So today we had pre-op with a doctor and with the hospital. The doctor was what they call the second surgeon. For what Amanda’s is having done they require 2 surgeons to sign off on the surgery. The main doctor doing the procedure is an interventional cardiologist, a doctor that performs catheter based procedures (ie stents, ballon angioplasty, and so on). The surgeon we saw today is a traditional cardiothoracic surgeon, what I like to refer to as the chest crackers! They mostly do open chest procedures working on the heart. From our experience not all but many of these surgeons are tools with a god complex! The one today didn’t seem to bad he was very personable and once he knew I was a railroad conductor, he wanted to know all about trains! He will be in the room tomorrow but barring an emergency he will do nothing but watch.
We had to go through pre-op with the hospital as well, they had to run a few tests also. It took a few hours to get everything done but we were still out for a late lunch. We found a nice little French bistro close by, needless to say we added a few pastries to our snack collection.
After we returned to the hotel we found maintenance men in our room working on a leak, so we had to pack all of our stuff up and move to another room. We have a nice room our points are paying for, it’s a two room suite with a separate living room and a small kitchen. It’s nice to have the extra space when staying this long. I always book us a room with two beds so when Amanda is out of surgery I’m not bothering her while we sleep. Makes us feel like the old married couples who sleep in separate beds though!
We’re still trying to decided if we’re going to go out for dinner or order in. Amanda doesn’t usually eat much the night before surgery but I think she feels like getting out tonight. I found a restaurant not far away that is a fine dining comfort food hybrid we might visit if she wants to go out. The chef is Le Cordon Bleu trained (my alma mater) and traveled Europe so it intrigued me. Do you see the regular occurrence of food in our story!? I guess that comes with growing up in the restaurant industry and being a classically trained chef! We are foodies, love eating out, and trying new places.
Ok so on to the surgery details. Last year Amanda had her tricuspid valve replaced. We initially went in for a repair but the damage to the valve was too great so they had to replace it instead. It was an open heart but done minimally invasive, on her side and between the ribs verses having to open her chest up for the 3rd time. That valve has failed and is allowing the blood to flow backwards from her right ventricle to right atrium. The procedure she is having tomorrow will correct this and is a trans-catheter valve in valve replacement of the tricuspid valve. The procedure is rare and not preformed often and wasn’t even an option a year ago when she originally had it replaced. The type of surgery is new within the last 5 or 6 years but only recently is being preformed on the tricuspid valve.
This surgery is the same as a TAVR (trans-catheter aortic valve replacement) only difference is replacing the tricuspid valve verses the aortic valve. Amanda’s tricuspid valve is bad because of the pacemaker wire that has to go through it to get from the atrium to the ventricle (top to bottom on the right side of the heart). With pacemakers becoming more prevalent and now having been placed in patients for 20 or more years they are seeing problems with this valve in long term pacemaker patients. Although Amanda has only had her pacemaker 10 years they have been in and out of her heart many times with new leads being placed and many other heart procedures, her’s wore out prematurely.
They will go through the femoral artery in her leg and advance a catheter up to her heart and then will expand the valve inside the existing tricuspid valve. The valve looks like and essentially is a valve inside of a stent. At this point the lead that goes through the tricuspid valve is entrapped on the outside of the new valve they placed last year. This is good that it doesn’t go thought the valve but bad because it is a permanent fixture now and can’t be removed. Leads only last 20 or so years, so eventually it will be replaced but will have to stay inside her heart along with the new one. That new lead may need to go through the valve at some point so it can not be a mechanical valve and must be organic. This new one is a bovine (cow) and the previous one is porcine (pig). I’ll hold off on any cow or pig jokes for the moment. When I was explaining to Amanda last year after her surgery that they had to replace the valve and the new one was porcine she asked if she was going to oink! We do have conversations like whether she is a cannibal or not if she eats pork, so the debate continues with the bovine valve being placed now. I’m #teamcannibal but who’s counting. Yes I know, we’re weird and silly but it’s just how we roll!
Amanda will be out of work for a couple weeks at minimum, so she is working on some last minute things for work right now. She should bounce back from this surgery much quicker than the one last year. She was very sore from the last one as you can imagine they spread her ribs apart as far as they would go and took 6 plus hours to get everything done. Ouch, that makes me hurt thinking about it. She should only have an few small incisions in her groin. They might have to go through her neck if they have a hard time accessing things, they didn’t mention that but it has happened before.
We are first case in the morning so we’ll be there bright and early at 5:30. Amanda just mentioned she wanted to go out to eat, so the comfort food chef better deliver! I know everyone wants updates and to know when she’s out, I’ll be posting updates here. So if you are wondering what’s going on you can just check this site, I’ll update it frequently. Amanda won’t have her phone till at least Thursday night, I have to put her on restriction otherwise she drunk texts or comment on FB while she’s still on the pain medicine! Thanks everyone for all the sweet messages, thoughts and prayers. We love you all!