Next Step

So everything can change at any time, but at this moment we have some idea of what our choices are.

It is hard to be reminded that every intervention from here on out is high risk. Even doing the angiogram for diagnostic purposes was high risk.  We really can't take anything for granted at this point.  Every day and every moment is a gift.

So here is where we stand.  Her heart is unable to pump effectively at this point due to the first heart attack.  Her left ventricle is basically like a loose sock with too much pressure in it.  The stents originally placed in her right coronary artery after the initial heart attack in June have failed.  Because of the trauma and damage to the left ventricle, she is not a candidate for a ventricular assist device, and at this point, the surgeons here still think the best bet is to try to save her heart.  With everything unresolved with her foot, she is not a candidate for a heart transplant at this time as well.  So we have some big decisions to make in the upcoming week.

The surgeons here would like to again do open heart surgery.   The cardiologist said that this one needs to be left to the "big boys" as it is very complicated, but that the surgeon that is following her case feels that this gives her the best chance of survival and quality of life at this time.  Once inside her chest they want to reconstruct the shape of her heart to be able to help it once again function.  So instead of a boob job, my mother needs to have a heart job.  Best analogy I can come up with at this time.  They also want to graft an artery from her leg to bypass her right coronary artery where that stent has failed and where they think the bleeding around her heart occurred.  

While I am grateful to have an option, it is scary to think of the possible ramifications.  We want to take our best shot at life, but at the same time, we want to feel peace that it is a shot worth taking.   There is no guarantee that we will not once again end up in multi-organ system failure or that she will not code again.  It is scary to think about going back to those really rough days.

The doctor I spoke with tonight thinks that it would be best if this happened in about a week.  He says we can wait longer but there is no way to predict when or if her left ventricle will rupture, at which point she would die instantly.  

Since being here they have changed her meds and her blood pressure has improved.  I asked if she should be trying to be up and moving at all, and at this point we just want to let the heart rest.  In it's current state it will not be able to rebuild itself and we should not add any stress.  It helps put in perspective why the last few days were so hard on her and why we never saw any improvement in rehab.  

So we will talk tomorrow and make a game plan.  Always best to talk about those things when you haven't gone on 2 hours of sleep and the "haha" medicine.  While the new location feels overwhelming, I have a lot of peace about the care my mom is receiving.  We are in the best of hands.

Going to try to sleep in my non reclining chair.  Wish there was more room to climb in bed with my momma. Maybe after the IVs come out from the angiogram we can make that happen.  Fingers crossed.