The pictures in this post were taken Saturday morning just after I finished assembling a swing set for the boys. Nana (my Mom) gave the boys a swing set as a combination gift for their birthdays and Christmas this year. This is a NICE set. It is one of those kits from Home Depot where you have to buy all the wood and follow the instructions. It was a great test of my patience as a stereotypical man who likes to do things by trial and error. I actually followed the instructions on this deal and amazingly enough it worked. The boys absolutely love it.
We are still in a holding pattern as far as the pacemaker goes. It has been a really interesting few days. The last time I talked to Caden’s cardiologist, it sounded like we might be in surgery today. They were trying to orchestrate a waltz between cardiology, anesthesia, operating room staff, surgeons, and orthopedics so that Caden could go into surgery, get his pacemaker removed, roll him to radiology for an MRI, get the MRI verified by orthopedics, roll Caden back to the operating room, and then troubleshoot/repair the pacemaker. I know that is a mouthful, but it should give you an idea as to what lengths the MUSC staff is willing to go to get Caden the care he needs. All this coordination is very difficult because the MRI is currently booked 24/7 and they need about a 1 1/2 hour window for Caden because they don’t know exactly when he will show up, due to the required surgery to remove the pacemaker.
Keep in mind that the pacemaker was malfunctioning during the last cardiology visit during the first week of August. Fixing the pacemaker is the primary focus. The MRI will be a bonus if it can be done. If I have not said it already, I think it is worth clarifying that the pacemaker was not installed to pace Caden heart all the time. It is only in there for safety sake. If monitors the heart and is only supposed to fire when the heart rate drops below 90 beats per minute. It was installed because the cardiologist said they found some abnormal and missing heart beats that warranted a pacemaker for Caden. Now the thing will not fire when tested with a computer diagnostic program. They can use the computer to tell the pacemaker to speed up the heart a little bit to verify that the pacemaker will do it automatically.
The MRI has nothing to do with the heart, but an MRI can not be done on a patient with the kind of pacemaker Caden has. I questioned whether an MRI could be done with the pacemaker lead still being intact and they initially said yes. Now the story has changed. It seems that a recent clinical study on this question was done by a doctor at Johns Hopkins. The results of that study were not scheduled to be released until today. A call from the MUSC pediatric cardiology department to Johns Hopkins resulted in a regrouping on the plan for the MRI as mentioned in the first couple of sentences of this post. It appears that this study says that there may be danger in doing an MRI on a patient with only a pacing lead in place. I am guessing here, but I think this may follow the logic that led to my question to the cardiologist on this very subject.
An MRI requires all or part of a patent’s body to be subjected to a strong magnetic field. The importance of the magnetic field is explained in an article on Duke.edu tilted “Generator Basic Principles to get an idea of where I am coming from about generating electricity with magnetism and a wire. The thing is that you can move magnetism over a wire or move a wire through a magnetic field to create the most basic of electrical generators. I was concerned that the resulting electricity running through a wire that is connected to the heart could cause irregular beats during the MRI. I was also concerned that another side effect of electricity running through a small wire is that it could create heat like in a light bulb filament. Have you ever got near a light bulb while it is on? It does not take very much electricity through a small wire to generate enough heat to cause a burn from a small wire carrying electricity. A burn in or near the heart could not possibly be a good thing. If the lead wire is fairly large then it would not be as big of an issue with the heat. I will spare you the explanation on that one.
Please keep in mind that those last two paragraphs as they relate to the pacemaker lead are my personal speculation as to what effects an MRI might have on a small wire left inside the body. I am only speculating that the Johns Hopkins study follows logic related to my above explanation of electricity and magnetism.
This all leaves us with a great deal of uncertainty. At this point, Caden will not be at the hospital tomorrow (Tuesday the 19th) as we thought. The cardiologist has mentioned a remote possibility of removing the pacemaker AND the lead to allow for an MRI, but I am not sure that the surgeon will go along with that idea. There are some meetings between all the powers that be in pediatric cardiology and cardio-thoracic surgery at MUSC on Monday afternoons. The were supposed to call us after their meeting today. It is almost 11PM and we have not heard a peep out of them.
We asked grandma to stay this week to assist us with caring for Riley during the scheduled hospital visit for Caden. She is loving her time with both boys and we are blessed to have her support.
Please continue to pray for Caden and our family.
Here are a couple more pictures from Saturday. Enjoy!
This is a picture of Caden signing more when asked if he wanted to get up or swing more.
