Heart Evaluation is Done…It’s Showtime!

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With Sandra and Fr. Francisco

Left Ventricular Assist Device (LVAD) – “The left ventricle is the large, muscular chamber of the heart that pumps blood out to the body. A left ventricular assist device (LVAD) is a battery-operated, mechanical pump-like device that’s surgically implanted.”  -American Heart Association, 2018

On March 31, 2018, Sandra and I anxiously sat at a circular table in a small office at Kaiser Santa Clara Medical Center’s Heart Transplant Clinic. We listened intently as the department’s social worker explained to us various options available to address my worsening heart failure. It was the first of several orientation meetings we had scheduled that day.

The transplant portion of her presentation was encouraging and exciting. When she described the LVAD – the controller, the batteries, the electrical wire sticking out of the abdomen – a few things crossed my mind: Nope, Nah, Not Me, Ain’t Gonna Happen! Needless to say, I wasn’t too excited about the proposition of implanting an artificial anything into my body.

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HeartWare Ventricular Assist Device

When the social worker asked if I had any questions, my response was simple and straightforward. I’m all in on the transplant. Let’s just put the LVAD on the backburner. After being connected to a multitude of life-support machines in the ICU throughout the summer of 2010, I resolved to never put my family through that kind of emotional horror again.

Last Friday, I got a call from my cardiologist with great news. After a 7-month long rigorous evaluation, the Stanford Hospital transplant committee accepted my case and placed me on the list, effective immediately. According to the United Network for Organ Sharing, a non-profit that manages the national organ transplant system, I’m one of 3,900 people currently on the list. Because there are only about 2,000 donor hearts available each year, it can take up to 2 years to make it to the top of the list.

The problem is that my heart is so sick that surviving the next couple of years could be challenging. The United Network for Organ Sharing estimates that 20 people die every day in the United States waiting for an organ transplant. With that in mind, the heart transplant team has been pointing me toward implanting a LVAD sooner than later to ensure my other organs stay healthy while I’m waiting for a new heart.

That brings us to the beginning of this process in the social worker’s office. At that time, I didn’t even want to consider the LVAD. When Sandra and I first presented this interim step to the girls, they agreed that I should take the LVAD option. The barriers to my deliberations included the memories of 2010 and my philosophical belief to not accept life-saving contraptions for no other sake that staying alive.

As I was deliberating this question, I again found myself sitting next to a round table in a small office. This time, I was visiting with Monsignor Francisco Rios, a longtime friend and spiritual advisor. He correctly analyzed that the LVAD isn’t merely a life-support system. It’s a bridge to my ultimate goal of a transplant. In that spirit, he thoughtfully provided me with a meaningful path of reflection.

From there, I went out and picked the brains of family and friends. I did research and read the latest literature about the technology.  Sandra and I participated in a support group with LVAD and transplant recipients. We kept the girls updated about everything we learned. As I continued through the evaluation process, it became clear that the LVAD was the smart option to stay healthy while waiting for a heart.

At the conclusion of the evaluation, the doctors’ recommended implanting a LVAD. That’s the surest and most effective way to prepare for a successful transplant. As I write this blog post, LVAD surgery is just a few days away. An amazing team of doctors, nurses, and health professionals are meticulously getting ready to perform what seems like a miraculous procedure.

The LVAD is high-tech device made up of four components (1) mechanical pump, (2) controller, (3) driveline cable, and (4) batteries. The pump, made of titanium alloy, has a base 2 inches in diameter with a stem an inch tall. Oxygen travels through the bloodstream from the lungs into the pump. The pump then delivers blood into the body.

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Illustration of implanted device

The controller is a computerized box-like device about 4 inches wide, 6 inches long, and an inch thick. It’s the nerve center that operates the pump. Connecting the pump and the controller is a driveline cable. A regular electrical outlet and specialized batteries to allow mobility power the whole operation. LVAD patients carry the components in a shoulder bag or fanny-pack style belt when moving about.

The operation to implant the LVAD pump and the driveline is major open-heart surgery. The surgeon will make an incision in the chest and cut through the chest bone to gain access to the heart. He will slice into the muscle to provide a tunnel into the left ventricle (lower heart chamber) and sew a titanium ring onto the muscle to keep the hole open. The stem of the pump is inserted into the ring until it clicks into place. The operation takes from 4 to 6 hours.

During the last week or so, I’ve met with the healthcare providers who will be on hand for the surgery. They are an awesome group of professionals that has vast experience in this emerging cutting-edge technology. The surgeon was part of the LVAD design team at Stanford Hospital before being wooed by Kaiser Santa Clara Medical Center to create the program there.

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Image by clarionledger.com

As I prepare for LVAD surgery and the next phase of my life, I’m ready in heart, mind, and soul. I’ve developed good relationships with my healthcare givers. I believe that they’re rooting for me as much as they are performing their professional duties. Sandra, the girls, and I have a faithful support system that has been without equal. God is guiding me every step of the way.

If you ever find yourself in a seemingly hopeless predicament, be it medical or otherwise, I hope my story encourages you to follow a similar path. A strong trust in God, loving family, and supportive friends will carry the day. You just need to take it on with hope, faith, and love.

 

 

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