Tuesday, October 21, 2003

Reported to Cardiac Cath Lab at JCMC at 7:00 a.m. Dr. P performed cardiac catheterization. He found "multiple extensive" blockages and referred us to Dr. K, a cardiac surgeon. During Randy's "waking up" period from the cath, we were visited by an anesthesiologist, a representative from cardiac rehab, and Dr. K. Dr. K explained that multiple bypasses are necessary. Randy has one cardiac artery that's half as big around as it should be (born that way). He has long areas of narrowing in his coronary arteries. Dr. K said that there were only three treatment options: 1) let nature take its course--not an option in Randy's case; 2) medication--this would relieve the pain, but would not reduce the imminent risk of heart attack; 3) bypass surgery, which would correct the problem. Dr. K asked about previous surgeries. Randy has had a total of six brain surgeries, starting in 1988. The first surgery was to remove a cyst in the third ventricle of his brain. Successive surgeries were necessary because: the flap of skull began to sink, requiring a plate to be put in; adhesions developed, causing seisures; and a shunt had to be run from his brain to his abdomen to regulate the pressure of the fluid in his brain. When I pointed out Randy's scars from the shunt (at the top of his breastbone and on his abdomen), Dr. K became concerned that the placement of the shunt might have it in the way. Randy was sent to x-ray for a chest x-ray and carotid ultrasounds. X-rays revealed that the shunt does, indeed, run midline through his chest, putting it in a bad position for heart surgery. Dr. K's office contacted the office of Dr. B, the neurosurgeon who performed Randy's brain surgeries. They told us that Dr. B would contact us re: relocation of the shunt prior to bypass surgery. Bypass surgery had already been scheduled for Monday, Oct. 27, but is now postponed until the shunt is relocated.

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