Tammy had a screw loose!

Tammy is out of surgery and doing well. A screw that held in one of her leads had come out. They were able to reattach it and there was no visable infection. However, they did culture it. She should come home tomorrow. They tried to fix her A-fib but were unable to do that.

Surgery Tomorrow

Tammy will have surgery tomorrow. Dr. McAnulty will go in and check the extent of the infection and decide what to do from there. Then he may go ahead and put in the new "PD" or they may have to wait and do that in a few days. He will also go in through her groin and put in two leads to try and fix the atrial fib. They will have an anesthesiologist there during the surgery because of the complication with the other surgery. Her fever is now at 100.5. They have done an echocardiogram. They found on the chest x-ray that her lung is better but their is still fluid in the pleurel space.

We Love Good Sam Hospital!

So far they have ran a CBC. Her white blood count is up from 9000 on Monday to 10500 today and she has been running a low grade fever, so they are sure she has an infection. They did a blood culture and chest x-ray. They have discovered that she has a faulty defibrillator. They have to accurately diagnose the infection and treat it before they can do anything. They will need to replace her "PD", but when and how is still a little up in the air. They will most likely be putting it in on the other side of her chest.

Wednesday October 1st!

The conversation with the nurse started out, "This is not good". The leads to the "PD" are not working. The wanted Tammy to come up tomorrow to have it checked out with Representatives from Boston Scientific so they can see what is wrong with it. So basically, they were sure that if Tammy needed to be shocked, the device would not shock her. After several conversations back and forth, Dr. McAnulty decided to have her admitted to Good Samaritan Hospital and run more tests. We took Tammy immediately up to Good Sam and checked her in! Tammy's mom got there at the same time we did and was ready to stay. Jenny is coming down in the morning.

The Next Day!

Tuesday, Tammy still was not feeling well and the swelling had increased. She decided to not wait until Wednesday and request the CBC that day. The white blood cell count came back normal but in the high range of normal. So again we waited.

It all started with a Second Opinion

Jenny (Tammy's sister) suggested that Tammy get a second opinion. Tammy was referred to Dr. John McAnulty at Good Sam Hospital. Her appointment was on Monday September 29th. The first thing they did is "interrogate" her pacemaker/defibrillator (PD). The "PD" is brand new on the market and has only been available for just over a month. The technician that was checking the device had not seen anyone with this model in before.

She did a printout of the "activity" recorded on the device since it was placed in Tammy. She found an arterial anomaly. She then said that there was a Lead Impedement, but because this device was so new she didn't know for sure what that meant. So, she went to check with the doctor.

He came back in with two medical students and continued his examination. He was concerned with the amount of swelling and tenderness around the device. He was perplexed by the arterial anomaly, because this is not normally associated with Toursads. He decided to lower Tammy's heart rate to 60bpm. Her pacemaker had been keeping her heart at 75bpm and had been running about half the time to maintain that rate. He felt that if they lowered that rate and allowed her heart to beat at is natural rate more often, that may help with her fatigue. He also decided to put her on a beta blocker at a low dose.

Tammy left the appointment with instructions to contact Dr. Kelber in two days if the swelling and tenderness of the site did not improve, to request a CBC with differential. If her fatigue did not improve, she was also to get a chest x-ray. The nurse was also going to check with the manufacturer of the device to get a cord sent to Tammy, so she could send a readout to her doctor anytime. The nurse was also going to check in to the error message about the impedement of the lead and get back to Tammy.