Last Night

Hi Everyone

Once more night is upon us and before I retire here is a report of the day. Andrea had the Ng tube installed yesterday, she was not very happy about it, but they are using it to feed her and it works but not very well as her stomach is not tolerating it very well because of her poor cardiac function. This morning paeds and adult transplant doctors had a conference to formulate a plan for Andrea, so this afternoon we had a meeting with three of them. Their findings and also past experience indicates that her heart function will not improve on it's own and in fact will likely deteriorate further quite quickly. They all agreed that she is eligible to be retransplanted and so tomorrow they will relist her and begin the workup for it like blood studies etc. Really they have most of the info needed to proceed but need to doublecheck some things. In the meantime they are highly recommending a VAD implant for her ASAP. Could be this week yet or early next week. They say that would be a 10 hour surgery, not because it is so complicated, the actual installation is only 1 to 1.5 hours, but they have to proceed slowly and be sure all bleeding is under control as they encounter it. It is a fairly simple plumbing job, sew a cannula into the left ventricle and insert another one into the aorta. They say that they routinely do heart surgeries far more complicated and risky than this, like rebuilding babies with hypoplastic heart syndrome where the ventricles are not fully developed. Still, this VAD implantation carries a fair exposure to risk and should not be approached lightly. They are finding that it is alot more successful to be somewhat aggressive and do these implantations early rather than late while the patient is not in end stages of heart disease. This is a very scary proposition first of all for Andrea and for us as parents. They view this implantation as a bridge to retransplantation, if she does well with it she would be delisted for 3 to 6 months for her to recover well, if not they would actively look at retransplantation. These devices are also used as destination therapy, older people have them and improve to the point that they have recovered to the enough that they are very comfortable with the device and do not desire a transplant. There is an older gentleman in Edmonton who asked them to take him off the transplant list, he was able to do many things he could not do for a long while before, now he plays a lot of golf. So please pray for us that we will make the right decisions on Andrea's behalf, also she will very much need the love and support especially of her close friends.

Goodnite, Maynard