And in the next episode...

Yes, there's a new installment in the latest drama of the Pollock lives :-)

I've had another echocardiogram since we lost Joshua and they've compared that with all my other echos I've had done in the 18 months I've been seeing the cardiologist here at Stanford and have determined it's gotten bigger, and was at it's biggest in the last ultrasound before I lost Joshua. So it's gotten bigger, and pregnancy made it worse.

Since we still want kids, they want me to have the aneurysm fixed before I go through another pregnancy. So we saw the cardiac surgeon yesterday, and are booked in to get it repaired on January 3, 2008.

I had a CT scan so they could get a good view of my heart, so here's that pic which I have put some labels on.



And this is kind of what it should look like:



So the Sinuses of Valsalva (the round things) are more prominent than they should be, and that's where the valves are that do all work. If that splits down there, I'm in big trouble!

The next thing is that in the diagram, you can see the ascending and descending aorta are a similar size. In my CT scan, you can see that my ascending aorta is wider than my descending aorta. So pretty much all of my ascending aorta is weakened, and that's what they want to replace.

Also, interesting to note is the 3 tubes coming off the aortic arch - the left carotid artery (LCA), right carotid artery (RCA) and left subclavian artery (LSCA). In my CT scan, the RCA branches off the LCA rather than off the aorta itself like in the diagram. That's not terribly common, but the cardiac surgeon said that they find patients with genetic aneurysm conditions often have that. It's nothing bad, and causes no problems, just interesting.

So, they replace from the Sinuses of Valsalva up to between the RCA and LSCA - you can see a line on the diagram which is where they'll fix up to, and the little hand drawn diagram to the right of that is the diagram the cardiac surgeon did to show how they do it - so they keep the bit of aorta where the arteries come off it, and just replace around it.

They should be able to keep my valves since they look good (as opposed to replacing them with a pigs valve or mechanical valve if they are also problematic), so they have a thick bit of Dacron for the ascending aneurysm (I think he said about 6/7 inches long?), then sew that onto a short, more narrow piece of Dacron where the aortic root is, and the valves will be inside the more narrow bit of Dacron.

They gave us a bit of Dacron to keep as well. This is the wider piece of Dacron.



Then, because they have to be fiddling with the bits around the arteries that deliver blood to my brain, they have to cool my body right down and stop my heart, then clamp the arteries, and hook them up to a heart bypass machine which will keep delivering cooled blood to my brain while they replace that bit of aorta. Apparently once they're down and starting warming up your body again, your heart just starts beating on its own again - they rarely have use the defibrillator to actually get it going again.

It's all pretty fascinating what they can do, and while it's pretty daunting that they're messing with my heart and the arteries leading to my brain, I have one of the world's best surgeons at this sort of operation, in one of the best heart hospitals in the US, and the risk itself is very low, especially given that I'm young, and it's being fixed before it's too damaged.

I think it'll be about 8 hours between putting me to sleep, and waking me up again - poor Andrew is going to be beside himself waiting for me to get out of surgery!!! Then I'll have about 5 days in hospital, then the next 4 weeks at home will be just focusing on recovering. Apparently you're not in pain so much (despite having your chest cracked open...), but just REALLY tired. Your body is using up every calorie available to heal and it just wipes you out. The nurse we spoke to said I have to walk, walk, walk as much as I can, but initially I'll walk for 5 minutes then have to sleep for a couple of hours out of exhaustion, but gradually I'll build up the walks, and won't have to sleep so much, and by 5-6 weeks after I'll be feeling close to normal, then by 12 weeks post surgery I'll have absolutely no restriction - I can run, ride, lift weights - basically do everything I'm not allowed to currently do. And most importantly, we can go ahead and have as many babies as we want, whereas they only wanted us to have one child if my heart didn't get fixed.

So it's scary and daunting, but I'm looking forward to getting it out of the way - it'll be a huge relief, and it'll take a load off our minds not to be worrying about it anymore.