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Monday, June 27, 2011

LVAD Warriors - and how one little fish can change a demeanor!

Sometimes in your world things just happen.  There is nothing you can do about them, so why not just face the inevitable and walk on?  Brave statement, indeed; but not so easy to do. 


Realizing what might make your LVADer happy while in the hospital can be taxing.  Personally, I finally remembered that Joe loves fish - not to eat, to watch - so I finally got smart and went and bought him a little beta to keep him company when visitors weren't there - or as a dialogue opener for the bazillions of medical personnel who interrupt your life on a continuous basis (do they really need to weigh you at 4 in the morning?).  One of the administration nurses came up with the name VAD - how appropriate - so VAD became pretty famous on the rehab floor in the Heart/Lung Center.  


All of our LVAD families have had to drastically change their lifestyles due to this medical wonder, most (no matter what the experience) are grateful to have been handed this new lease on life.  It's a fine line you must walk to keep yourselves from being passive when it comes to what an LVAD has to offer.  Sometimes people are so lulled into this numbing experience that they are almost afraid, or too proud, to step up and ask questions that could make a major difference in their care or peace of mind. It's okay to have an opinion, it's okay to speak up, and it's okay to disagree (if you have the facts to back you up). 


When you first come on the scene you are made to feel like everyone is part of the "team" - but sometimes you have to remind the "experts" - that your recipient and you as wingman (caregiver) - are the most important part of that "team" - without you and others willing to take a chance on this medical marvel (and it is pioneering/experimental) there would be no "their part" of this team.  


I have become a bit bolder since first coming on to the scene - and I must say that that is due to my own conscious and upbringing but also because of some pioneering women, who have come before me, that have stood up and are counted. 


Since, the LVAD "explosion" - communication has gotten so much better between people who are involved with an LVAD world.  There will be those who are "versed" in Thoratec, who I loving call "Thoratechys" they are soldiers who want the world to know what a perfect thing this can be and won't utter a negative word about things that happen, and there are those that I call "Warriors" who touch reality and try to make changes while still being grateful for theirs or their loved ones lives.  


There will be those who will say, "I did it with no pain medications after the first or second day", and those who can't do it like that - we all carry our pain differently and some have great inner strength (or they're just plain crazy :) ) but remember that it doesn't make them better than anyone else - just makes them different.  Nothing that helps you recover - your way - should make you feel less than anyone else or ashamed of how you did it.  This goes for caregivers (wingmen) also.  Everyone handles stress differently, and, quite frankly, I don't know how any of us makes it through without a trip to the local funny farm for ice baths and frontal lobotomies.  


In the LVAD world we are all the same, either we carry an extra piece of machinery around to keep us walking, talking and loving - OR - we care for those who are walking around with that extra piece of machinery.  I say, "Cheers to us all".  We are mighty, we are powerful, we are at times sobbing pieces of sponge - but we are all one of the ultimate survival stories.  


For our LVAD Warriors we are providing bands that portray us "LVAD Warriors"... to get yours send an email to tootsgran@gmail.com        If you can, a dollar donation would be appreciated, if you can't you will still get your bracelets.  

Wednesday, June 22, 2011

Let's Talk About Your "Wingman"

Being the recipient of an LVAD is not the only way to go through life, with the emotional challenges (as well as physical) thrust upon us in such a hurried manner.  As primary caregivers you will experience, first-hand, every ounce of those challenges as closely as the recipient themselves.  Sometimes your challenges will be greater than their's, because you not only have to worry about doing the right thing for the recipient but also the right thing for your families and yourselves.  The major obstacle is to figure out how you (the caregiver) are going to overcome, adapt and improvise (to borrow a phrase from the Marine Corps and Clint Eastwood (Heartbreak Ridge, 1986)).

Big Bang Theory's "Wingman" clip

I would not be presumptuous enough to begin to give you an "instruction book" on how to be a "wingman".  I have no degree in psychology, family counseling or any other credentials that would make me worthy to do so, and my On the Job Training (OJT) is in it's infant stages.  Besides those particular facts, everybody's experiences and personalities are different and as individual as snowflakes.  How can I possibly tell you how to hang onto your own identity when sometimes I feel like I have lost my own?

Here seems to be the top 3 fears we wingmen have the most:
 1.  Feeling trapped and having an inability to sleep because you are concerned about your "ward".
 2.  The fear of doing just one little thing "wrong" and make healing/recovery harder (or impossible) for our "charge".
  3. Scared to death you will not know "how to intervene" should something "malfunction", no matter how much training you've gone through.

To the people that did this study I say, "DUH!!!!!!!!!!!"  I'm wondering how much that study cost them? (Findings from:  Cardiac Assist Devices, Daniel J. Goldstein, Mehmet Oz.  Chapter 14:  Quality of Life Issues Associated with the Use of Left Ventricular Assist Devices, Peter A. Shapiro, M.D.)

What I have learned from fellow "wingmen" and recipients is that everyone's experiences are different and, interestingly, everyone's geographic location holds different "bags of tricks".  Some change dressings daily, and some every 4 days - and not everyone uses the same equipment, not only for dressing changes but for daily use.  Recommendations from clinics are as different as there are days in a month.

The most major point of this blog chapter is that since our journey's beginning, the cyberspace LVAD world has grown rapidly, and connecting to all of these fantastic resources is a major goal of ours.  If you deal with LVAD (in any way shape or form), or have in the past, help us all out by contacting us - and giving us your "wealth of knowledge".

On May 3, 2011 the Veterans put out the following press release, announcing that they will start paying caregivers, even if they are immediate family:


VA to Take Applications for New Family Caregiver Program
VA Implementing Enhancements to Existing Services
for Veterans and Their Caregivers


Although this applies to post-911 caregivers, I'm hoping that they will recognize the rest of also.  I have attached the link to the letter here:  http://www.va.gov/opa/pressrel/pressrelease.cfm?id=2088

To all the LVAD Warriors out there - Have a great day!!!!!!

Sunday, June 19, 2011

Ummmm Hello Higher Powers - We're Still Here and I Can't Begin to Thank You

I cannot possibly begin to explain the comings and goings of the last 6 weeks.  It seems so impossible to me that it has been so long since the mind numbing, world collapsing times of May. 

By the grace of whatever powers of the Universe my husband and I are still a couple.  Absolutely freaking amazing.  To defy all the odds, to stay one step ahead of complete disaster, fate....I just cannot tell you what a feeling that is.  

Joe, thankfully does not remember anything past being in the parking lot on our way in to the Heart Failure Clinic, here in Salt Lake City on May 10th.  I have always told the clinic that they needed to change their name, because it sounded so "fatalistic", but that day we were the epitome of that name.  Joe's wonderful, life-saving HeartMate II had failed us, failed our family, failed the doctors, had failed the staff, had failed our friends.  I heard phrases like "unprecedented", and thought words like "why us"? 

I have kept my blog going with facts, figures and pictures that hopefully will help LVAD families, because it was the only thing I could think of to do.  And now, here it is 6 weeks later and I am finally climbing out of my fog - one rung at a time. 

Last weekend our youngest daughter and her friends came to visit and this weekend (Father's Day weekend) our middle son, daughter-in-law and 5 month old grandson graced us with their presence.  Seeing them has afforded me the opportunity to start my climb back.  It made me realize that Joe and I still have a life other than the one we have been forced to occupy in the last six weeks.

You know how people talk about how "your stars align" when good things happen?  Well, I've been thinking about that a lot lately.  I think how if just one breath, one step, one anything had happened differently, I would not have the opportunity to be writing this particular blog chapter.  The fact that we decided that staying close to the hospital was the "right thing to do", which put us only 5 minutes away when our crisis began, the fact that Dr. C happened to be here in the hospital and could start operating on Joe, because Dr. R was already in surgery saving another patient, the fact that that particular day when we walked in, that (the other) Dr. R. and the rest of the staff in the clinic, although they had never seen "hemolysis" (red blood cells bursting) knew exactly what was happening - everything, absolutely everything went as perfectly as it possibly could, the fact that Dr. C. stayed in the OR when Dr. R. finally was able to get there (having two top notch cardiac genius surgeons working together), the two of them working so carefully and diligently to get that humongous blood clot (the size of an Italian sausage) out without letting any of it break off and travel somewhere that could have killed Joe.  I could go on and on - but you get the gist, "our stars were aligned".  

So instead of going through anymore of the horror story - let's concentrate on the miracle of our ordeal.  Because of the hemolysis, Joe's kidneys went on a "vacation" - it could have been a permanent vacation - but 6 weeks later they're back in working condition.  The miracles just keep on coming.  He suffered a few strokes during the crisis - but they were not debilitating - just minor inconveniences - lost some hearing, a bit of weakness in the right arm, worries about aspirating and not knowing it kept him on tube feedings for 5 weeks - but we're back to food again.  Are you amazed yet?  I certainly am. 

So now we work on getting a bit stronger and then, hopefully, we get back on that road to transplant.  

So what is our LVAD lesson here (?), because we are all for letting our experiences help the other LVAD families of the world - Never, ever, ever give up hope.  AND to the LVAD pioneers that have come and gone before us - thank you so much for getting us to where we are today.

Three more observations:  First, sometimes people that received LVADs check out for a while, in our case they had Joe in a medically induced coma for a few weeks, and they can have some very scary things happen inside their subconscious - Joe relayed to me, just this last week, that while he was in his head having these "scary times" he could hear my voice telling him that "every thing's ok", "I'm right here", "Don't worry - We got this" - "I love you".  He said it's what he held onto and that I kept bringing him back from his hallucinations - so remember - THEY CAN HEAR YOU - talk to them.

And second, these were times that I have no idea how I, personally, made it through sane.  Through the toughest times of this, besides my immediate family and a few lifelong friends, I had the support and love of fellow LVAD "Caregivers" that I have met through Facebook.  These ladies, "my ladies", are not even close to my geographic location but they got me through - they were tireless, amazing and the most awesome people in the world - so to Jamie, Tracy, Lisa and Rebecca - my lifelong love and allegiance.  My advice to others - use us, use others, make those networks that will keep you going. 

And third, to Joe, my Joe, you are an amazing human being - thank you for picking me to live your life with, and thank you for fighting so hard to come back to me.

Friday, June 10, 2011

Batteries - the "What to Know" - The LVAD word

 What to Know about your Batteries:

  1. Only use Thoratec's PBU to charge HeartMate batteries. Other battery chargers may
  2. damage the batteries.
  3. * Do not use batteries below 150 F (-10o C) or above 1050 F (40'C) or they may fail
  4. suddenly. If batteries are below room temperature (68-720 F, 20-230C) during use, their capacity will be reduced. At the low end of the temperature range (I150 F, -10WC), run time will be reduced by 50%.
  5. The batteries should be routinely replaced, approximately every six months, or if operating time is reduced to two hours.
To prevent deterioration or damage to batteries:
  1. Do not drop or subject batteries to strong physical shock. Dropped batteries should be replaced.
  2. Do not leave or store batteries in hot or cold areas (car trunks, etc.) or battery life will be shortened.
  3. Do not directly connect the negative and positive battery terminals.
  4. Do not use expired or defective batteries. Use of expired or defective batteries may result in reduced operating time or abrupt loss of LVAD function.
  5. Recharge used batteries within 12 hours or battery life will be shortened.
  6. Use of expired or defective batteries may result in reduced operating time or abrupt loss of LVAD function.

Monday, June 6, 2011

Stuff to know for LVADers and LVADees

Emergency bag
 
has to be with you "at all times" - ours contains the following:


1.  Emergency procedures card
2.  Stethoscope 
3.  Extra controller
4.  Two batteries at their fullest charge
5.  Latest medications list
6.  Extra little round battery for the controller itself.
7.  Transplant Pager (attached to strap)













Dressing Changing

In the Intermountain Medical Center Heart/Lung unit they recommend changing the bandage once every three days.  Places vary, geographically, on the type of products they use and recommended times for changing
1.  2 face masks
2.  2 hair covers
3.  exam gloves for set up
4.  sterile gloves
5.  3 packages (2 each) Kendall Q-tips (sterile)
6.  1 package (10 sponges) 4 x 4 12 ply (sterile) Accu-Sorb
7.  1 Tegaderm Foam Adhesive
8.  1 sterile 10 ml syringe
9.  2 Power sterile cups 90 ml (1 for chlorhexidine - 1 for sterile water
10. 2 or 3 Tegaderm Film
11. 1 3M Cavilon No Sting Barrier Film (lollipop)

LVAD Fact Sheet
http://www.thoratec.com/downloads/LVAD-FactSheet.pdf

Original FDA approval letter for the HeartMate II 
http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm074231.htm 

Heartmate II - Instructions for Use - pdf file (113 pages)

http://www.accessdata.fda.gov/cdrh_docs/pdf6/P060040c.pdf

Considering Traveling - Check Out Where There ARE LVAD Centers:  (Ever heard of a country named "Reunion" - just kind of interesting looking at it - 2500 sq miles - but has an LVAD Center)
http://www.thoratec.com/patients-caregivers/find-a-center.aspx

Other LVAD blogs:

Tracy Riepl:  http://livingwithanlvad.blogspot.com/2011/06/celebrate-life-donate-blood-rock-on.html


Jamie Burns Pejo:  http://heartslvadsandlifeohmy.blogspot.com/2011/06/welcome-back.html


Michael-Joshua Morris (aka LVADone):  http://fromthebottomofmylvad.blogspot.com

Mac Sinclair: (sorry to report that Mac has passed away, but he pioneered the way for the rest of us - We miss you Mac)  http://heartmateii.blogspot.com/2011/03/tough-times-at-shands.html


The Bruns Family:  http://brunsfamilyfun.blogspot.com/2011/04/easter-2011.html


Monica McFarlan:  http://monicasheart.blogspot.com/2011/06/brighton-my-day.html


Karl Heinz (in German):  http://www.eichler-ac.de/

If you have a blog that isn't listed here - please let me know so I can add yours to this list, and follow your story.