Some of us kids saw him as he was typing this to his sister. Dad was explaining to us a deep sense of the severity of her situation. He showed us charts of her heart rhythm (much of which went right over my head, but Elliot seemed to grasp most of it), and told us a little about what had been going on. He emphasized that we are measuring her condition in terms of heartbeats. He noted that each beat is significant and could change things drastically. Your faith and prayers are so appreciated in her continued critical condition.
Betsy has had a good day. 21 hours without a shock! I'm not sure what all have heard, so to summarize, Friday morning she had an implantable defibrillator [an ICD] placed, much like a pacemaker, in fact it is pacing her now at a rate of 100 to suppress inappropriate foci of pacing [improper location of heart contraction] inside her heart. That is her problem. There are cells in her heart that are irritated by something, which cause them to fire off. When they do that, the electrical signal propagates to all the surrounding cells, and occasionally puts her into a lethal arrhythmia [life threatening beating pattern]. So far every time that has happened the device has properly assessed it, and appropriately fired, resynchronizing her heart. . .
The placement of the ICD Friday should have been a slam dunk, we were thinking she could go home Saturday. But while on the table in the EP lab, she began to go into a malignant tailspin of lethal arrhythmia's. Each time, the device properly assessed and fired, ending the fibrillation. But it was far too frequent and dicey to go on that way. So they put her back under general anesthesia to quiet the heart. She stayed that way til Saturday morning. Then a parade of visitors came, and we learned fairly quickly that her heart just couldn't tolerate the excitement of the visits. Any elevation of circulating catecholamines causes her heart to fibrillate. She was shocked over a dozen times Saturday. Each time I could give her a couple seconds warning, but it was excruciating nonetheless...
Today has been a better story. With sedation, and strictly no visitors, we have been able to keep her ICD from firing again. She did fibrillate once when the boys came to give her a blessing, and offer the sacrament, but she broke it without a shock, a very good thing. Continuous shocks cause the myocardium [heart muscle] to be stunned, and the effectiveness of the heart to pump blood is decreased. This is measured by ejection fraction [EF] on echo. EF on Thursday was over 55 percent. She is now about 40... [this is not good.]
So we are very motivated to keep the shocks to a minimum. Yesterday, the family gathered around her bed and offered prayer. Each giving voice in turns. It was a sacred time for us. This has bound our hearts, and made plainly manifest the deep love each of us feels for the others. We can't help but feel the love of the Almighty, the reality of our pre-mortal love for each other, and that this event, though painful in the extreme, serves a divine purpose. I have learned that I love this woman more than my own life, and will do anything for her.
Today has been much better. No shocks for 22 hours now. She's on the mend. Her doctors are considering surgery to cut the sympathetic innervation to the heart. These come off the thoracic nerve roots at levels T1 thru T4. This would involve thoracic surgery [invasive chest cavity surgery], something I would dearly love to avoid. They have discussed the possibility of air ambulance to Mayo Clinic [in Minnesota] for that. I'm way reluctant to take her away from here. Please pray that we don't have to take her away from Dallas. Love to all, more to follow if you wish. Karl and Betsy.