LVAD Partners, Caregivers, Heroes

      In early April, two years ago, as I lay in St. Marys Hospital of Mayo Clinic in Rochester, MN, with a newly minted LVAD, I had no notion of exactly or even approximately what was happening.  Drugs will do that to you. 

      The wheezing was gone as was the shortness of breath.  I wasn't ready for a workout on the dreadmill. I'd get to that in due time.  I didn't know I couldn't walk.  But I was alive and didn't need to pinch myself to ensure I wasn't dreaming.

      I knew that implanting the tiny pump was open heart surgery.  I knew that but had no concept of the scope of the operation or its aftermath.   I did not know that I was bleeding near the LVAD and would have to be opened up twice more in the next 10 days for a tuneup.  The bleeding was stopped.  Third time is a charm, right?

     However, the Mayo team also had to deal with blood that seeped into my lung cavity. That was resolved without so-called "chest cracking" (a sternotomy, the term for the inline, vertical incision made along the sternum) using instruments that entered the plural cavity through my rib cage.

      My constant companion was at my side.  Call her my wife, my LVAD partner, my caregiver or what you will. She is the hero of this story.  For the patient, the role is essentially passive.  It was up to the surgeons, nurses, and others on the staff to install the heart assist device, the HeartMate II, and keep me alive. For the LVAD partner, the roller coaster of emotions is unfathomable if your not in her shoes.

     Open heart surgery is no walk in the park.  Who knew?  Not me.  I was so far out of it that I do not remember signing consent forms for each of the procedures.  My signature was shaky and crooked.  I would have consented to just about anything.

      For the LVAD partner, I can only imagine the level of anxiety propelled by the unknown.  Life or death hung in the balance.  I was out of it. Watching and waiting is mind numbing.  Nothing prepares one for the role of LVAD partner, particularly since I had a short decision making window.  It was less than a week between being life flighted to Rochester from Fargo and the implant operation.  Some recipients have weeks or months to make a decision.  The pump looked to me like something for the toilet plumbing but if it worked, I was ready.  Let's do it.

     It was a hell of a ride but I'm here to testify to the positive result.  Another wag said that every day above ground is worth it. The alternative is always there. 

     During the first two weeks after implant, I became vaguely aware of the medical team's morning rounds.  They seemed to appear from somewhere stage right like a Greek chorus, 10 or 12 of them, huddled in discussion outside my room.  Then two white coated team members came in and briefed me and Dolly on what was happening to me, my progress, if any, and the next step they planned to take.  Then the doctors retreated and the Greek chorus shuffled out of sight stage left.

     My LVAD partner, my wife Dolly, was there throughout all the days.  She was bedside taking notes on what the doctors said. She read to me and was there for me. She had a notebook to write thoughts and questions for the medical team.  I had no idea of what she was going through.  I've heard only some of it.  I know she's pleased with the result.

     Gradually in the hospital, I became aware that I was "tethered" to a machine by a cable.  It was the Power Module. Essentially the Power Module transforms regular current to the low level required to operate the LVAD.  Batteries by day; PM by night.

     At first I was unaware of the required bandage changing on the percutaneous (through the skin) lead site. The percutaneous lead or drive line required a dressing change using sterile procedures once a day.  The site was an open wound that eventually healed around the wire.  The wire carried power to the HeartMate II through a small computer system controller. The system controller has two other wires that connect to the batteries that power the pump.

     Before Dolly and I left the hospital six weeks later, we had learned how to care for the drive line site.  We learned so much more, including for me, how to walk and use stairs.

     I have a greater appreciation for the mantra attributed to the Navy commandos, the SEALs, of whom I have only a passing knowledge as a retired Navy captain. Their mantra:  the only easy day is yesterday.

     Experience shows that heroes often don't have a clue about what they have done and are doing.  They say they were just doing their jobs.  My LVAD partner is my personal hero.  I love you Dolly.