Just got a phone call from Melissa at Northwestern University. Dr. Rigolin (Cardiologist) and Dr. McCarthy (Surgeon) have fully reviewed Joel's records.
He needs open heart surgery-- mitral valve repair-- as his posterior valve is fully ruptured and while the anterior valve is a little loose – it’s nothing too bad. They are very confident they can REPAIR the valve and insert a ring to tighten the area up rather than having to a replacement. WHOO HOOO!
They, too, are amazed that Joel has no symptoms as the rupture is significant. His ejection fraction rate (how heart pumps blood) is around 35 percent and they’d like it to be around 55-65 percent. They want to move fast and get this corrected before more damage occurs. The repair should help improve his overall heart function.
We will be headed to Northwestern next Thursday, April 30th, to meet the doctor and surgeon. Joel will undergo another ECHO (to make sure no more damage has occurred since the last set of tests). Surgery will occur, most likely, within the first or second week of May.
While open heart surgery is a big deal, we are SO thankful to God that this has been caught before too much irreparable damage has occurred and that we have surgery as an option. Dr. McCarthy’s area of expertise is mitral valve surgery.
Joel will be in the hospital for 5-7 days after the surgery and then come home for 8-12 weeks of recovery of which he will not be allowed to work. He also won’t be able to drive for 4 weeks after his surgery and will be on Coumadin and low blood pressure medication during his recovery – with the end goal – to win him off over time.
Thank you for all of your prayers, support and love. Keep those prayers coming because they are working!
We are looking forward to getting this behind us so that we can enjoy the summer with our girls and hit all the fun chicken fry’s on Lake Springfield with Miller Lites in hand :).
With Love,
Michelle
PS – Melissa you are a GODSEND! Thank you for everything!!!
Friday, April 24, 2009
Monday, April 20, 2009
Things do happen for a reason...
This weekend my Aunt Carla called to see how we were doing. I expressed my frustration that things were moving SLOWLY and that I felt like a gerbil in a cage --spinning my wheel as fast as I could yet getting nowhere. I also expressed how I felt Joel was just a “number” to many people and likened our experience, thus far, to being in a herd of cattle.
Carla offered me some reassurance in saying all things happened for a reason and that God had us in the palm of his hand and we needed to trust in Him. Yes, I know this but I did need a reminder. Thank you, Aunt Carla. I felt so much better after our call.
Within 2 minutes of hanging up with her, I had received an email from my lifelong friend’s (Derek Fraley) fiancé, Melissa Shyrock. Melissa had read Joel’s blog and emailed me to see how we were doing. While I knew Melissa was in the medical field – I wasn’t sure to what capacity.
Through our exchange of emails, I found out that Melissa is a Physician Assistant of Cardiothoracic Surgery at Northwestern Medical Faculty Foundation in Chicago and she works for Dr. Patrick McCarthy.
After a few emails back and forth, Melissa and I had a long phone conversation about our situation. She immediately offered to help in anyway that she could.
Dr. McCarthy is specialist for Joel’s particular heart condition. Prior to accepting a position at Northwestern, Dr, McCarthy practiced at the Cleveland Clinic Foundation from 1990 until March 2004 with Dr. Lytle. Dr. Lytle is the doctor at Cleveland Clinic that Joel was referred to.
Honestly, I couldn’t believe I couldn’t my ears (or rather cochlear implants :)).
Melissa offered to get Joel’s records read by Dr. McCarthy for another opinion and I quickly took her up on her offer.
Melissa called me first thing this morning to let me know that she had spoken to the doctor and he was awaiting our medical records and would review them as soon as they received them. Talk about customer service!!!
I am picking up all of Joel’s records at 2pm this afternoon and will be FEDEXing them to Northwestern today. They should have them by tomorrow morning. The doctor will then review them and make a determination on if he thinks he can help us and then schedule us for a consult and more testing.
Wow! Had Joel’s records not been delayed in getting to CC, we would have probably already had an appointment there. Of course, we are not ruling out any options and if CC is where we need to be then we will go there. On the other hand, I can say, without a doubt, I know Joel wouldn’t just be a number at Northwestern. Melissa has offered to be our medical advocate and assist on Joel’s case. Melissa, thank you from the bottom of my heart, words can’t express my gratitude.
For those of you asking what you can do to help? Please pray that Dr. McCarthy has the experience, expertise and knowledge to help Joel.
Once again, I am reminded that things do happen for a reason. And, yes, Aunt Carla, God does have us in the palm of his hand.
Love, Michelle
About Dr. McCarthy
Patrick M. McCarthy, MD
Previous | Search Again | Return To Results List | Next
Medical Education: Loyola University Stritch School of Medicine 1980
Residency: Mayo Clinic-Rochester
Fellowship: Mayo Clinic-Rochester 1988
Fellowship: Stanford University Hospital 1989
Board Certification: Thoracic Surgery (Cardiothoracic Vascular Surgery)
Specialty: Cardiac Surgery
Clinical Interests: Valve Repair/Replacement, Mitral Valve Repair, Atrial Fibrillation Surgery, Maze Procedure, Aortic Aneurysm, Coronary Bypass Surgery, Hypertrophic Cardiomyopathy / Myectomy, Minimally Invasive Surgery
= This doctor accepts new patients. For important legal notice, click here
Request an appointment Electronically (new patients only)
You may also call Northwestern Memorial's Physician Referral Service at 1.877.926.4NMH (4664) to arrange an appointment
Biographical Sketch | Publications
Practice Contact Information
Website: www.nmff.org
675 N. St. Clair, Galter 19-100
Chicago, IL 60611
P: (312)695-4965
View Map
Please contact the physician's office to verify that your insurance is currently accepted.
Biographical Sketch
Patrick M. McCarthy, MD has distinguished himself as both a clinician and researcher in the field of cardiac surgery. On April 1, 2004, Dr. McCarthy became professor of surgery at Northwestern University's Feinberg School of Medicine; co-director of the Bluhm Cardiovascular Institute; and the chief of the division of cardiothoracic surgery at Northwestern Memorial Hospital. In recognition of his continued, outstanding achievements, Northwestern University's Feinberg School of Medicine named Dr. McCarthy the Heller-Sacks Professor of Surgery on November 9, 2006.
Until March 11, 2004, Dr. McCarthy was the surgical director of the Kaufman Center for Heart Failure at the Cleveland Clinic. While there, he was the first occupant of the George M. and Linda H. Kaufman Endowed Chair.
Dr. McCarthy has achieved national and international recognition in the fields of complex adult cardiac surgery including, valves, cardiac transplantation, mechanical ventricular assist devices, coronary artery bypass, minimally invasive surgery, aneurysm repair and atrial fibrillation ablation. He has performed several thousand heart operations, averaging 400 per year. He has authored or co-authored more than 300 papers and 30 book chapters. He is on the editorial board of four medical journals and is a member and officer in numerous professional societies.
He was one of the youngest surgeons ever to be elected into the prestigious American Association of Thoracic Surgeons at the age of 38. He has given over 325 lectures, has been Visiting Professor 34 times and has lectured on six continents.
Dr. McCarthy developed the Edwards "MC3" three-dimensional annuloplasty system for the repair of tricuspid regurgitation. He also recently modified this three-dimensional design concept to develop a ring to repair the mitral valve called the "Carpentier-McCarthy-Adams IMR Et logix" ring. He has more patents pending and projects underway to facilitate other valve operations, minimally invasive heart operations, and catheter-based approaches to valve disease.
Dr. McCarthy is a graduate of Notre Dame and Loyola University, Stritch School of Medicine. He completed his general and cardiac surgery training at the Mayo Clinic and completed a special heart and lung transplantation fellowship at Stanford University Medical Center. He practiced at the Cleveland Clinic Foundation from 1990 until March 2004.
Carla offered me some reassurance in saying all things happened for a reason and that God had us in the palm of his hand and we needed to trust in Him. Yes, I know this but I did need a reminder. Thank you, Aunt Carla. I felt so much better after our call.
Within 2 minutes of hanging up with her, I had received an email from my lifelong friend’s (Derek Fraley) fiancé, Melissa Shyrock. Melissa had read Joel’s blog and emailed me to see how we were doing. While I knew Melissa was in the medical field – I wasn’t sure to what capacity.
Through our exchange of emails, I found out that Melissa is a Physician Assistant of Cardiothoracic Surgery at Northwestern Medical Faculty Foundation in Chicago and she works for Dr. Patrick McCarthy.
After a few emails back and forth, Melissa and I had a long phone conversation about our situation. She immediately offered to help in anyway that she could.
Dr. McCarthy is specialist for Joel’s particular heart condition. Prior to accepting a position at Northwestern, Dr, McCarthy practiced at the Cleveland Clinic Foundation from 1990 until March 2004 with Dr. Lytle. Dr. Lytle is the doctor at Cleveland Clinic that Joel was referred to.
Honestly, I couldn’t believe I couldn’t my ears (or rather cochlear implants :)).
Melissa offered to get Joel’s records read by Dr. McCarthy for another opinion and I quickly took her up on her offer.
Melissa called me first thing this morning to let me know that she had spoken to the doctor and he was awaiting our medical records and would review them as soon as they received them. Talk about customer service!!!
I am picking up all of Joel’s records at 2pm this afternoon and will be FEDEXing them to Northwestern today. They should have them by tomorrow morning. The doctor will then review them and make a determination on if he thinks he can help us and then schedule us for a consult and more testing.
Wow! Had Joel’s records not been delayed in getting to CC, we would have probably already had an appointment there. Of course, we are not ruling out any options and if CC is where we need to be then we will go there. On the other hand, I can say, without a doubt, I know Joel wouldn’t just be a number at Northwestern. Melissa has offered to be our medical advocate and assist on Joel’s case. Melissa, thank you from the bottom of my heart, words can’t express my gratitude.
For those of you asking what you can do to help? Please pray that Dr. McCarthy has the experience, expertise and knowledge to help Joel.
Once again, I am reminded that things do happen for a reason. And, yes, Aunt Carla, God does have us in the palm of his hand.
Love, Michelle
About Dr. McCarthy
Patrick M. McCarthy, MD
Previous | Search Again | Return To Results List | Next
Medical Education: Loyola University Stritch School of Medicine 1980
Residency: Mayo Clinic-Rochester
Fellowship: Mayo Clinic-Rochester 1988
Fellowship: Stanford University Hospital 1989
Board Certification: Thoracic Surgery (Cardiothoracic Vascular Surgery)
Specialty: Cardiac Surgery
Clinical Interests: Valve Repair/Replacement, Mitral Valve Repair, Atrial Fibrillation Surgery, Maze Procedure, Aortic Aneurysm, Coronary Bypass Surgery, Hypertrophic Cardiomyopathy / Myectomy, Minimally Invasive Surgery
= This doctor accepts new patients. For important legal notice, click here
Request an appointment Electronically (new patients only)
You may also call Northwestern Memorial's Physician Referral Service at 1.877.926.4NMH (4664) to arrange an appointment
Biographical Sketch | Publications
Practice Contact Information
Website: www.nmff.org
675 N. St. Clair, Galter 19-100
Chicago, IL 60611
P: (312)695-4965
View Map
Please contact the physician's office to verify that your insurance is currently accepted.
Biographical Sketch
Patrick M. McCarthy, MD has distinguished himself as both a clinician and researcher in the field of cardiac surgery. On April 1, 2004, Dr. McCarthy became professor of surgery at Northwestern University's Feinberg School of Medicine; co-director of the Bluhm Cardiovascular Institute; and the chief of the division of cardiothoracic surgery at Northwestern Memorial Hospital. In recognition of his continued, outstanding achievements, Northwestern University's Feinberg School of Medicine named Dr. McCarthy the Heller-Sacks Professor of Surgery on November 9, 2006.
Until March 11, 2004, Dr. McCarthy was the surgical director of the Kaufman Center for Heart Failure at the Cleveland Clinic. While there, he was the first occupant of the George M. and Linda H. Kaufman Endowed Chair.
Dr. McCarthy has achieved national and international recognition in the fields of complex adult cardiac surgery including, valves, cardiac transplantation, mechanical ventricular assist devices, coronary artery bypass, minimally invasive surgery, aneurysm repair and atrial fibrillation ablation. He has performed several thousand heart operations, averaging 400 per year. He has authored or co-authored more than 300 papers and 30 book chapters. He is on the editorial board of four medical journals and is a member and officer in numerous professional societies.
He was one of the youngest surgeons ever to be elected into the prestigious American Association of Thoracic Surgeons at the age of 38. He has given over 325 lectures, has been Visiting Professor 34 times and has lectured on six continents.
Dr. McCarthy developed the Edwards "MC3" three-dimensional annuloplasty system for the repair of tricuspid regurgitation. He also recently modified this three-dimensional design concept to develop a ring to repair the mitral valve called the "Carpentier-McCarthy-Adams IMR Et logix" ring. He has more patents pending and projects underway to facilitate other valve operations, minimally invasive heart operations, and catheter-based approaches to valve disease.
Dr. McCarthy is a graduate of Notre Dame and Loyola University, Stritch School of Medicine. He completed his general and cardiac surgery training at the Mayo Clinic and completed a special heart and lung transplantation fellowship at Stanford University Medical Center. He practiced at the Cleveland Clinic Foundation from 1990 until March 2004.
Monday, April 13, 2009
Hurry up and wait.
Sigh. So, we've been waiting and waiting and waiting for Joel's records to get to Cleveland. They were to get there Monday of last week. However, they didn't get there until Thursday. Dr. Lytle began reviewing them on Friday and as luck would have it...the films were bad and he couldn't read any of the records. So, they called the Springfield office and requested they resend the records. Stuff like this just irritates the heck out of me. To make the situation more unnerving, Dr. Lytle is out this entire week on vacation so he won't be able to read the films until next week. Finally, they won't let us schedule an appointment until the records can be read to ensure Dr. Lytle is the right Dr for Joel. I will post more when I know more.
Hope everyone had a Happy Easter!
Michelle
Hope everyone had a Happy Easter!
Michelle
Monday, April 6, 2009
The I'm Sorry's
Hello. First, I would like to apologize to our friends and family who've reached out to us over the past few weeks and have not received a reply, update or response from us. We've been a bit overwhelmed and I am sorry I have not done a better job in following up with each of you. I personally want to thank everyone who has sent cards, e-mails and words encouragement; but, most importantly, for your prayers. Keep them coming!
Anytime I have new information about our situation, I will make a blog post. To follow my blog postings, simply click on the right hand side of this page and click "follow" and follow the directions on the screen.
The Beginning
Let me start from the beginning...every 36 months, Joel has to go for his flight physical so that he can maintain his private pilot's license. As such, in February, he went in for what we thought was a routine exam which included an EKG. Shortly thereafter, Memorial Hospital called and left a voicemail on our home answering machine (which we rarely check) and indicated Joel "might want to follow up with his cardiologist." A little weird but not alarming...if it were something bad, they would have called and spoken to us directly, right? Hmm. Still makes me wonder how many people get voicemails like we did and disregard them. Secondly, Joel doesn't have a cardiologist. But, with some nagging from me, Joel made an appointment Dr. Mishkel at Prairie Cardiovascular. We've gotten to know Dr. Mishkel as he is Joel Sr's cardiologist. He is really second none at Prairie. I like him alot.
The Gut Instinct
I decided to go with Joel to his appointment although Joel repeatedly told me I didn't need to go because it would be a huge waste of my time. In all seriousness, Joel thought he was going to go see him and would get his medical records signed off and be released that day. Those you that know me well...know that I have highly sensitive intuition. Come hell or high water, I wasn't missing that appointment. I'm glad I didn't ignore my instincts.
The Waiting
We waited for about 45 minutes before they called us back. We were the youngest people in the waiting room by about 30 years!
Once in the room, the nurses did their assessments and then said the doctor would be in. More waiting. More Joel telling I was wasting my time. After about an hour, Mishkel came in and said he was really glad to see us. But, really was not sure why we were there. So, we explained...flight physical...voicemail indicated we should follow up and it seemed natural for us to call him since had gotten to know our family through caring for Joel Sr. He quietly sat at his computer reviewing all of Joel's medical records electronically for what seemed like an hour...a few times telling me to be quiet. ;) Then listened to Joel's heart and did a few more assessments. At that point, he stood up and said that he needed to go see a few more patients very quickly and that he would come back because he wanted to give us his undivided time and attention. RED FLAG.
The Confusion
Joel and I sat confused. We had just done 8 miles of biking, jogging and walking on Sunday followed by 4 more miles of jogging on Monday night. Furthermore, Joel has been on a diet since October of last year and has lost over 40 pounds. He has never looked or felt better.
The Initial Diagnosis
Upon his return, Dr. Mishkel informed us that Joel had severe Mitral Valve Prolapse (MVP) characterized by the displacement of an abnormally thickened mitral valve leaflet into the left atrium that was ripped both on the anterior and posterior. The MVP was also causing Mitral Regurgitation (MR), a valvular heart disease also known as Mitral insufficiency or Mitral incompetence, which is the abnormal leaking of blood through the Mitral valve, from the left ventricle into the left atrium of the heart. This in turn was causing the left chamber of his heart to be enlarged. Note: Joel was diagnosed with MVP when he was nine and it's really never been much an issue other than him having to take antibiotics preceding dental work.
The Recommendation
Due to the severity of the valve rip, both on the anterior and posterior, Dr. Mishkel indicated that he felt that we might be better served at Cleveland Clinic where they had more experience in repairing severe valve issues such as Joel's. Okay, wait, back up. Prairie is rated in the top 2 percent in the nation for being a leader in cardiovascular. Huh? You can't treat him here? That really freaked me out.
Mishkel indicated that because of Joel's young age of 42 he definitely recommended that the valve be replaced rather than repaired. He wasn't even sure if it could be repaired but if so, the number one specialist for valve repair was at Cleveland Clinic. The advantages of repair compared to replacement are many...high success rate of returning to normal, less likely to have to take a lifetime of medications like blood thinners, etc. Enough said.
The Next Steps
In order to make the referral to CC, there were two more tests that had to be done: 1. a TEE and 2. A heart cath.
The Boring Medical Definitions
The TEE an alternative way to perform an echocardiogram. A specialized probe containing an ultrasound transducer at its tip is passed into the patient's esophagus. This allows image and doppler evaluation which can be recorded. The advantage of TEE versus an echocardiogram is that TEE's usually produce clearer images, especially of structures that are difficult to view through the chest wall. The TEE results would show us how badly the valve was ripped and if there were any hopes for repair.
The heart cath is the insertion of a catheter into a chamber or vessel of the heart. This is done for both investigational and interventional purposes. Mainly, they wanted to ensure that Joel didn't have any blockage. This test was being done as more preventive in nature.
The Testing Day
Joel was admitted to Memorial on last Friday morning to undergo the test. Talk about a long 15 hour day of waiting.
The Results
The TEE results were actually good news. After further diagnostic testing, results indicated that Joel's valve was actually only "mild to moderate" rather than "severe". The specialist indicated he felt Joel was a good candidate for heart valve repair rather than replacement. Momentary sigh of relief and BIG praise to God.
The heart cath results were not as good. This test indicated that Joel's heart was weak and was more enlarged than what they first suspected. Furthermore, they felt that it was more genetic rather than being caused from the valve. To explain, doctors initially thought that his valve was causing his heart muscle to be weak and significantly enlarged and that repairing it would fix the issue. However, now, they are not sure. To clarify, they are not certain that repairing the valve would be a good option as with any surgery there are alot of risks involved and they don't know if it will improve the condition of heart because it is not the cause or root of his problem. Rather than having one issue -- he has three.
The I Don't Knows
Basically, Dr. Mishkel indicated he didn't quite know how to clearly explain the test results because Joel has several very concerning issues going on that were "far and above his pay grade". I appreciated not only his honesty and true compassion but also him readily admitting he didn't have the knowledge to make further assessment. That doesn't mean I liked what he had to say. All in all, there are LOTS of unknowns and Dr. Mishkel has reassured us that they will do everything they can to figure out what is going on and get us to the right place.
The Referral
We are in the process of being transferred to Cleveland Clinic. The letter was faxed to our insurance company today and I talked to Mishkel's office 3 times as well as CC. Everyone has been so wonderful and caring. I love the secretary at CC. Joel will be seeing Dr. Lytle at CC. Mishkel's office overnighted all Joel's records today and they will arrive at CC in the morning. The doctor at CC will then review Joel's record and then a consultation will be scheduled. I will let you know via this blog as soon as we get a consult appointment at CC. It should be within the week. They are NOT jacking around (a little Michelleism for you) with any of this.
The Hope
The Miller Family Heart & Vascular Institute at Cleveland Clinic is one of the largest cardiovascular and thoracic specialty groups in the world, treating patients with severe heart, vascular, thoracic and esophageal conditions. We trust that Joel will be in the best possible hands possible and that they will have options for us. Most importantly, we trust in God and know He listens to our prayers. Please keep us in yours.
With Love,
Michelle
Hello. First, I would like to apologize to our friends and family who've reached out to us over the past few weeks and have not received a reply, update or response from us. We've been a bit overwhelmed and I am sorry I have not done a better job in following up with each of you. I personally want to thank everyone who has sent cards, e-mails and words encouragement; but, most importantly, for your prayers. Keep them coming!
Anytime I have new information about our situation, I will make a blog post. To follow my blog postings, simply click on the right hand side of this page and click "follow" and follow the directions on the screen.
The Beginning
Let me start from the beginning...every 36 months, Joel has to go for his flight physical so that he can maintain his private pilot's license. As such, in February, he went in for what we thought was a routine exam which included an EKG. Shortly thereafter, Memorial Hospital called and left a voicemail on our home answering machine (which we rarely check) and indicated Joel "might want to follow up with his cardiologist." A little weird but not alarming...if it were something bad, they would have called and spoken to us directly, right? Hmm. Still makes me wonder how many people get voicemails like we did and disregard them. Secondly, Joel doesn't have a cardiologist. But, with some nagging from me, Joel made an appointment Dr. Mishkel at Prairie Cardiovascular. We've gotten to know Dr. Mishkel as he is Joel Sr's cardiologist. He is really second none at Prairie. I like him alot.
The Gut Instinct
I decided to go with Joel to his appointment although Joel repeatedly told me I didn't need to go because it would be a huge waste of my time. In all seriousness, Joel thought he was going to go see him and would get his medical records signed off and be released that day. Those you that know me well...know that I have highly sensitive intuition. Come hell or high water, I wasn't missing that appointment. I'm glad I didn't ignore my instincts.
The Waiting
We waited for about 45 minutes before they called us back. We were the youngest people in the waiting room by about 30 years!
Once in the room, the nurses did their assessments and then said the doctor would be in. More waiting. More Joel telling I was wasting my time. After about an hour, Mishkel came in and said he was really glad to see us. But, really was not sure why we were there. So, we explained...flight physical...voicemail indicated we should follow up and it seemed natural for us to call him since had gotten to know our family through caring for Joel Sr. He quietly sat at his computer reviewing all of Joel's medical records electronically for what seemed like an hour...a few times telling me to be quiet. ;) Then listened to Joel's heart and did a few more assessments. At that point, he stood up and said that he needed to go see a few more patients very quickly and that he would come back because he wanted to give us his undivided time and attention. RED FLAG.
The Confusion
Joel and I sat confused. We had just done 8 miles of biking, jogging and walking on Sunday followed by 4 more miles of jogging on Monday night. Furthermore, Joel has been on a diet since October of last year and has lost over 40 pounds. He has never looked or felt better.
The Initial Diagnosis
Upon his return, Dr. Mishkel informed us that Joel had severe Mitral Valve Prolapse (MVP) characterized by the displacement of an abnormally thickened mitral valve leaflet into the left atrium that was ripped both on the anterior and posterior. The MVP was also causing Mitral Regurgitation (MR), a valvular heart disease also known as Mitral insufficiency or Mitral incompetence, which is the abnormal leaking of blood through the Mitral valve, from the left ventricle into the left atrium of the heart. This in turn was causing the left chamber of his heart to be enlarged. Note: Joel was diagnosed with MVP when he was nine and it's really never been much an issue other than him having to take antibiotics preceding dental work.
The Recommendation
Due to the severity of the valve rip, both on the anterior and posterior, Dr. Mishkel indicated that he felt that we might be better served at Cleveland Clinic where they had more experience in repairing severe valve issues such as Joel's. Okay, wait, back up. Prairie is rated in the top 2 percent in the nation for being a leader in cardiovascular. Huh? You can't treat him here? That really freaked me out.
Mishkel indicated that because of Joel's young age of 42 he definitely recommended that the valve be replaced rather than repaired. He wasn't even sure if it could be repaired but if so, the number one specialist for valve repair was at Cleveland Clinic. The advantages of repair compared to replacement are many...high success rate of returning to normal, less likely to have to take a lifetime of medications like blood thinners, etc. Enough said.
The Next Steps
In order to make the referral to CC, there were two more tests that had to be done: 1. a TEE and 2. A heart cath.
The Boring Medical Definitions
The TEE an alternative way to perform an echocardiogram. A specialized probe containing an ultrasound transducer at its tip is passed into the patient's esophagus. This allows image and doppler evaluation which can be recorded. The advantage of TEE versus an echocardiogram is that TEE's usually produce clearer images, especially of structures that are difficult to view through the chest wall. The TEE results would show us how badly the valve was ripped and if there were any hopes for repair.
The heart cath is the insertion of a catheter into a chamber or vessel of the heart. This is done for both investigational and interventional purposes. Mainly, they wanted to ensure that Joel didn't have any blockage. This test was being done as more preventive in nature.
The Testing Day
Joel was admitted to Memorial on last Friday morning to undergo the test. Talk about a long 15 hour day of waiting.
The Results
The TEE results were actually good news. After further diagnostic testing, results indicated that Joel's valve was actually only "mild to moderate" rather than "severe". The specialist indicated he felt Joel was a good candidate for heart valve repair rather than replacement. Momentary sigh of relief and BIG praise to God.
The heart cath results were not as good. This test indicated that Joel's heart was weak and was more enlarged than what they first suspected. Furthermore, they felt that it was more genetic rather than being caused from the valve. To explain, doctors initially thought that his valve was causing his heart muscle to be weak and significantly enlarged and that repairing it would fix the issue. However, now, they are not sure. To clarify, they are not certain that repairing the valve would be a good option as with any surgery there are alot of risks involved and they don't know if it will improve the condition of heart because it is not the cause or root of his problem. Rather than having one issue -- he has three.
The I Don't Knows
Basically, Dr. Mishkel indicated he didn't quite know how to clearly explain the test results because Joel has several very concerning issues going on that were "far and above his pay grade". I appreciated not only his honesty and true compassion but also him readily admitting he didn't have the knowledge to make further assessment. That doesn't mean I liked what he had to say. All in all, there are LOTS of unknowns and Dr. Mishkel has reassured us that they will do everything they can to figure out what is going on and get us to the right place.
The Referral
We are in the process of being transferred to Cleveland Clinic. The letter was faxed to our insurance company today and I talked to Mishkel's office 3 times as well as CC. Everyone has been so wonderful and caring. I love the secretary at CC. Joel will be seeing Dr. Lytle at CC. Mishkel's office overnighted all Joel's records today and they will arrive at CC in the morning. The doctor at CC will then review Joel's record and then a consultation will be scheduled. I will let you know via this blog as soon as we get a consult appointment at CC. It should be within the week. They are NOT jacking around (a little Michelleism for you) with any of this.
The Hope
The Miller Family Heart & Vascular Institute at Cleveland Clinic is one of the largest cardiovascular and thoracic specialty groups in the world, treating patients with severe heart, vascular, thoracic and esophageal conditions. We trust that Joel will be in the best possible hands possible and that they will have options for us. Most importantly, we trust in God and know He listens to our prayers. Please keep us in yours.
With Love,
Michelle
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