Revision of the Revision

V’s second surgery in a week – we are calling it the revision of the revision – did not go well. The surgeons could see an exposed pacemaker lead wire through the hole that had opened in her incision from the previous surgery. Though the cultures for infection have been consistently negative, because the wire had been exposed to the outside air it was considered contaminated. Both the pacemaker and the lead wire had to be removed to prevent the possibility of a life threatening infection. They did repair the hernia and plastic surgery did close the wound.

V is now in ICU with an external pacemaker. This involves a little box run on a 9 volt battery and three blue wires (N +2 configurations for you geeks out there) that are sewed onto her heart and poke through her chest wall and attach to the box that is lying in the bed next to her. She is also on three different antibiotics to try to head off any potential infection.

She is sore and grumpy as she should be. But overall she seems to be doing very good considering. She is eating well, pooping and peeing well, and her lungs work just fine. Over night a good bit of her personality came back. If we are exceedingly careful and the nurse helps, we might be able to hold her today.

We had a long talk with her primary cardiologist yesterday after V was settled. We are all disappointed and a bit confounded at this point. It seems her biggest obstacle right now is just that her frame is too small to tolerate the device well.

There are three options on the table for how to proceed, none thrilling but each with a few positives and their own not insignificant risk. Her life at this moment, while uncomfortable is in no immediate jeopardy. We will be hanging out in the ICU with the external pacemaker and monitoring a few things so that we can determine which plan of action is in her best interest. Specifically we will be paying close attention to the healing of her incision site, the results from the new set of cultures for infection, and the pace her heart beats on its own when the pacemaker is backed down. We are now in a wait and see mode of indefinite length.

The end goal is to get a new internal pacemaker placed and healed correctly so that she can go home and rule the world.

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