11/6/13
Day after surgery.

By all accounts Nicole is progressing well. The pain meds help her with incision-related pain so she actually got some sleep last night.  This morning her pulse is back equally in both feet and she is getting good blood pressure.  She had a chest xray to take a look at the left lung as well as the lead placement for the device.  The device team came to assess her and said that the leads are in the right place and haven't shifted.

The device team did a test of the device, pacing her heart for a brief period.  Everything seems to be working well, both in terms of signal detection and pacing.  The whole thing about the device is a bit mind-boggling.  One thing gave us quite a shock, particularly Nicole:  When they initiate the wireless interface with the device it makes a high pitched buzz/whine from inside her shoulder!  You should have seen my and Nicole's eyes!  And then the nurse put in the parameters for the pacing cycle, tells Nicole: "You're going to notice your heart rate pick up speed and beat a little harder".  She presses a button on the screen and bingo, the change to Nicole and on the monitor is clear.  Still trying to get my head around this.....

The treatment team is talking about discharge sometime today, although there are still some details to get worked out.  There are a dizzying number of follow-ups to be had, as she now has three separate cardiology teams: one for the device, one for the valve issue, and another for the cardiomyopathy (heart muscle issues).  She also has a pediatrician and an internist.  They also are wanting to get a neuropsychological assessment to assess current cognitive function and to track recovery.  We will have that scheduled in the next several weeks.

PT has had her out for her morning constitutional and given her a clean bill of health.  They are expecting 2-4 weeks to get her strength back, but other than some restrictions on the movement of her left arm and lifting restrictions for two months (to avoid disrupting the placement of the device) she can slowly return to activity.