Quick update from Day 2 a.m….

After waiting all morning with no food, in anticipation of the TEE, we finally saw the doctor about an hour and a half ago. She is amazingly personable, just like pretty much everyone here, and she brought her whole team with her: a fellow, an intern, a pharmacist, a pharmacy student, the nurse, and a patient resource manager. The doctor sat on the bed, had a nice conversation with Tami, listened to everything (liked her nice strong artificial valve opening sound!), and went over the plans again. She decided, given that Tami has been on coumadin for three and half years, that the risk of clots has to be so small that there was no need for the TEE. Yeah!! Tami is very excited to avoid that yucky procedure!!

The doctor went on to say that they should be able to start the new medicine tonight (they have to get her potassium and magnesium up first, but they are working on that now with some extra pills) and that they would want 5 doses done before they do the electric shock to correct the heart rhythm. So that means Monday (as we suspected yesterday). We also found out that there is no problem to do this electrical cardioversion multiple times – in the same day, a few days later, or some time months or more later – to put the heart back in a normal rhythm.

They also don’t anticipate her INR to be down any time soon (certainly not by tomorrow), so the heart cath (if they still want to do it by then) also won’t be until Monday, So that means (yes, as we suspected) lots of sitting around from now til then. The couple of extra EKG’s per day to monitor the new medicine won’t be any excitement at all.

The cardiologists are wanting to have the hepatologists weigh in on the interferon/ribavirin treatment since the cardiologists are tending to think all of Tami’s symptoms (except the afib) seem to be related to the interferon. So now the cardiologists are wondering whether there is any way to consider cutting back on or stopping the interferon. Obviously that will depend on seeing the hepatologists and having them consult with Tami’s doctor at home, but Tami would be more excited about that than anything else they might think of.

I think that’s all for right now. I’ll blog again tonight. It won’t be posted so late tonight. We stayed up too late and didn’t sleep well with all the hospital noises last night. So we are planning to be in bed by the time the 11 p.m. EKG is done. More before then…