Three Months Old Today

Good morning everyone,

Yes, it is early, very early in the morning. My Mom and Dad can finally heave a sigh of relief and can head off home. It’s been a marathon day for all of us; me being in two long five hour procedures, and my folks pacing the passages awaiting news of my progress.

Since my last posting, which was at about midday, a lot has happened. As you are aware, after my first procedure, which didn’t yield all the desired results intended, I was sent back to the ward, intra-theatre, which basically means I was kept in the same state I was under when in theatre. This meant that the sheath in my femoral vein remained in, and I was kept hepranised (i.e. my blood was kept thinned to avoid any kind of clotting). Furthermore, I was kept semi-sedated, which has made the writing of the blog a little more difficult than usual.

At about 4:30 in the afternoon, I was collected again to go to theatre. I was truly impressed by the surgical team that had done an afternoon of procedures, and then were still keen to operate on me for another 5 hours. These guys are truly amazing. One of the theatre nurses even came in from being on leave to take care of me.

All in all, the second procedure was successful, with the outcomes of the morning’s procedure laying the ground work. Prof. Fourie, a truly remarkable and ingenious man, managed to coil a micro catheter five times over in the fistula in my head during the morning procedure. These coils would then begin to lay the foundation of the remaining work that was done earlier this evening. Shortly after arriving in theatre and the final preparations were completed, Dr Mennen, a maestro in his field, made an incision in the back of my head. Through this incision another catheter was passed, inside which the Amplatzer PFO Occulder was housed, waiting to fulfil its mission. Slowly and meticulously the catheter made it way to the fistula, and once there, the occluder was deployed. Success! A world first had been achieved. Basically the Amplatzer PFO Occluder is actually intended for repairing holes in the heart, and never before was it used in the head. It was so awesome that a representative, Jennifer, from the company was present to witness this usual event. (Click here to view an animated video clip of an Amplatzer PFO Occluder being deployed in a heart.)

Once the jubilation of the successful deployment of the Amplatzer PFO Occulder had settled around the theatre, the next big objective was started, which was to position platinum coils into the fistula behind the occluder that had just been deployed. The idea was that the occluder would prevent the coils from being flushed away, which was the problem encountered during the morning’s procedure. Before long, one, two, three, four, and so on coils were installed, one after the other, each one being a reason to celebrate. The micro-catheter that was wound around in the fistula also assisted in ensuring the coils would not be flushed away.

The second five hour procedure of the day began to conclude, and pretty soon I was on my way back to the ward. I really felt very special as almost all of the two theatre teams that attended to me during the procedure walked with me back to the ward, with my Mom and Dad in tow. I could hear from their voices of delight that they were choking back tears and had frogs in their throat.

Although this was a watershed moment for me, the journey is still going to take a while before I’m on the full road to recovery. First and foremost, I have to go back down to theatre later in the morning to have the sheath from my femoral vein removed – it was through this sheath that the coils were administered. I must point out that the catheter, running from my groin to my head, will always remain a part of me, as it is attached to the coiling of the micro-catheter in my head. There is no way this could have been cut at the fistula and extracted. Subsequently it will be terminated at my groin, during a small procedure tomorrow. Secondly, while I’m in theatre, there is a chance I will need to undergo an angiogram.

I also need to report that the late evening was a really tussle for me. I was really struggling to have my stats settle. Different machines were tried, machines were recalibrated, to no avail. The paediatrician on duty, Dr Lewis, battled long and hard to settle me. After lots of trials I was taken off the conventional ventilator and put onto an oscillating-ventilator, similar to the one that I was on when I was last intubated at Morningside Medi-Clinic. The intention behind this was to reduce the amount of CO₂ that was in my body. Apparently the oscillating-ventilator is great at extracting high levels of CO₂. Some time later more chest x-rays were taken and all seemed in order. Eventually all settled, and I drifted off to a deep sleep.

Well, that’s about all for this early morning. Prof Fourie provided some digital images of my procedure, which I have posted below, with a small explanation of each underneath. To any medical practitioners out there reading this blog, please forgive me simple terminology in describing what is depicted in the diagrams, and secondly, if I have incorrectly reported something, please leave a comment on the blog for other readers’ benefit.

Last but not least, I must thank all my supporters out there. You are all so incredible, and I get a lump in my throat when I think of how much love there is out there, from strangers, friends and family alike, all rooting for me, praying and sending me lots of positive energy and wishes. Throughout my procedure I could feel the presence of all the wonderful angles and guardians that you dispatched to keep and eye over me and to guide the thoughts and actions of the medical team that attended to me, to ensure that I reached my three month birthday, today.

Lots of love, hugs, and kisses,

Jarrod

Figure 1 Occluder successfully deployed

In Figure 1, the occluder has been successfully deployed. The occluder is the item that looks like a round net. The thicker rings on the outside is the micro-catheter that was wound into place during the procedure during the morning. Bottom of the scan are some pliers which are not, I repeat, are not inside of me!

Figure 2 Platinum coils installed

In Figure 2 the darker finer coils are the platinum coils which were installed via the original catheter that was inserted during the procedure in the morning.

Figure 3 Occluder catheter is detached

In Figure 3 one can clearly see the catheter that introduced the occluder detached. The catheter that carried the occluder is the thicker, darker ribbed looking catheter. And yes, those pliers are still lurking around!

Figure 4 The Final Product

In the last figure (Figure 4), the catheter that introduced the occluder through the back of my head has now been retracted. What lingers behind is the occluder, the micro-catheter, and the coiling, all of which will remain inside me to occlude the fistula. You can see the micro-catheter trailing away to the left – this extends all the way down to my groin via the femoral vein, and will remain there forever. As time progresses, the inflammatory responses of my body will begin to attack all these foreign bodies and collect and attach to them, and in turn grow bigger, making the occlusion more dense and solid.

Tags: Dad, Mom, Morningside Medi-Clinic