Wednesday, July 24, 2013

Cardiac Crisis Continues

After the cardiac pacemaker surgery and the entire trauma that happened during recovery in the PACU (Post Anesthetic Care Unit), I felt exhausted,yet so thankful that this part of Mighty Z’s journey was done.


However, that feeling of elation was short lived. On Saturday, after only a couple days home from the CICU (Cardiac Intensive Care Unit),Mighty Z’s body started twitching, she broke out in a cold sweet and she started telling me her heart hurt. Honestly, at first I thought that she was taking about her incision, but then it kept happening. I waited to make sure that what I was seeing -- what I thought I was seeing after the third time -- was Mighty Z’s cardiac pacemaker going off,  it as if it was mis-firing. I called the cardiologist on-call and she had me bring Mighty Z into the E.R. While there, we had x-rays and an EKG (Electrocardiogram) and we were told all looked good. We were given a pat on our head and  sent home.The next day,Sunday, Mighty Z started exhibiting the same symptoms off and on all day. Again I called the cardiologist. This time the cardiologist asked us to try and ‘tough it out’ until Monday -- she had set aside time in the morning for Mighty Z and the cardiologist was going to try and figure out what was going on.



Bright and early on Monday morning, Mighty Z and I drove to Children’s Medical Center’s Cardiac Clinic to start what turned out to be a long and devastating day. The day started at 8am when we went down for more X-rays, then they downloaded Mighty Z’s cardiac pacer, then they began to make the cardiac pacer firer to see if it was working, then an echo (echocardiogram), then a period of waiting, then another echo, followed by more waiting.


I don’t know if it is because I have spent so many years experiencing bad news that I just automatically pick up the vibe that the doctor doesn’t know how to tell me what is going on, or what he is suspecting, but as they day wore on, I had the feeling that he was going to tell me that I needed to prepare to hand Mighty Z back over to the surgeons to redo the cardiac pacemaker.


I set the stage for Mighty Z’s daddy -- I called him and gave him the information I had gathered just by looking over the shoulder of the Cardiologist as he looked at Mighty Z’s x-rays and echos. Of course Mighty Z’s daddy was hoping I was wrong, but since he had been on the receiving end of bad news about his baby girl, he, too, was resigned to the fact that I was probably right.


As the Cardiologist came back into my room, he took a big, deep breath and told me exactly what I had already figured out. The cardiac lead that goes from the cardiac generator to the left ventricle of Mighty Z’s heart had slipped out, and we were indeed going to have to go back in and fix it. As I spoke to the cardiologist I told him that I understood that these things happen (they had told us that there was a 10% chance of this happening), but thenI began to set a different stage for how I wanted the surgery to go this time around. I wanted a new anesthesiologist, I wanted a different mixture of narcotics and I wanted a CO2 monitor at all times. I do not know if it was my forcefulness, or the fact that I didn’t lay blame on the surgeon, that made the cardiologist take note of what I wanted, but he made sure this time I got what I wanted.



With a heavy heart, I had to call Mighty Z’s daddy and grandmothers and break the news – the second round of bad news in less than a week. I will tell you that Mighty Z handled the doctor’s news with the same grace and fortitude that she has always shown. She said, “Well, at least we can fix this cardiac pacer and it will stop shocking me.”


Once again, not even a week after the first cardiac pacemaker surgery, I scheduled Mighty Z’s second cardiac pacemaker surgery.  And once again, I handed my baby over to the hands of strangers in hopes that this time all would work out.


I will say that this surgery and recovery was easy as pie. Mighty Z woke up in recovery mad, but responsive and breathing, and so far no more shocking from the cardiac pacemaker.


So, the question you may be asking is “how in the world did the cardiac pacemaker lead slip out of her heart?” Well, in recovery after the first cardiac pacemaker was put in, when the Cardiac ICU doctors where trying to resuscitate her, they were a little rough -- and rightly so! When you have to resuscitate a patient and your first thought is to get them to breathe…you aren’t being careful of the incision and the device that was implanted! When Mighty Z came home from the first cardiac pacemaker implant, her little body was covered in bruises from nurses and doctors trying to get her to breathe and be responsive. Every night I kissed those bruises simply because they were symbols of how hard the ICU team worked to make sure my sweet Mighty Z woke up and was able to breathe once more.
We are now two weeks post surgery, the bruises are fading, and so are the nightmares that have haunted my dreams of late. Mighty Z is skipping around, playing her piano and singing like a little bird just as if nothing bad has ever happened to her.


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