Heart Working

Jun 18 6:28pm – R had a restful day.  Still offloading fluid at a fairly predictable rate.  Jessica called and R is scheduled for a 10am or 11am visit to the OR to remove the ECMO.  R is the second patient tomorrow so the time is predicated on when the first patient is complete.  I got the impression that she will be Dr. Bond’s second patient of the morning.  Not sure if the team will attempt to close her, too, or just remove the ECMO and put her on her own heart and then wait and see.  I gave consent to remove the ECMO several minutes ago.  I am somewhat assuming they will at least get the ECMO out and see how stable she is and then, perhaps, close her a bit later.  But that is my assumption.  Laura says R will probably end up in CVRR again after the surgery so we will be back down in the OR underground camp ground waiting for results tomorrow.  The place gives me the willies, frankly.  Anyway, her old friends milrinone and epinephrine will begin dripping at midnight to begin preparing her heart to take on the duties it needs to assume tomorrow.  This is, frankly, a pretty big deal.  As said before, there was some concern that the new heart may have been stressed too much initially due to the excessive on-board fluids the first time the bypass machines were removed.  This time around, much is being done to prepare R for the assumption of duties by her new heart.  C’mon new heart!  I will get a new tooth in the morning around 8am (you can cheer!) and then R will maybe get her new heart back around 11am.  I wonder if R will be impressed with the karma of this whole ‘new tooth’ vs ‘new heart’ thing?  (Answer: No!)  Seriously, R can never have enough prayers and we will need lots and lots of patience and understanding for the next 48 hours.  This – it would seem – is the Big Kahuna!

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