Tuesday, July 14, 2009

Teamwork

When friend Jeff and I were autocrossing regularly, we got pretty good at planning our approach to a course before we each made our first run. We'd watch other drivers, occasionally time them, note where they placed each wheel, watch which turns they struggled with and how they improved on subsequent passes. Between our runs we'd compare notes on weight transfer, braking points, exit speeds, and adhesion limits ("it's either sticking or it's going in the trees!"). Our pre-run planning and mid-race adjustments often paid off, for not only did we improve our times on every run, we'd both finish at or near the top of our classes. Working together made both of us better drivers.

As Ann Marie and I seek a path forward with my heart condition, we're seeing my doctors rely on the wisdom and expertise of their peers in much the same way. While we found more questions then answers in my appointment today, we're comforted knowing some very smart people are on the job.

Now to the details. We want to share the pertinent info so everyone has it, but know we run the risk of glazing your eyes over (as ours sometimes do). Sure, we might lean on you for wisdom or support, but we promise we won't quiz you on specifics as long as you do the same for us :-)

That said, this morning's CT scan shows the narrowing is in the pulmonary artery, at the point where the donated tissue meets mine. The valve itself is doing fine, which is great. If the doctors and we conclude a surgical replacement of the affected area is our best option, there's a fair chance this longer-lasting valve can be spared. Regardless, the man-made material used in a new artery would set me up for a simpler surgery if and when the valve needs to be replaced.

But surgery isn't necessarily the only option. A possible alternative still being discussed is the balloon and stint procedure I mentioned in a previous post. To succeed, it would need to widen the artery without causing the pulmonary valve to leak, or at least leak significantly. A valve that leaked too much would again lead to surgery, perhaps on the same day. A delicate decision, considering the degree of narrowing.

To reinforce the team, our surgeon has recommended two respected Ross procedure experts be consulted. One doctor is from St. Louis and the other Philadelphia, the latter primarily a pediatric surgeon where the Ross procedure is a necessity since the living tissue grows with the child. We're all for more expertise.

What these doctors will also consider, assuming I have surgery, is our surgeon's suggestion for a related preventative procedure. The car analogy, if crude, comes to my mind: "if you're going to replace the timing chain you might was well replace the water pump". In my case, it's a portion of the aortic artery which has widened since surgery. It isn't causing any problems, but could in the future. Like the problem with the pulmonary artery, the widening of the aortic artery is something that happens to many Ross procedure patients. For me, it just happened a lot sooner than most.

We'll sort all this out over the coming weeks. We appreciate your thoughts, prayers, and help. In the meantime, I think it's time for some more autocrossing :-)

2 comments:

Anonymous said...

Again, my prayers are with you! This has to be one of the toughest decisions to make--ever! The only tougher one? If it is your child....

And I had no clue that the procedure was actually named the "Ross procedure" seeing that Dr. Ross was my sister's very first cardiologist at GW so many years ago. There was mention of the "balloon" thingy back then, brand new stuff; he was instrumental in developing and perfecting it. We were so proud to have such excellent doctors on her case! Small world, getting smaller everyday!

Further, 2-D echo-cardiograms were just beginning that amazing journey of looking inside the heart without having to cut it open. We were lucky enough to have one of the doctors there show us (after her successful surgery) the video of the procedure, where we could see the heart beating, the tumor bouncing around in the blood flow--awesome! They've come so very far since....

Susan, Rob's wife

Maggy said...

thinking of u