Heart Disease and a Tribute to Abraham Kuhn
Thursday, April 5th, 2007I am writing this story to help you make decisions for a family member with cardiovascular heart disease or even cardiovascular heart disease and diabetes.
My story starts with my father, Abraham Kuhn, may he RIP - April 26, 1926 - April 4, 2007. I love you DAD.
My father had diabetes and heart disease. His diabetes was pretty much controlled. His heart was the problem. He had 2 bypass surgeries over the past 28 years.
He was having chest pains over the past 4 months and I kept sending him to his doctor and his cardiologist. He had EKG’s done which only show the electrical activity occurring in my father’s heart.
As the chest pain and shortness of breath started occurring more and more, he was put on a nitroglycerin patch. First during the day, but then having chest pains at night and then switching the patch to the night and then removing for at least 8 hours during the day.
Nothing seemed to be working. We kept calling the cardiologist and told us “there is nothing more we can do” except if he wants a procedure called Extracorporeal cardiac shock wave therapy or ECS. Not knowing too much about it and my father having to travel down to Elizabeth for the treatment, discussion was just about dismissed.
My father and I just had enough and went to the ER at Robert Wood Johnson. He told me that the hospital will do more in depth tests to see what was wrong. He was upbeat about the whole visit to the ER and trusted the doctors at Robert Wood Johnson. They did some blood work that showed he had a small heart attack. He had a Standard Echocardiogram done but he did
not order a TEE or TransEsophageal Echocardiogram.
What is the difference between a STANDARD ECHO and a TEE and I am bringing this up because it may make a huge difference in what the following treatment may be.
A standard echocardiogram or Echo is obtained by applying a transducer to the front of the chest. The ultrasound beam travels through the chest wall (skin, muscle, bone, tissue) and lungs to reach the heart. Basically it travels through the front of the chest or thorax. At times, closely positioned ribs, obesity and emphysema may create technical difficulties by limiting the transmission of the ultrasound beams to and from the heart. In my father’s case he was slightly obese.
In such cases, your doctor may select to get a transesophageal echo or TEE, where the echo transducer is placed in the esophagus or food pipe that connects the mouth to the stomach. Since the esophagus sits behind the heart, the echo beam does not have to travel through the front of the chest, avoiding many of the obstacles described above. In other words, it
offers a much clearer image of the heart, particularly, the back structures, such as the left atrium, which may not be seen as well by a standard echo taken from the front of the heart.
His new cardiologist from Robert Wood Johnson decided, based on his blood work and echocardiogram, to do a cardiac catheterization to possibly open a possible artery that may be blocked. If he had done a TEE, most likely he would not have done a cardiac catheterization because the TEE would have shown moderate problems with his arterial valve and his mitral valve.
When the cardiologist started to do the cardiac catheterization, it put him in cardiogenic shock. His heart was failing and now they had to insert a balloon pump to help his heart pump the blood. My father was now on full support–respirator, foley catheter and all these IVs and invasive lines going into his body.
After 4 days on full life support, he started spiking a temperature. All those invasive lines in my father was now giving my father septic shock. Eventually his blood became sepsis and died.
I know it was my father’s time to go but to all of the significant others and people that have heart disease, please do not accept a simple echocardiogram if you are having any kind of invasive surgery before they do a more in depth TEE and other appropriate tests. They did do a TEE after the fact when he was on full life support. I actually was allowed to watch the TEE. Since I am a
nurse, some of this made sense. I did not work in a hospital setting so all this ICU stuff was foreign to me.
The thing is we all talked to my father before he had the surgery, but he never spoke to us again after that because he was heavily sedated and on full life support. I could understand why he was sedated because why should he be subject to any kind of pain or waking up to see what was happening to him?
We all spoke to him and I feel he did give us an indication that he heard us. One day my niece and me were in the room and we saw 1 tear come from his eye. I told my niece it was just his water from his eyes so that wouldn’t upset her, but I knew it was a
tear. Before he was going down to get another procedure to help with his kidneys, I was there with my brother. I saw tears coming out of his eyes and he was trying to move his mouth to tell us he heard what we were saying and that he was trying to say he loved us too. At this time he was less sedated.
Then after doing the procedure to do dialysis for him, he came back to his room, and the hospital then started a BLUE CODE. He was in septic shock and he was losing his blood pressure. He was on the max medications for his blood pressure.
There was nothing more that could be done. The whole family was there as he was leaving his body. From the information I had read, as people are dying, they can still hear you.
Please become an informed patient or significant other before doing any kind of invasive surgery and make sure they do as in depth testing, if possible, first.
My father was a kind and loving man. Through my whole life I can’t remember a single bad time. He never got angry or yelled at any of us. He was the most laid back man I have ever met.
Dad, you will always be in my heart. Always tell the person you care about how much you love them. Actions speak louder than words. Spend time with the one you love.
