David finally had his heart catheterization tonight, and I finally got to speak with his cardiologist in person.
The procedure went well, and David is SO happy to be able to eat again!
I sort of don't know how to go about writing this post. I'll just do my best to say what the doctor told me. David will definitely need heart surgery. Dr. Pohwani, his cardiologist, wants to refer us to a surgeon in Sacramento. He is hoping the hole in David's heart will be able to be patched through a catheterization process rather than through open heart surgery. This surgeon will consult with us and let us know if David is a good candidate for this or not. If not, then he will have open heart surgery instead.
I was asking a LOT of questions, and I think the doctor thought I was resistant to surgery (which wasn't the case - I just really wanted to know the details especially after having been told by someone else earlier that there could be a problem with patching his heart because the right side is bigger than the left - as I was writing about in my last post). Anyway, the doctor looked me in the eye and said, "If he has another stroke, he will die."
I reassured the doctor very quickly that I was not resistant to surgery but that I just wanted to understand as fully as I could.
He told us we were very lucky. We are lucky we had warnings, because they could have been fatal rather than being warnings. He also told us we were very lucky that he received tPA in ER, that this was a "true stroke, a major stroke." Dr. Pohwani said that if David had not received the tPA he would have been left permanently paralyzed on his left side.
David will be in a different room at Memorial tomorrow morning and early afternoon (on second floor in telemetry), and then he will be transferred to a rehab facility. He will be put on Coumadin rather than the Aggrenox he is on now as a blood thinner.
We are sure learning to live one day at a time. I have no idea how long he will be in rehab. I have no idea how long it will be before surgery. A few days ago I was told it would be a couple of months before surgery so he could get his strength back, but tonight Dr. Pohwani was talking about getting him in "as soon as possible." I don't know what that means - maybe "as soon as possible" IS a few months; I don't know. At the time of the surgery, if he is able to have the cath type he will be in the hospital in Sacramento for about 5 days with that. I really don't know what the time frame is, but it looks like a rather long road ahead, yet we are finding ourselves able to take it one day at a time.
I was really impressed with Dr. Pohwani. David was not supposed to have been his patient, but for some reason he ended up doing David's first test. He told me tonight he wanted to stay with this case because it really scared him. He told me David is only one year older than he is. He seems to really identify with David. I'm really grateful for the personal interest Dr. Pohwani has taken in David's case.
I'm not sure what he meant, but Dr. Pohwani said this has really been on his mind, and he's been puzzling over it for two days trying to understand what is going on with David, which is why he ran so many tests. I'm just so thankful he was so very, very thorough.
I truly do believe that David will recover fully. I am very confident about that. The one thing that is fearful for me right now is that for 5 to 7 days before his surgery he will have to be taken off the Coumadin in order for his blood to clot regularly again. That window of time scares me after having heard the doctor say tonight that another stroke would kill him. I think for those 5 to 7 days I won't be able to sleep at all but will be wanting to watch over David all the time. I don't even know if that is a rational fear or not, but it is the only fear I'm feeling right now - that window of time.
I'm so grateful for the technology that is available - that they are able to send a "camera" right into David's heart to see what is going on. I'm also so grateful for the medication tPA. I'm grateful too for all the well-trained medical personnel who have been working with David.