Heart Attack

On June 26, 2011 James had chest pain and shortness of breath so I drove him to Medical City Emergency Room.  I told the ER about his 5.2 aneurysm in his Aorta Arch and he was rushed into the Heart Cath Lab.  The aneurysm was bulging and mildly sclerotic, but had no tears or leaks. The Left ventricular cavity size was severely dilated.  The left ejection fracture was 40-45%.  The left Atrium was moderately dilated. The LAD is 100% occluded.  The right Coronary artery was 100% occuled at the astium.  He was placed in the ICU and dr bowers escorted Michael and I to the waiting room on 4th floor.at 2 o clock am Michael went home and I called back asking to see James.  He refused oxygen and medication until the morning shift arrived and then he ate breakfast, took his meds and allowed the nurse to put on oxygen.  He was transferred to the Advance Heart Failure wing in Building E 5th floor.  That night he asked twice to make the bed stop moving, but the nurse explained that it was the air mattress circulation movement he felt.  He grabbed up his pillows and blankets and wanted to go outside to sleep.  His nurse said he could not allow James to sleep outside but that they would change out the bed.  He got James to bed and we went to sleep.  The next morning everything was fine, but there was a note on the door alerting everyone not to disturb until 5:45 am.  He was dismissed and went home with instructions to follow up with Dr Rosenthat.  I stated we had appointments at the VA and would follow up with the Vascular Clinic and Cardiologist care at the VA.  On July 7 he had a CT Scan of his heart.  July 12 he saw his doctor, July 14 the orthopedic specialist and then on July 15 the Thoracic Clinic.  His blood pressure was extremely low at all clinics.  His doctor asked that I bring copies of his heart cath to his Thoracic appointment and Cardiologist Appointments. On July 15 the Thoracic specialist said that the aorta aneurysm was smaller but the root was weakened.  Thoracic would follow Cardiologists lead if he had any heart surgery then they would repair the Aorta at the same time.  Tomorrow James and Michael will go to the Cardiologist Clinic and hopefully we will have some answers.  Today the Dermatologist Clinic called to set up an August appointment for his back moles.  I tried to get the cardiologist Clinic to change his appointment to one of the days we were already at the clinic but no...so I will get the news by phone as I take care of my own issues.

Broken Arm

10 weeks ago, While exiting the Waffle House, James slipped his flip/flop on the cement bumper and fell breaking his fall with his right elbow.  We went over to Medical City and after an ex-ray showing a fractured radial head, the nurse put James' arm in a brace from fingers to shoulder.  Poor James needed help with toileting and bathing which the girls did not volunteer to perform.  The next day we went to the VA to talk with his primary doctor who has to request consults.  She sent James for another ex ray and to the Orthopedic Clinic.  The doctor recommended that he continue to use the sling but removed the brace.  After 6 weeks the fracture was slightly displaced and not mending.  The doctor told James not to lift anything heavier than a dinner fork and return in 4 weeks.  James was declared healed on 7/14/2011.   

Vascular Lab 3/11/2011

I took James to his follow up appointment at the Vascular Lab.  The PA Davidson explored the incision site with hands, looked at the fading purple and read the CT reports.  He recommended 6 more weeks of recovery before Jim could participate in Physical Therapy.  I had him complete FMLA papers for the follow-up appointment so that I would not be docked after returning to work.  I asked him about the last Aorta Aneurysm that was measured at 5.1.  He said that within 6 months to a year the aneurysm could grow the last CM that would require surgery.  James has an appointment in July with the Thoracic Surgeon to discussion the Aorta Arch aneurysm.  Open Heart surgery will be necessary to correct the Aorta arch aneurysm. James came through Open Heart surgery and cranial surgery really well in the past and this last aneurysm surgery went really well so hopefully he will bounce back from the next one, however all of us are worried.

3/23/2011-3/25/2011 VA Hospital

James spent the first night in SICU with close supervision by the nurses and good doctor updates.  The doctor was concerned about the excessive bleeding on the right side due to calcification of the iliac artery. The surgeon said two doctors applied pressure for 45 minutes trying to stop the bleeding and there is a chance that they may need to go back in if the bleeding began again.  He was hungry and awake.  The lounge on 5th floor has soft recliners and couches with wide screen TVs.  The next day he was moved to 4th floor.  Past experiences had me recommending James' IVs and catheter being removed as soon as possible.  Also I requested a patch, but James was up roaming before the patch could be approved,  He sent me to get him coffee.  When I took the elevator to the basement canteen, I found him walking down the hall.  His pants were wet.  I guess when he got on the elevator the downward pressure forced the urine out for the first time since the catheter was removed.  I took him back to the room and told him I was going to get coffee from the vending machine down the hall.  I found him walking again on my way back. I asked his nurse if I could push him outside to smoke and maybe he would settle the nurse agreed.  They assigned him 1-1 care but James told me to lean back in a chair and put my feet up on the other, so I spent the night assuming he wanted me near.      On 2/25/2011 they dismissed him around 1:00.  Yep, we are all relaxing at home.    He wanted to go to the Waffle House and spent a couple of hours talking to a friend.   He slept until dinner and now is on the phone talking to a friend in Mt Vernon.   He's Very purple moving slowly or very little but acting normal.

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2/23/2011

James had an upside down Y shaped stent combination placed in his abdominal aorta to improve blood flow and to enforce the blooming walls.   He is alert, ate dinner, and already wants to come home.   He will spend 24 hours in the SICU at the VA then may be moved to the 4th floor if no complications develop.   Michael and I came home tonight.   She plans to go to work tomorrow and I plan to spend the day at the hospital until he is dismissed.

3/3/2011 Home again

James came home on Thursday and the stent implants are looking good with no pseudoaneurysms shown on the CT scan .   The purple colors are less vibrant..   He is feeling better.  I am still placing pain pills and stool softeners in both his morning and afternoon meds because it hurts to move around and pass BMs.  The doctor signed for me to provide continuous care for him until his doctor appointment on 3/11/2011 so I am FMLA.

3/1/2011

Yesterday, James went to the VA ER for groin pain on the right side.   The vital nursing assistant ask the RN why she was hooking Jim up to the Heart monitor just for groin pain.   The nurse told her his groin hurts because of surgery.   They admitted him when the Doppler ultrasound reviled a possible pseudoaneurysm.   The left side was still purple from the Hematoma that occurred during the original surgery due to the calcification of Jim's iliac vein.   The DR said that they had to hold the left side for 45 minutes to stop the bleeding.   Today they took a CT SCAN.   The 3rd year South Western Medical Student assigned to Jim's case for the next two days, met with Jim and me this evening.   I teased the girls about the 4 young med students who came to take him for tests. pseudoaneurysm, also known as a false aneurysm, is a hematoma that forms as the result of a leaking hole in an artery. Note that the hematoma forms outside the arterial wall, so it is contained by the surrounding tissues. Also it must continue to communicate with the artery to be considered a pseudoaneurysm.   Abnormal AV fistulas like the one that caused Jims brain hemorrhage are usually the cause of pseudoaneurisms. Femoral pseudoaneurysms may complicate up to 8% of vascular interventional procedures.

VA Hospital

My husband signed the papers finally to qualify for veterian's health benefits and was approved October 2010.  His doctor ran exrays, CT Scans and MRI just like previous hospitals, but the difference is we are kept informed of the results and follow up appointments are scheduled by the doctor to address areas of concerns like a small growth on his right lung, aorta aneurism, and pancreitis.  His expensive heart  medication were ordered with little to no co pay and arrived in the mail. Next week we will talk with the Thorastic Surgeun about his Aorta Aneurism.