Hospital: Day VII (2)

The news was not good today. The results from the trans-esophageal echocardiogram came back and the doctors believe that heart surgery is required. Assuming that happens, it won’t happen for at least for another 7 to 10 days. First her blood has to get clean. So she needs to continue her antibiotics.

There are three main doctors involved with Zora: the cardiologist, the infectious disease doctor, and, now, the cardiothoracic surgeon.

I knew there was trouble with the cardiothoracic surgeon, Dr. Sheel Vatsia, came into the room. He was a man I didn’t want to see. He described the surgery as “inevitable.” Zora was still a bit groggy from the echocardiogram and the surgeon was off to operate, so he didn’t have a lot of time. But wanted to tell us the news. “He’s very good,” someone told Zora, “he operates on infants.” Yes, but are they sick?

Dr. Vatsia said that he would go into the heart and try and clean it up. Depending on what he saw while operating would determine whether or not the valve would be replaced. Repair is definitely a better option than replacement.

There are two problems, both involving her mitral valve. The mitral valve is on the left side of the heart. Quick biology lesson: blood comes in to the right side of your heart, which pumps blood to the lungs. Then the blood goes back to the left side of your heart, which does the hard work, pumping blood to the rest of your body.

Problem one is the “severe” leakage of the mitral valve. Two flaps are supposed to swing shut when the heart pumps. If this doesn’t happen, then blood is being pumped back into the the left atrium and the lungs. Blood backing up. Very inefficient.

Problem two is the “moderate to large” vegetal growth of bacteria, again on the mitral valve. The fear is that this breaks free, goes to the brain, and causes a stroke. The cardiologist with a horrible bedside manner, Dr. Sumit Mittle, also said that surgery was needed, but seemed a little less insistent that the surgeon. The third doctor involved, the I.D. man (and Northwestern graduate), Dr. Bruce Farber was not present today (at least when I was there).

Zora wonders if there’s a parallel to dentists wanting to pull your wisdom teeth. Sure it may be better, but is it needed? I guess that is what second opinions are for.

Meanwhile, a family friend proposes that Zora gets transferred to New York Presbyterian Hospital. North Shore University is good, but perhaps Presbyterian is better. It is certainly closer. We’ll see.

Zora’s main complaint right now is having to stay in the hospital. Outwardly, she seems perfectly fine. So we’re trying to spring her tomorrow. Because she can continue the IV at home. This will be up to the I.D. doctor. Zora feels like if she has to have surgery, she’s not really in a position to get her strength up while staying in the hospital. We can bring her food. But she can’t get a good night’s sleep there.

The PICC line is the key to her trip home. Zora’s worried about a slight redness around the PICC line. Hopefully this isn’t an infection (how could it be with all the antibiotics?). So hopefully it’s fine. But again, we’ll see. It certainly would be nice to have her here.

For those wanted to visit. Here are a few more details on the journey to North Shore University. Again, we’re going to try and get her home tomorrow. But who knows? Take the LIRR to Great Neck (next stop after Little Neck and before Manhasset). $6. From there take the N25 bus (metrocard taken) to the Hospital. The bus leaves from the outbound side of the train station. Go to the street and walk forward a bit, to the second bus stop (just past the first bus stop). The train ride is about 20 minutes. The bus about 10 minutes. The connections actually work pretty well. Door to door (from Astoria) it’s an 80 to 90 minutes journey.

Google "mitral valve repair replacement endocarditis" for many interesting links.