Oral surgery postponed again

Mike was scheduled to have his first wisdom tooth removed this morning, but that appointment has been canceled due to his blood test from yesterday. Leading up to each of these surgeries, Mike has to have his blood drawn the day before to test the clotting. I forget the name of the test, but his levels were too high. This is another way of saying his blood is too thin and the risk of bleeding is high.
If you remember from last week, the Rx wasn't ready causing Mike to miss his appointment. This morning, they originally told mom that they couldn't reschedule until November 6th. However, with a little prodding from mom, the nurse is "checking into it."
On another note, Mike's family doctor here in Abilene suggested that Mike see a hematologist here to help ease the communication between the doctors in Abilene and those in Dallas. Additionally, he thought it was a good idea to have a hematologist in town in case Mike were to have complications with the tooth extractions. Mom asked the family doctor what his opinion was about Mike's clotting disorder (prothrombin mutation type II) and the family doctor wasn't even aware of the condition. I don't understand why it's so hard for the doctor's offices to communicate. They don't send records to one another, even after we request it. The lose records, they all tell you something different, they force you into appointments on their schedule, they charge whatever they want...Anyway, how can you have faith in these doctors when the medical system in America as a whole is so screwed up?!? It's utterly ridiculous. I obviously have my opinions on the matter, but I'll save the rest of those for later.
Hopefully I didn't forget anything on this update. I'll keep posting as I get information.

Mike still has his teeth

The wisdom tooth extraction has been rescheduled for Wednesday October 24th. After arriving at the doctor today, Mike was informed that he would have to have the mouthwash Rx filled before they proceed with the extraction. After calling the pharmacy, they were informed that the supplies would need to be ordered and the mouthwash will be mixed when they receive the order. Mike said that the oral surgeon plans on getting two of the wisdom teeth next Wednesday. That's about all I know.

Oh, Mike called me to give the update and acted like he had just had the extraction. It was funny and I fell for it, especially considering all the drugs they give you at the dentist! Anyway, Mike got one over on me, but I couldn't stop laughing at him because I really thought he was loopy.

First Wisdom tooth being removed

Mike is scheduled to have his first wisdom tooth removed this morning at 10:45a. His appointment went well on Tuesday, they were able to complete the fillings. Today, he goes to get blood work done first, then if the coumadin levels are within the specified range, they will proceed with the removal of the tooth. Mike is still taking the coumadin (blood thinner) and that is the major concern about today's surgery. They are giving him a special mouthwash that they expect to stop the bleeding. We're a little anxious about this mouthwash and hope it performs up to it's ridiculously expensive price tag!

Provided Mike's body handles this extraction well, he'll be scheduled to have the other teeth removed. At that point, he'll have to wait at least 6 weeks before the heart surgery can be performed. Please join me in praying for Mike this morning. I'll post an update as soon as I know something.

4 fillings today

Mike is going in to the dentist for 4 fillings today. I'll keep you updated on that. Also, he is scheduled for the first extraction of that abscessed wisdom tooth on Thursday. If that one goes well, they are going to pull 2 other wisdom teeth and one more tooth that is next to the wisdom tooth, I'm assuming that's a molar?
The reason they are doing all of this dental work is twofold. One, they have to take all precautions necessary to insure that they minimize the risk of infection leading up to the heart surgery. Any form of infection in his teeth could have adverse effects on his recovery from the heart surgery. Two, he will not be able to have additional dental work done until at least 6 months after the heart surgery, so they want to do it now.

Toothache, to say the least...

Mike visited the oral surgeon today. The oral surgeon will not perform the surgery unless Mike stays on the coumadin, after conferring with the cardiologist and his family doctor. Basically they will remove the tooth and then use a special medicine to stop the bleeding. The medicine is called (something) acid. The oral surgeon has only used it once, but he thinks that it will stop the bleeding. Basically, the medicine is some kind of expensive mouthwash that Mike will have to use 4 times daily during the days following the surgery.

In addition to the wisdom tooth, Mike has 3 other teeth that need attention. The oral surgeon said that each of them will have to be looked at before the heart surgery can be scheduled. Each tooth runs about the same risk of infection as his wisdom tooth does, according to the doctor. The doctor thinks that he will be able to save the teeth, at least for now. The plan at this point is to extract the wisdom tooth and see how Mike's body handles it, paying special attention to the bleeding, obviously. After the wisdom tooth is taken care of, the oral surgeon will proceed with addressing the other teeth, but his treatment will depend on Mike's reaction to the first extraction. The wisdom tooth is scheduled to be extracted on October 18th, though it could be delayed until early the following week, we're not sure about that yet.

November 27 is the date that the skin cancer will need to be removed, but, once again, that depends on the outcome at the oral surgeon's office.

Mike is depressed of this recent news. He's going through a lot of pain and is uneasy about his heart condition. The last week has brought a lot of answers, but it has also initiated another waiting period. I know it must be agonizing having to wait on everyone else to decide when they can treat you and how-each decision being a major factor in your own quality of life and health. Mike is beaten down and struggling, I know that he could use a phone call of encouragement, if you have the time.

Please pray that my role will be clearly defined in all this. I want to be as supportive as I can, but I want to concentrate on the right things. For now, I just need to love on that boy and encourage him, he's got a whole world of pressure on him right now. I better go for now. As always, ask questions if you have them and I'm sure mom will help clarify what I've written above as well.

Prothrombin Mutation test positive

Mike got a call from the hematologist's nurse in Dallas this afternoon. And what do you know...he tested positive for Prothrombin Mutation. A quick search on Google produced this article.

The nurse said that it should not affect the surgery, but we're not too sure until we are able to talk to the hematologist and cardiologist. This particular mutation is said to increase the risk of PE (pulmonary embolism) and DVT (deep vein thrombosis). Mike most likely would have had a PE if he didn't have the hole in his heart (PFO).

If you all remember me talking about my cousin Nicholas a couple of weeks ago, you'll remember that he had a PE. I can't remember if I wrote this but Nicholas had a PFO as well, but it was fixed when he was little, from what I understand. This makes perfect sense why the clot traveled to his lungs. Put these two cases together and now we know why Mike's clot went to the brain.

Once again, this is a lot of speculation on my part, but with my understanding of things so far...it seems to be a logical conclusion. I know that we tend to over-diagnose ourselves when we have such wide-spread access to all these medical articles. However, I reserve that the right to theorize if I want! Just to be clear.

All that said, it begins to make sense why mom has had clotting issues in the past. Possibly why my grandpa had early heart attacks. Maybe why miscarriages have been rampant in my family. Maybe my headaches. Maybe dad's headaches.

I don't know and I realize that I'm over-reacting a bit, but what in the world are we supposed to do? I know, I know, trust that the Lord is in control. Well, I do, but it doesn't keep worries from creeping in. I just have to keep all these theories in check and not let them get out of hand too much. Quality of life is something that I feel I have control over, unlike quality of health. I guess I'll try to concentrate on making life meaningful, memorable and enjoyable for me and those around. So, if you catch me making your life hell, I give you permission to call me on it. But be warned, I'm ready to call you on it too.
Good evening.

Surgery Postponed. Tuesday Update (10/2)

I started this post on Tuesday but was unable to finish it. I just decided that I need to finish it this morning, regardless of how busy I am.

From Tuesday:

Mike visited the cardiologist in Dallas today. They had a good visit and were able to have most of their questions answered, as the cardiologist spent at least 45minutes with them. They were finally able to talk about the results of the Cranial Doppler test. Basically, they rate the patient on a scale from 0-6. Mike was a 4 which is moderately to mildly severe. This is the reason the cardiologist and neurologist want the heart repaired. In addition to the hole, he has an aneurysm on his atrial septum. The umbrella procedure should fix both problems. The cardiologist is still optimistic that we will be able to do the catheter procedure through a vein in his leg and he says the success rate is very high. If complications such as a heart puncture were to arise during the two-hour surgery, then they would have to perform emergency open-heart surgery. The cardiologist says he has had this happen once, but it is very rare. There is also a risk of embolization(sp?) of the umbrella device. This is where the device works loose and eventually lodges somewhere in the bloodstream. If this were to happen, they would have to go in and retrieve the device. I'm not sure how common this is. During the surgery, Mike will be under conscious sedation, which means he'll be awake but he want real be aware of what's going on. Leading up to the surgery, they will take him off Coumadin (blood thinner) 4 days prior to the surgery and replace it with Lovenox shots. Immediately following the surgery, they'll place him back on Coumadin. They suggest that Mikes stays at the hospital for 48hrs, but insurance will only pay for 24 hours. So, we'll have to keep him in a hotel room near the hospital for an additional day. When they start the surgery, they'll put a little balloon instrument in his heart that will measure the exact size of the hole. This will help them determine which size umbrella to use during the procedure.

I wanted to explain what we found out about the heart surgery before I forgot. However, THE HEART SURGERY HAS BEEN POSTPONED. Read on and I'll tell you why.

You probably remember me talking about one of Mike's wisdom tooth that was giving him problems right after he had the stroke. The cardiologist will not perform the heart surgery until at least 6 weeks after the tooth has been removed. The risk of infection is high and he's afraid bacteria, or vegetation around the heart may form. Once again, realize I'm no doctor, so I could be saying this wrong, but I'm trying here! The bottom line is that Mike's tooth has to be fixed before the heart surgeon will proceed. Mike has a consultation appointment with the oral surgeon next Tuesday, 10/9/07.

In addition to the tooth, Mike has had a spot turn up on his neck. He recently visited the doctor and had it removed. After a biopsy, they determined that the spot was cancerous and it will need to be looked at by a dermatologist. The dermatologist will use a technique called the Moh's procedure to cut it out and check the tissue until the margins are clear. This is to insure that all of the cancer is removed. Once again, this is a step that must happen before the heart surgery will be scheduled.

Lately, it's been one thing after another and we are on the edge of our seats at this point. Once again, we are grateful that Mike has been triumphant against the stroke so far, but the road is long and we still have a long journey ahead of us. I realize that our journey is no different than yours. We all have our struggles and trials and triumphs-I guess life wouldn't be worth much without these things. I believe that it's during these times that we really are more alive. It's amazing how your eyes are opened to what matters and things are instantly placed in perspective. We are thankful for the Lord's graciousness so far and know that he will carry us through, as well as you.

I've been constantly reminded of my attitude lately. It needs some work.

Mike's Heart Surgery Scheduled

Mike's heart surgery is scheduled for Wednesday, October 10th at Baylor in Dallas. Mike is heading to Dallas tomorrow for a consultation with the cardiologist to iron out the last-minute details. That's about all I know for now. I'll try to write more later.