The 3 Month Check Up

July 22, 2016

Today is Den’s 3 month check up for the Momentum III Study. We have our first of many appointments at 7AM. So we are up and at it very early today.

We arrived at UofC in plenty of time for Den’s echo cardiogram at 7AM.  This is the test where they take ultrasound images of the heart and valves to see if there are any problems. It usually takes about 30 minutes once the tech starts taking pictures.

Next, Den had his 6-minute walk. He used the walker, just to make sure he didn’t fall. Den walked 430 feet today, but he could have gone farther. He didn’t walk the entire time. He lost his wind and couldn’t get it back in time to walk more. I think he started too fast and his body could not keep up. The good news is that he walked 6 feet further than the last time and he walked all 6 minutes the last test 2 months ago. So there is definite improvement in is walking.

Next, we went over to the device clinic to meet with the LVAD team. We had some questions for them. Like, Den not sleeping at night…even with a dose of malatonin. They suggested adding a medication that would help Den sleep and would also help with his arthritis. (They sent a script to our pharmacy.) What about PT? Home health care was ending. What now? Well, next Den needed to go to Cardiac Rehab. It is out patient and we could choose where we wanted to go. Almost every hospital has a Cardiac Rehab in or near the facility.

Now we got on to the LVAD stuff. Den’s drive line site looks great. No signs of infection or irritation! We could now go from daily dressing changes to every 3-4 days or even weekly if we wanted. We would need a different kind of dressing. This one has a clear “window” so we can see the drive line and monitor it for any changes between dressing changes. The team sent us home with a month’s worth of dressing kits. Den had been feeling a little sluggish the last 2 weeks, so the team increased his LVAD speed to 5400rpm. This should give Den a little more energy.  We all noticed that Den had a little fluid retention in is legs. It had been creeping in over the last few days. The team gave us the instructions to increase his Lasix to 60mg in the morning and 40mg in the evening for the next 2 days. They told us that if Den had a PI consistently below 2.0 to call them. (I found out later that this is an indicator of dehydration.) They also wanted to schedule a procedure called a RAMP Study. This is done in the CATH lab. They insert a probe into the heart, drop the LVAD speed to it’s lowest setting, increase the speed by 100rpm increments and take readings at each changes in speed. They pick the most optimum speed for the patient and make that the set speed on discharge. This is done outpatient and you are home later that evening.

Finally, before we left the clinic, we met with a group doing a new study. This study was to see if an ICD and LVAD would work together to help keep a patients heart in good condition. Den immediately signed the paperwork. We were told Den would get an IPAD with a daily quality of life survey and a fit bit to use during his time in the study…about 3 months.

Before we left the facility, Den needed a chest x-ray and some blood work, so off we went. By the time we got home, we were all exhausted. It had been a very long day and we were all glad to be home and resting.

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