Ridges and valleys

Amanda’s rate was a little lower after a night’s sleep, and the new rate medication had time to kick in. The medication is Flecainide, an anti-arrhythmic specifically made for lowering arrhythmias. So far, she has been on beta blockers, drugs that will reduce her rate, as well as blood pressure (which is typically on the lower side).

Last night, when speaking with the doctor and fellow, I wanted to know precisely where the arrhythmias originated. That is likely not a regular question they get, but we are familiar with the heart’s electrical system and have a basic knowledge of it. The EP told me, but with his accent and unfamiliar words, I couldn’t understand. Once the fellow came in the recovery, I asked him. He told me the first two areas were on the crista terminalis. Then, he explained that it was an area of ridges and valleys. 

The last spot where the arrhythmia popped up was near the sinus node, the heart’s natural pacemaker. If too much damage is done to the sinus node, it will cause the need to have a pacemaker. Amanda had a pacemaker before her previous ablations, so they might have been slightly more aggressive in their approach to ablating that area. I heard the term “do no harm” multiple times from different doctors yesterday and this morning. They could get the arrhythmia but, in turn, might cause more issues. This is the story of our heart journey: fixing one thing causes another problem, and so on and so on. Chasing our tail, so to speak, and we don’t want to be back in that spot. I’m glad they are taking the conservative route and consulting with us to see how much risk we are willing to take.

This might be too in-depth for most, but some may find this interesting. I was unfamiliar with the crista terminalis; it’s not a common area for arrhythmias. I did a little research, and it’s a ridge on an adult’s right atrium that runs between the superior vena cava (what Amanda had bypassed in her first open heart) and the inferior vena cava. The vena cavas are large veins that carry blood into the right atrium, superior on the top and inferior on the bottom. Interestingly, the crista terminalis marks a junction where the embryonic quadrant of the heart and the right atrium come together. The embryonic quadrant is eventually incorporated into the wall of the atrium. 

I found all of this very interesting; I’m amazed at how I once, when an atheist, would’ve just thought this was by chance and of “mother nature”. How can you not see God in something like this? This reminds me of a verse in Psalms. I like this version: You made all the delicate, inner parts of my body and knit me together in my mother’s womb. God knit that heart in someone else’s body, knowing it would eventually be Amanda’s. He has a plan, and we know that, even in the midst of all these trying times, we’ll trust in Him.

All in all, I’m glad all of this is happening here in the hospital. We could be getting treatments and going back and forth from home to Houston, trying to figure it out. We’re in the best spot we can be, the transplant ICU, with our cardiologist leading the team. Yesterday was a low, but maybe we’re climbing back up today. We’ll take it in stride and be grateful for the little things right now.

Last night, our nurse seemed to enjoy our music. I played worship music as he was getting Amanda all situated. He was very flamboyant, singing and humming along—let’s say I didn’t expect that from him! I wanted to update on the rest of last night and add some details. Later this evening, I’ll post on what transpires thoughtout today.