A few days later I went into their office and had a transcranial doplor (TCD) done. This device according wikipedia measure the blood flow through the brain's blood vessels. They put this headphone type thing on your head. Then they also put an IV in you and then inject a saline solution into your bloodstream. They pump it through with some air. They do this several times--one while just resting, one when pushing, one when breathing, etc. The point of the test is to see if this saline solution is reaching your brain. Theoretically, you should see none of this saline solution in your brain because it would flow throughout your body. However, if you have a hole in your heart then some of the saline solutions flows from your left to right atrium and then up to your brain.
The test only took a few minutes and then they took me into a waiting room for the results. I was pretty nervous going in for this testing just because I didn't know what to expect. I almost felt silly for going in just because my headaches aren't that bad compared to other symptoms they ask you after.
After waiting for awhile, the nurse finally came in and told me that I had exactly what my dad had. They told me I had a PFO (Patent Foramen Ovale). This is the flap between your left and right atrium. Everyone has a 'hole' when they are little but it is supposed to close over by the time you are two. In some cases, it never does and it can cause problems. Mostly neurological problems--light headiness, dizziness, etc. The biggest fear of this is that you may have blood clots that flow across this hole and up to your brain which can cause strokes, etc.
At this appointment they didn't tell me how severe they thought my hole was. The nurse did reference several times that it appeared there was a lot of blood flow going through the brain but then wanted you to come back and do an echo cardiogram to determine more of the size and what they would recommend.
First, however, they sent me to get an MRI just to see if I had any damage to my brain basically. Luckily, when I went in for this test everything about my brain looked good. They said it didn't appear I had any strokes or damage to my brain. That is good news!
I then went back to Sorensen Cardiovascular to have an echo cardiogram (ultrasound) of my heart done. This was pretty interesting to see your heart. They once again inject the saline solution into me and wanted to see if it flowed from the right side of my heart to the left. When they injected the solution we watched as bubbles flowed very quickly from the right side to the left confirming what they had suspected. When they were done with the echo I waited to see Dr. Sorensen himself. He came in to tell me that on a scale of 1 to 5 (5 being the highest) my hole would be considered a 5. He said that I had blood flow moving across my heart at all times (resting, exercising, whatever). He said that he would recommend closing this hole. They still didn't know the exact size of the hole but based on these tests could tell that I was having a lot of left to right blood flow which isn't normal.
Ben and I didn't have to think about it long before we decided we should do this. We felt like it would be a good preventative thing to do and were also hoping it might make me feel better in regards to my headaches. We scheduled my procedure for a few weeks before our Hawaii trip at the end of September.
I was pretty nervous simply because I have never had a surgery done or been in a hospital except for when I had Logan. I wasn't allowed to eat anything for 7 hours before my surgery. They had me to come in to the hospital at 1 pm. I was lucky enough to have my mom and Ben there with me to support me and calm my nerves. My wonderful sister and dad were watching Logan for me. They didn't take me into the surgery room until about 3 pm. They didn't put me out completely but did give me some 'forgetting' medicine they called it. However, I would have to say it didn't make me forget a lot. I was very coherent during the surgery and watched them on the x-ray screen. They didn't do an open heart surgery, they simply used a scope and went up through a vein in my leg to put this device into the hole--an Amplazter Occluder. I remember a very butterfly feeling in my chest when they opened the device up. The b picture below is what I could see on the x-ray machine. I could then see the scope as they went around the device to make sure it was in properly.
The surgery took about an hour and half. They told me when they were done that I had a 13 mm hole. That is the size of the inner part of the device. The device itself is over an inch. Dr. Sorensen also has a hole in his heart. He told me his was a 10mm hole. Normally they close around 7-9mm holes. He told me that for a female my hole was very large.They also confirmed after this surgery that I didn't have a Patent Foramen Ovale (PFO) but an Atrial Septal Defect (ASD). The main difference is that a PFO means you have a flap of some sort that is allowing blood flow across from left to right. With an ASD you have NO flap at all so not only can you have left to right blood flow but right to left. They had suspected this is what I had from the large amount of blood flow they had seen on the tests but they cannot tell for sure until they go in. All of the concerns are the same as the PFO for the ASD but they also worry that you might have heart failure problems because your right side of your heart is having to work a lot harder than it should.
When I came out of surgery I had a horrible headache but otherwise felt just fine. I had to lay still for 3 hours and not move my legs which got very uncomfortable towards the end. My dad brought Logan up to the hospital to see me and he rode on my bed as they moved me to my room. I wish I had a picture of this as it was definitely a highlight of my stay there. I had to stay the night and Ben was nice enough to stay with me. My mom and dad took Logan for the night and this was officially his first night away from us. Here I am in the morning with my cardio breakfast which actually wasn't too bad.
They had to do an echo one more time to make sure the device was in the correct place and that they heart wasn't rejecting it. I checked out in the clear and was sent home at 9:30 in the morning.
I was told to keep it easy for a few days and then I could resume normal activity. The only restrictions I had were I could not lift, pull or push more than 50 and I couldn't engage in strenuous exercise. Not really that restricting for me. :)
I felt really good the first couple of days and then after 3 days I felt like I started to get worse. My leg started to get really sore from where they had gone in with the scope. Come to find out I was bleeding internally and had developed a hematoma which was very painful. When I left the hospital they didn't prescribe me with any pain medication. I had to call my doctor and ask them to get me something because I was so uncomfortable. The bleeding stopped on its own so I just had to wait a few more days till I started to feel normal again. A little after a week I felt back to normal.
I have to take Plavix for 3 months and Asprin for 6 months but otherwise am back to good. I am happy to report that my headaches seem to less often and more responsive to medicine which is wonderful. It will take 6 months before my heart tissues fully grows over the device so it could take some time to see what the effect is. Nevertheless, I am grateful that we were able to find this and have it fixed before it caused more problems when I got older.
