam and gave him some time to decide which one he wanted to go with.

1. Do a Echo, TEE test and Cardiac Ablation to correct the Atrial Flutter/PVC's

2. Perform a Cardioversion on the heart (shock the heart back to it's normal rhythm)

3. Get discharged and use oral medications to maintain his heart rate

Sam talked this over with his mom and I and we thought option 1 was the best solution given he has been battling this on/off all week. We reasoned this because if they were to do a cardioversion and shock his heart he still runs the risk of his heart going back into the Atrial flutter and needing it again. Option 3 was not an option in my opinion since the medications haven't worked really well in the hospital so I don't think they will work that well out of the hospital.

The plan was to do an echo cardiogram of the heart first and then from there they would do a TEE test to ensure there were no blood clots within his heart - if there were ANY they could not do the Cardiac Ablation. If they were to do the Cardiac Ablation with a blood clot in the heart Sam would run the risk of having a stroke. However, Beaumont wasn't able to even do the cardiac ablation that was needed as they needed a part for the equipment that wasn't available. Lucky for Sam at the time his A flutter was calming a bit so they discharged him with medications and we go back on Tuesday to fulfill option 1. Not ideal but there is no need for him to stay at the hospital all weekend when they can't do anything but watch him. My nursing duties are in full force again!

They sent Sam home on Digoxin and have him on a burst dosage to start.. he has to take 4 pills and then a few hours later take 3 and so on until his heart rate can go down and be regulated until Tuesday. They also put him on Pradaxa to thin his blood for the next 30 days. I have cut him off of the knives again and anything sharp around the house.

We are going to have a nice low key weekend at home with Baxter... I think some Modern Family Season 1 and 2 are in order. Monday we are going to U of M to meet with Sam's other cardiologist Dr. Bach and go over everything that has been happening. More to come on Monday & Tuesday!

Atrial Flutter

Sam has been experiencing atrial flutter on and off for the past week. Its mainly occurred during cardiac rehab where he is being monitored and each time it happens they alert both U of M and his Beaumont cardiologist. Today it happened during his cool down phase of rehab and unlike the other times this week hasn't gone away. We are currently going on 8 hours and it shouldn't last this long. 


Atrial flutter is is an abnormal heart rhythm that occurs in the atria of the heart. Sam had a heart rate of 155+ in cardiac rehab. A normal heart rate is between 60-100 beats a minute. I got a call late this afternoon from Sam that he was having A flutter and he called Dr. Hanzel's office and we had to go to the emergency room. I bolted home, changed and let out Baxter (I haven't announced our newest Kalef... he is a cute goldendoodle) and got some items to keep me occupied at the hospital. We came up to the hospital where he had the VIP treatment (must be his recent surgery or something ;) and checked his vitals and put us in a ER module room. Sam's heartrate was 135+ when we got to the hospital. They gave him heperain and cardisol and between the two it was supposed to drop down.....it hasn't. So needless to say we were then expedited to being admitted and he will see Dr. Hanzel in the morning. 


I feel like some of this is deja vu... I am up late blogging again in my ever famous costco sweatsuit i love so much and about to sleep in a sweet hospital chair. I think in my next career I will invent amazing hospital chairs and beds! My brother is being so kind to stay at our house with the puppy since he doesn't understand why he was placed in the cage so fast and we left. For now we are hanging out watching tv and I am trying to keep Sam comfortable and not too stressed out. As much as he hates hospitals and doesn't want to be here - I am thankful we are in the right place for this and not home guessing if things are ok or not. 


To lighten the mood I would like to introduce you to Baxter Kalef. Yes, He does speak Spanish and Sam did name him after Anchorman :) He is like a small buddha covered in fur. 

He was born 11.8.11 and is a goldendoodle. He will get to be 20-25lbs full grown. We have had him over a week now and he has adjusted great to our house and schedules. He is starting to find his voice and he loves to get your attention with his little bark but he will start the Sam Kalef Puppy school 101 very soon to correct this! :) We are happy to have him and I think him and Sam have really bonded during the day. 

I will post an update tomorrow after we see the doctor and hopefully get some answers. Thanks for all of the thoughts and prayers - we appreciate it!!

8 Weeks Post-Op Update

Now that the holidays are over and I am finally getting some real sleep I wanted to give everyone a 8 week post-op update.

The main hospital in our area is Beaumont. Sam was signed up to go there for his cardiac rehab but they were in the middle of a contract negotiation between our insurance company (Blue Care Network HMO). Beaumont didn't feel the need to tell us or U of M that they weren't going to accept Sam into the cardiac rehab program due to the negotiation situation. After a few phone calls Sam is now going to Crittenton Hospital for his cardiac rehab program.

Sam goes three times a week for a hour each session. They hook him up to a heart holter monitor and watch him closely as he does his session. They did see a few PACs (Premature Atrilal contractions) on his monitor strip and alerted Sam. They feel similar to PVCs but appear in the left atria of the heart. We were very pleased that the nurses during his rehab session printed off a holter monitor strip and sent it to both our surgeon, Dr. Bolling and cardiologist, Dr. Bach at U of M. By the next day both the surgeon's office and cardiologist's office called to talk to Sam. They say these are common to have post-op but should they happen more often or cause arrhythmia issues he needs to head to the nearest ER.

Sam has an appointment scheduled with his U of M Cardiologist Dr. Bach on Valentine's day (fitting right?). He is going to do an exam and do his first post-op echo to check on the hearts size and compare from over the summer when it was at its largest. This way we will have a baseline moving forward to see how much the heart continues to go down from the surgery.

With Sam starting to feel a bit better you may even catch him out and about... I can finally give him some errands to run ;) And his cooking has never been better!