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Thursday, April 25, 2013

My Life at 9200 rpm's: It takes a licking and keeps on ticking.

John Cameron Swayze, the late TV newsman and Timex watch pitchman, made the phrase a well recognized advertising slogan for the wrist watch company in the l950's and into the 1970's.  Once, Swayze met an ocean liner as it landed, removed a Timex from the ship's keel, and uttered "It takes a licking and keeps on ticking."  Well done.

As for me, I'm still ticking with my HeartMate II LVAD, three years and three weeks after implant.  There have been a few challenges but the cardiologists at the University of Minnesota Medical Center, Fairview, overcame them and I and my family and friends are forever grateful.

A kidney infection and signs of a blood clot forming in the pump, caused me to be flown by air ambulance from Fargo to Minneapolis March 20.  I was in and out of the hospital (mostly in) over the next month, returning to Fargo as the Red River of the North tried to make up its mind whether to flood the city.

Because the LVAD is a continuous flow device, it pumps blood at a fixed pace until the pump cannot pump.  My fixed flow is 9200 rpm's, which moves more than five liters through my system every minute.  One effect of this constant flow through titanium is to break up some red blood cells.  

The shearing of parts of red cells can begin the clotting process because the body cannot tell that it should not stop the blood flow.  The doctors use medical terms for all of this but I've reduced it to English.

Since there is no way to see inside the pump, blood tests for things like hemoglobin and plasma hemoglobin have been used as indicators of what is happening within the pump.  Hemoglobin is the blood's oxygen carrying capability.  Measuring plasma hemoglobin gives a view of how many red blood cells are being cutup by the pump.

The point is that if the causes of the cell shearing cannot be slowed, stopped, and reversed, replacing the LVAD becomes a real possibility. The body cannot help itself in deciding to try to clot the perceived wound.  

Fortunately, after IV drug treatment and adjustment of medications that can negatively affect kidneys along with adjustments to other medications, my hemoglobin and plasma hemoglobin values began to stabilize.

No LVAD replacement for me for now.  I continue on the heart transplant list, awaiting a suitable donor heart.  As I've said repeatedly, without my LVAD, I would be toast.




Monday, April 8, 2013

My Life at 9200 rpm's: Hope for the weary heart

In keeping with my commitment to spread the word on the value of mechanical circulatory support devices, The University of Virginia Medical Center in the linked article below offers a snapshot of where matters stand. Left ventricular assist devices are becoming more abundant for congestive heart failure patients.  Simply put, LVADs work.

I've had my Thoratec HeartMate II LVAD for three years and a few days.  The company's website carries a note that some 13,000 HM II's have been implanted worldwide.  

Last year at this time the figure was 10,000.  Progress comes in increments, but 3,000 new pumps worldwide in a year is pretty significant.  Other manufacturers, of course, are not represented in the 13,000 figure.  The more pumps and pump owners the merrier, from my perspective.

Here is the link to the UVA cardiologist's post   http://www.dailyprogress.com/lifestyles/vital-signs-learn-the-facts-about-heart-failure-and-the/article_2001cbf6-98a4-11e2-8164-0019bb30f31a.html

I have continued on my LVAD journey these last few days as an inpatient at the University of Minnesota Medical Center.  I had some symptoms of a blood clot in my pump and a kidney infection to boot.  The infection was resolved with antibiotics.  The clot is another matter.

Since the pump is not susceptible to internal inspection while installed, the docs use a series of tests to confirm their clot theory. Meanwhile, the patient gets a continuing dose of heparin by IV, which is a strong anti-coagulant.  Heparin keeps the blood flowing, avoiding a stroke.

One option for a clot in the pump is to have another LVAD implanted.  Another option is a new heart.  Fortunately for me, another LVAD was ruled out "at this time."  A new heart is the eventual goal, but none is on the horizon.  

I've been on the UMMC heart transplant waiting list since Hallowe'en, 2011.  In that time, I've had two 'dry runs'.  The good news for me is that my HM II has allowed me to have a life awaiting a new heart.  For that I am grateful every day.

Thursday, April 4, 2013

My Life at 9200 rpm's: My third LVAD-aversary and counting

April 2 marked my third LVAD birthday.  Thanks to the skillful folks at Mayo Clinic I got my life back 4-2-2010. There have been some bumps the in journey but three years downrange from implant is a victory in my book.

Since the implant, I transferred my care to the University of Minnesota, where I wait as a candidate on the heart transplant list.

In my internet wandering, I often visit Thoratec.com.  There and elsewhere I read what I can about congestive heart failure, not out of a sense of the macabre but to glean insight into this pernicious disease.

Thoratec's website linked to an account by The University of Michigan of a story about a woman who has had her LVAD since August, 2005.  Like mine, she has a HeartMate II.  She is thriving. 

Here is the link:  http://www.uofmhealth.org/news/archive/201303/meet-joeann-bivins-heart-failure-choir-singing-record-setter