Six months after the Heartastrophe

Six months ago I woke up in the Cardiac ICU having no knowledge of what happened. No knowledge of how close to death I was. All I knew was the excruciating and agonizing pain I was in. The screaming, the struggle to breathe. That’s all I knew at the moment. My mom took my hand in hers and explained the surgery didn’t go to plan. That I suffered a catastrophic injury that nearly cost me my life. 

Since then, I’ve faced so many complications. So much lingering pain. Still lingering issues with my lungs that require 3 inhalers a day. Complications that have caused my hernia repair to fail, and thus my parastomal hernia to reoccur. Complications of a wound dehiscence. An incision infection that was initially dismissed by the Nurse Practitioner at the surgeon’s office. “It’s just a surface infection”, is what i was told. Complications and actions that have led to trauma. There’s days the pain around my incision is a 9, there’s days it’s a 4. It’s always a dull ache though. 

I can barely walk these days. I can barely last 10 minutes outside in the heat and humidity due to my lungs. Bibasilar Atelectasis..still at 6 months post op. The fatigue is awful. Simple tasks leave me utterly exhausted. Is this my new normal? What quality of life do I have? 

I had to go to a local wound care clinic to get help for my incision to close back up. Daily dressing changes with packing. Weekly Wound Care appointments for debridement. Do you know how that feels? It’s not pleasant. Having to use special packing and dressings to prompt healing. 

Me in July 2024.

I’ve also received no accountability from the cardiology office. As it turns out, someone had shut off the home monitoring for my pacemaker March 2023. Had it been on, and monitoring my device, we could have caught the malfunctioning of the device when it began in August 2023. Instead it wasn’t caught until January 23, 2024. However, it was not known the leads had frayed, and the risk was tremendous. 

See, Biotronik has a monitoring alert system for their devices. If the home monitoring isn’t connected, the Doctor’s office is notified by Biotronik. So to ask, who ignored the alerts? How was it missed that my home monitoring was not connected, thus not transmitting data from my device nightly. I’ve asked this many times. I’ve used my voice not only as a patient, but an advocate to get answers. I’ve received none. 

I’ve read the operative report so many times. I’ve learned what I could about what happened. Maybe that’s the PTSD. Though there’s still so much I don’t know. One big question, how was i stable when pulled from Bypass in the OR, but on a ventilator less than an hour later? WHAT HAPPENED? I’ve never gotten an answer regarding that. There’s only one note in my paperwork about it. Absolutely nothing else. 

I’ve tried to transfer care. I’ve tried to find a cardiac team. Unfortunately I’m in a situation where I need a specialized team. This requires travel. Which is what I’ll do. I want a better quality of life.

Six months of wanting answers. Six months of trying to piece together what happened. Six months of trying to process and heal the trauma. I think that may be the hardest part. The flashbacks, the memories of being in such agonizing pain not knowing what is going on. The anger, fear, anxiety, sadness at times is so overwhelming. 

 I get frustrated. I’ve built my name in advocacy. I’ve built my own voice, and have advocated for myself and my community. Yet in this I feel voiceless. I’m not though. Maybe they wish I were, but I truly feel there needs to be accountability for this situation. Accountability for the abysmal post op care, the astronomical medical costs I’ve incurred due to the complications. The medical costs have affected me tremendously.  Complications that may be permanent. 

Six months of wondering how this happened. We need transparency in healthcare. We need accountability. This is a situation that possibly could have been prevented if the malfunctioning lead was caught sooner. I refuse to just let this go. I refuse to be voiceless any longer.

Quote from Ed Troxell

Heart-astrophe

On February 9th I was scheduled for a pacemaker replacement surgery at UF Health Heart & Vascular Institute.  An overnight stay I was told. I’d be home Saturday. Oh how I wish that’s how it went.

Prior we had discussions over which pacemaker to be put in. It was decided to use a BIOTRONIK Edora. I was fine with that as I needed the CLS feature. I’d had a Biotronik Evia for 14 years. I had faith in Biotronik. 

I arrived at the hospital. We went over everything. I gave my mom a hug and I was wheeled back to the OR. Ready for my new pacemaker. I woke up February 11, 2024 in Cardiac ICU in agonizing pain, confused and scared. I had no idea what happened. No idea why I was in ICU, no idea where the previous few days went. I have flashes of memories from those days, but it’s foggy.

My mom was there, at my bedside. Apparently she hadn’t left for days. I remember looking at her, confused about where I was. She took my hand and explained there was a complication and I was in the Cardiac ICU. It turns out it wasn’t a small complication. While trying to remove my Atrial Lead, it fragmented and frayed. I had a sudden drop in BP, and my cardiothoracic surgeon made the decision to perform an emergency sternotomy. Upon opening my chest It was discovered my RA/SVC had a complete tear. I was put on CPB to repair the tea, which they did successfully. I was removed from bypass. However I had to stay on the vent, as my lungs had to be deflated to access my heart and repair it.

To say I was confused and scared is an understatement. It took me days to fully comprehend what happened. The cardiologist and cardiovascular surgeon explained it to me. My mom explained it. The ARNP explained it. Yet I was struggling to comprehend and process it. My priority was my son. My son’s well being, HIS mental health with this. Also my mom’s. As a parent I can’t imagine the fear she went through. The sight of me laying in the hospital bed hooked to machines to help me breathe. She snapped a picture of what she saw when she first walked into my room in the ICU. She wouldn’t show it to me until weeks later. It was heartbreaking to see. Each day in the hospital I was told my restrictions. I can’t use my arms much, I have to protect my lungs and chest. I can’t drive for 4-6 weeks. 

Heading Home, Finally

Finally I was discharged after 8 long days in the hospital. I’ve spent the last 14 weeks healing, processing and learning what happened and what’s next. It turns out they did not put the new pacemaker in. I also still have a fragment left in my ventricle chamber. I have a lot of questions for my team, though I’ve honestly lost trust and faith. 

My dad spent the first 3 days with me when I got home. He helped with meals, making sure I ate, took my meds. And helped with Mathew. I’m so grateful he came up to help, and give my mom that small break. Once he went home my mom then traveled back and forth from where I live and where she lives t help me shower, do laundry and grocery shopping. Several nights a week, all while working 9 hours during the day. I’m so immensely grateful to both of my parents.

You see the post op care from the cardio team was awful. They dismissed an infection, dismissed breathing issues. Dismissing my concerns. The surgeon actually laughed at me when I asked when the remaining fragment would be removed. His reply, “What so I can knick your heart again?”. That’s not funny. To learn I CODED on the table. To learn, I almost didn’t survive. The nonchalance has been too much for me. 

Through all the recovery I had my birthday in March. Turning 38 was a big celebration this year. I also celebrated my son’s 15th birthday in April. Small celebrations through this hellish recovery.

Finding out More Information

We found out someone at the cardiologist’s office shut off the home monitoring in March 2023. Biotronik sends alerts if data isn’t transmitting. This was ignored. Thus NO DATA was transmitted from March 2023 forward. This means when my atrial lead started malfunctioning, it wasn’t caught. This means when my low battery alert should have happened, it didn’t. Someone didn’t uphold their job. They didn’t maintain cardiac care. This is a scary thing. This has led me to have trust issues with that office. Honestly, rightfully so I believe. 

I’m still dealing with fluid in my lungs. Still dealing with overwhelming fatigue. PVCs, low heart rates, palpitations. My portacath was also broken during the surgery and had to be removed.

A recent 48 hour Holter monitor showed 86 bradycardia episodes in 48 hours. Thousands of SvT episodes, PVCs. 

A recent TTE Echo showed an enlarged left ventricle, left systolic function of 55%, left atrial enlargement, IVC Dilated, RA Pressure high, Regurgitation of the following: Mitral, Pulmonic, Tricuspid. -None of these findings were on my 2019 Echo. Were some of these the result of the surgery in February? Are these concerns? I’m still waiting on answers. 

What’s Next?

 I’ve decided to seek consultations from previous electrophysiologists that I trust. Consults with top hospitals and cardiothoracic teams in the country. Thus I can make a fully informed decision on what comes next. 

Many know I’m a fierce patient advocate. I am vocal on healthcare change, holding physicians accountable for things. This time i’m conflicted.  I praise them for recognizing there was a complication and reacting so quickly that they saved my life. My cardiac surgical team did amazing work. I’m told the repair time was amazing. My surgeon caught the sign something was wrong and immediately made hard decisions. I truly feel he is why I’m still here. Though the post op, after discharge care has been horrible. I can’t tell if that’s due to the surgeon or his office continuing to schedule me with the ARNP. 

Me as of May 16, 2024

 We sometimes focus so much on what physicians do wrong, we don’t acknowledge the good they do. We should. We should show the good and the bad. I’m grateful for his quick reaction. I’m thankful for his skill in cardiothoracics. I’m grateful for such an amazing surgical team. What I’m not grateful for is unanswered questions, anxiety and trauma from this. 

My closest friends have been such blessings through this. Being there for me via text, calls. Understanding my mental health and just listening when I was struggling to comprehend this all. Aly & Chelsea, from the bottom of my heart I’m so grateful to you, and love you both so much.

I am still emotionally processing having open heart surgery. I’m processing what happened. This has left me emotionally drained. This has left me with anxiety, and trauma. This has been such a traumatic experience. This has also impacted me tremendously financially. Having to travel out of state for care is not easy financially. However I must get cardiac care. I have started a shop to help with costs, also any donations would be so immensely appreciated.

I’m grateful for my team. For their quick actions saved me. Praising my surgical team. Thankful for my nurses and my aides that I had in-patient. We often don’t acknowledge the good. Maybe it’s time we do. We can celebrate the good, while also advocating for transparency and accountability.