I spent Thanksgiving day with Mom and Dad. Grandpa made the drive from Daytona Beach (about 90 miles each way). Grandpa is 92 and still healthy. In fact he looks pretty much the way he always has. We had a great meal and enjoyed our time together. Tomorrow Mom and Dad are driving me home to Raleigh. It will be great to see my son Max, who is home from college. I have much to be thankful for.
Although tired, I am feeling better each day. Best of all, I have gained 4 pounds since the antibiotics were started.
I am thankful for my family and all the friends who have offered me prayers and best wishes. Here is wishing everyone a happy Thanksgiving.
Thursday, November 27, 2008
Wednesday, November 26, 2008
The PICC Line
I'm out of the hospital and recuperating at Mom and Dad's home in Jacksonville, Florida. This is a good spot for me to rest. It was great to sleep in a regular bed with no one waking me up to draw blood or take vital signs or hang another bag of antibiotics on my IV line.
The bacteria in my system is most vulnerable to a continuous dose of antibiotics. Letting those devils alone for even a short time allows them to regroup, establish a new base, and continue their assault on my heart tissue. In the hospital this is done by an IV line. But I need the antibiotics for four to six weeks. So now I have a pump that delivers the dose almost directly into my heart 24 hours a day.
The method for doing this is called a Peripherally Inserted Central Catheter, or PICC line. A small tube in inserted in my upper arm. From there it follows a vein almost to my heart. I Carry a small pump with me everywhere I go and a small dose of antibiotics is squirted directly into my heart all day and night. It may not be the sexiest fashion accessory around, but it allows the battle to continue while letting me get almost back to normal life. I can't get it wet so swimming is out. My Dad is an expert at wrapping it so I can shower while it stays dry.
My arms are pretty sore. I say arms because there was a complication in the first PICC inserted in my right arm. So they repeated the procedure in my left. But that should heal in a day or two.
It is an amazing bit of technology. I just need to keep it with me. I look like I'm carrying a purse so I will get teased about it. Small price to pay for the benefit it is giving me.
The bacteria in my system is most vulnerable to a continuous dose of antibiotics. Letting those devils alone for even a short time allows them to regroup, establish a new base, and continue their assault on my heart tissue. In the hospital this is done by an IV line. But I need the antibiotics for four to six weeks. So now I have a pump that delivers the dose almost directly into my heart 24 hours a day.
The method for doing this is called a Peripherally Inserted Central Catheter, or PICC line. A small tube in inserted in my upper arm. From there it follows a vein almost to my heart. I Carry a small pump with me everywhere I go and a small dose of antibiotics is squirted directly into my heart all day and night. It may not be the sexiest fashion accessory around, but it allows the battle to continue while letting me get almost back to normal life. I can't get it wet so swimming is out. My Dad is an expert at wrapping it so I can shower while it stays dry.
My arms are pretty sore. I say arms because there was a complication in the first PICC inserted in my right arm. So they repeated the procedure in my left. But that should heal in a day or two.
It is an amazing bit of technology. I just need to keep it with me. I look like I'm carrying a purse so I will get teased about it. Small price to pay for the benefit it is giving me.
Tuesday, November 25, 2008
Test Results
The only really good result from the TTE test would have been that my heart was undamaged by the infection, or that the damage was minimal and did not require surgery. Unfortunately, my aortic valve was damaged and surgery will be required. This will be open heart surgery requiring a week hospital stay, followed by three weeks of limited activity (not even driving) while the chest heals.
The surgery can't be done until the doctors are sure the infection is completely clear, that takes four to six weeks. So the surgery will be sometime early in the new year.
The doctors disagreed about wheather my heart valve is salvageable. One thought a repair job might be possible, the other two don't think so and believe a replacement is required. But all three said that the decision would be made at the time of surgery based on a new TTE test.
The idea of having my chest pryed open and doctors tinkering around my heart is unnerving as hell. But on the bright side, the doctors said I'm an ideal candidate because I have never experienced any chest pains and aside from the valve all the other heart tissue appears undamaged.
The surgery can't be done until the doctors are sure the infection is completely clear, that takes four to six weeks. So the surgery will be sometime early in the new year.
The doctors disagreed about wheather my heart valve is salvageable. One thought a repair job might be possible, the other two don't think so and believe a replacement is required. But all three said that the decision would be made at the time of surgery based on a new TTE test.
The idea of having my chest pryed open and doctors tinkering around my heart is unnerving as hell. But on the bright side, the doctors said I'm an ideal candidate because I have never experienced any chest pains and aside from the valve all the other heart tissue appears undamaged.
Monday, November 24, 2008
The Garden Hose Down the Throat Test
The antibiotics are waging war on the bacteria, and at 72 hours the bacteria is on the run. Unfortunately the little buggers are experts at hiding, kind of like Osama Bin Laden, they find remote caverns and can lay low for long periods of time. Intravenous antibiotics must be delivered for four to six weeks to be sure they are all dead. Thankfully that can be done as an outpatient. I may be let out tomorrow, but that depends on several factors.
Today the doctors wanted to assess the damage done to my heart tissues, particularly the valves, by these nasty bacteria. The test is called a Transeophageal Echocardiogram (TEE). A regular echocardiogram is similar to the ultrasound shown to expectant parents, good enough to see the major structures, but with all the ribs and other tissues, the picture is not clear enough. To get a better look, a TEE puts the ultrasound device very close to the heart, by sliding it down the throat.
The thing is about the size of a garden hose and it is in there for 15-20 minutes. So they gave me some awful tasting lubricant to help it slide down the throat, then thankfully put me under. I felt nothing at all of course, but my throat is a little sore and it hurts a little to talk.
Tomorrow I will post the test results.
Today the doctors wanted to assess the damage done to my heart tissues, particularly the valves, by these nasty bacteria. The test is called a Transeophageal Echocardiogram (TEE). A regular echocardiogram is similar to the ultrasound shown to expectant parents, good enough to see the major structures, but with all the ribs and other tissues, the picture is not clear enough. To get a better look, a TEE puts the ultrasound device very close to the heart, by sliding it down the throat.
The thing is about the size of a garden hose and it is in there for 15-20 minutes. So they gave me some awful tasting lubricant to help it slide down the throat, then thankfully put me under. I felt nothing at all of course, but my throat is a little sore and it hurts a little to talk.
Tomorrow I will post the test results.
Thanks for the Good Wishes
Wow, I am so grateful for all the kind notes and words of encouragement. I'm sorry that I don't have the time to offer a personal reply, but I will when I'm able. I'm sure that all the positive energy and prayers are helping me.
Sunday, November 23, 2008
Diagnosis
Here is what they think I have. Endocarditis.
This sounds kind of bad, some nasty bacteria entered my blood stream and set-up a base of operations in my heart, specifically on my aortic valve. This unwelcome guest can damage things to the point that heart surgery may be necessary to repair the valve.
but I don't want to jump too far ahead of myself. The doctors are intravenously delivering some pretty powerful antibiotics, to battle the bacteria. This began shortly after I was admitted, about 36 hours ago. At the moment I'm feeling better than I have for weeks. The antibiotics may be doing the job.
They have been drawing blood out of me every 12 hours. The bacteria levels are being monitored to see if the antibiotics are killing of the bacteria.
Monday will be another day of testing. There are several tests scheduled to determine if my aortic heart valve has sustained any damage, and if so how much. Once the results of those tests are known, then the doctors will advise me of my options. So I'm going to be pretty anxious until then. But I'm definitely enjoying feeling better.
This sounds kind of bad, some nasty bacteria entered my blood stream and set-up a base of operations in my heart, specifically on my aortic valve. This unwelcome guest can damage things to the point that heart surgery may be necessary to repair the valve.
but I don't want to jump too far ahead of myself. The doctors are intravenously delivering some pretty powerful antibiotics, to battle the bacteria. This began shortly after I was admitted, about 36 hours ago. At the moment I'm feeling better than I have for weeks. The antibiotics may be doing the job.
They have been drawing blood out of me every 12 hours. The bacteria levels are being monitored to see if the antibiotics are killing of the bacteria.
Monday will be another day of testing. There are several tests scheduled to determine if my aortic heart valve has sustained any damage, and if so how much. Once the results of those tests are known, then the doctors will advise me of my options. So I'm going to be pretty anxious until then. But I'm definitely enjoying feeling better.
Why I'm at Mayo - The Midnight Phone Call
I have not been well for several weeks, feeling tired and cold and also losing weight. My doctor has been searching for a cause, but had not found the source of my illness.
At the suggestion of a friend (thanks Clark!) I applied for an appointment to the Mayo Clinic.
I was surprised to be granted an appointment almost immediately. I arrived at 8am Friday to complete the paperwork, met with a doctor promptly at 9am. By 10am I had a schedule of appointments for various tests around the clinic that would consume the next 3 days. Since this was a Friday, the tests were going to take me through Tuesday, culminating with the dreaded Colonoscopy. I was amazed at the efficiency of the place. Each time I arrived at a new station, the records were there and with only a few minutes waiting, I was called in.
By Friday afternoon I was getting tired, but hopeful that all these tests would reveal something. Back at Mom and Dad's, I enjoyed a nice dinner and some quiet time (there is still nothing quite as comforting as Mom's cooking.)
Shortly before midnight a doctor from the clinic called. They had found a reclusive, but nasty strain of bacteria in my blood at it looks very serious. He advised me to come to the Clinic's Emergency Room as quickly as possible. Although unnerving, at least we were on to something. My Dad drove me to the Emergency Room and I was admitted.
The last time I was admitted to a hospital it was 1971. I was in the 7th grade. I got hurt playing football and the doctor thought I might have some internal injuries. Fortunately, I was better the next day and sent home with instructions not to play for a week. I don't think things will be so simple this time.
At the suggestion of a friend (thanks Clark!) I applied for an appointment to the Mayo Clinic.
I was surprised to be granted an appointment almost immediately. I arrived at 8am Friday to complete the paperwork, met with a doctor promptly at 9am. By 10am I had a schedule of appointments for various tests around the clinic that would consume the next 3 days. Since this was a Friday, the tests were going to take me through Tuesday, culminating with the dreaded Colonoscopy. I was amazed at the efficiency of the place. Each time I arrived at a new station, the records were there and with only a few minutes waiting, I was called in.
By Friday afternoon I was getting tired, but hopeful that all these tests would reveal something. Back at Mom and Dad's, I enjoyed a nice dinner and some quiet time (there is still nothing quite as comforting as Mom's cooking.)
Shortly before midnight a doctor from the clinic called. They had found a reclusive, but nasty strain of bacteria in my blood at it looks very serious. He advised me to come to the Clinic's Emergency Room as quickly as possible. Although unnerving, at least we were on to something. My Dad drove me to the Emergency Room and I was admitted.
The last time I was admitted to a hospital it was 1971. I was in the 7th grade. I got hurt playing football and the doctor thought I might have some internal injuries. Fortunately, I was better the next day and sent home with instructions not to play for a week. I don't think things will be so simple this time.
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