Posts Tagged ‘Johns Hopkins’

Disciplining your Cardiac Kid

April 15, 2009

You may have the impression that when I was growing up, life around the Funky Heart household was all roses. I’m afraid not – I was a kid, and like all kids, I got into trouble!

I don’t remember exactly what I had done, but since it was a Sunday night, I had probably misbehaved at church. (Ten year old boys are very good at that!) And when we got home, I was spanked for my misdeeds. The next day at school, I had a coughing spell and threw up blood… and within a month, I underwent my second heart operation.

Were the two events related? As far as I know, they weren’t. I’ve written before that the doctors at Johns Hopkins had predicted that my first operation would last ten to twelve years before I outgrew it and something else would have to be done. Since I was ten years and six months old at the time of the second surgery, they were pretty accurate. But I also know that was the last spanking I ever had.

Maybe my parents were a little scared to spank after that. I never got into too much trouble; Heart Moms can tell you, their Cardiac Kids usually aren’t hellraisers. (Though every now and again you meet a Cardiac Kid who is spoiled rotten. I have to resist the urge to tell those children to straighten up, you’re giving the rest of us a bad name!)

Disciplining your Cardiac Kid is an issue that you will have to face – they are children, after all. Nobody gave them a list of the rules of proper behavior when they were born, and even if they did, the child can’t read them. And other than telling you that the “average” spanking probably won’t hurt them, I can’t tell you what to do. You will have to speak to your child’s cardiologist about it.

Don’t be ashamed or embarrassed; Pediatricians and Pediatric Cardiologists have been here before. They aren’t going to give you a hard time or call Social Services, unless your idea of discipline is pretty extreme. Just ask, and follow his/her advice.

Dad may have rethought his ideas on physical discipline, but he replaced it with this glare that lets you know he is not pleased with your actions. I have seen that glare…trust me, it’s not pleasant!

We’ve come so far…

April 10, 2009

Here’s an article from a 2001 issue of the medical journal Circulation: Researchers studied Centers for Disease Control (CDC) records from 1979 to 1997, searching for deaths in which a Congenital Heart Defect was a factor. After identifying over 124,000 deaths that met the criteria, they discovered a few amazing facts:

* From 1979 to 1997, Congenital Heart Defect (CHD) deaths declined 39.4%.

* During the same time period, deaths associated with a CHD – in other words, a death in which the defect was a contributing factor but not the direct cause – dropped from an average of 7169 to an average of 5822. That is a decline of 5.32%.

* The number of infant deaths dropped by 50% over the study period.

So the big question is why? What are we doing right? The answer is “Nearly everything.” We’ve got better technology. Better methods of putting the patient under for surgery. For example, the “correct” formula for rendering a patient unconscious used to be X milligrams of Ether per Kilogram of body weight. Ether hasn’t been used since the 1960’s, and hardly anyone remembers the correct ratio anymore.

We’ve got a better, standardized heart-lung machine. In the early days of cardiac surgery there was no open heart surgery because no one could figure out how to operate on a beating heart. There were experiments with using another human being as a heart-lung;  running cross- circulation tubes and then stopping the heart while the other person’s heart and lungs took over for them. This left the chance that two people could perish during a surgery gone wrong – but surprisingly, the first person to undergo the procedure survived. She’s still alive today, but is a very private person and only a few select people know where she lives.

There were experiments with putting the patient in a tub full of ice and stopping the heart that way. The idea was interesting, but it never really worked. And then there was the first heart-lung machines – everyone who had an idea built one, it seemed, and in the mid 1950s there were several different versions available. Most of them used tubing from the same beer company – the same type of plastic tubes that deliver the beer into your glass when the bartender pulls the handle! But that was the best tubing that could be found, so that’s what they used. But now we have an even better, standardized Heart-Lung machine. A surgeon who worked last week in Chicago can step into an operating room in Sacramento and feel comfortable with his equipment.

The level of care has improved. Post surgical procedure used to involve sending the patient to “Cardiac Care” which was really just a spiffy ward. Only over time did the highly specialized Heart Units develop, along with the skills of the people who work there. Take the best nurse at Johns Hopkins in the 1940’s – better yet, take Helen Taussig herself – and drop her into a 2009 Cardiac Intensive Care Unit. She wouldn’t have the skills needed to work there.

And it is improving even more, all the time.

Eli and Me

February 16, 2009

Good news from Lisa, who’s son Eli had surgery on Monday, February 9: Eli is doing great! Surgeons closed his ASD, resceted a “blob” of extra tissue near the Pulmonary Artery, and then performed the Bi-directional Glenn. Everything went well and Eli was discharged three days later! (And I get to tell you again that the drawing on the Glenn Operation page is not the Bi-directional Glenn… it’s the Unidirectional Glenn, sometimes called the Classic Glenn. It’s the operation that I have!)

February 9 is going to be your second birthday, Eli. Trust me on this one, I know. Because I’m coming up on my second birthday:  On February 17, 1967, I had my first heart surgery.

“He’s down to hours,” Cardiologist Richard Rowe told my parents that Friday night. “We need to go to surgery right now.” Afterwards I was in the hospital three weeks; Eli only had to stay three days. Three days – times sure have changed!

You probably won’t see a post on my second birthday, since I’m traveling. I’ll be heading to Atlanta, where on Wednesday morning my Cardiologist will put his stethoscope to my chest and hear that Classic Glenn Shunt just chuggin’ along.

So Happy (second) Birthday, Eli! And I hope you have many, many more!

Your buddy;

The Funky Heart

Our heroes are human

January 3, 2009

Don’t get me wrong, the man is a hero. But like a lot of heroes, we tend to overlook their shortcomings.

I’m guilty of that with my hero, Helen Taussig. She’s deaf, she’s dyslexic, she’s a woman working in a man’s world. But you rarely hear about her stubborn streak. When Helen Taussig made her mind up, she was right, and that was all there was to it. Being that focused usually served her well but it did occasionally get the better of her. At times, she was so stubborn she would continue to do research even when the data was not showing any progress.

Alfred Blalock had his own little habits and faults, too. But rather than harm the man’s standing and reputation, they just make him that much more interesting.

While Blalock gets credit – and deservedly so – for performing the Blalock-Taussig Shunt, he was not the best surgeon. After all, he did call for Surgical Technician Vivien Thomas to stand beside him and guide him through the surgery. Not once, not until Blalock felt more sure of the procedure, but every single time.

When Blalock graduated Johns Hopkins in 1922, he applied for a surgical residency. He didn’t get it. He chose to hang around and try again, so he interned in Urology and even tried Ear, Nose, and Throat work. Finally he left for a hospital in Boston but turned right around and left for Vanderbilt University. “I didn’t even unpack my trunk,” he said of his stay in Boston.

Although the first Professor of Surgery at Vanderbilt, Blalock was more of a researcher. Very few stories of him in the operating theatre exist but he produced scholarly research by the truckload.  Assisted by Vivien Thomas, the two changed everything that was known about shock at the time.

Thomas was certainly the better cutter of the two. After his return to Johns Hopkins, Blalock was again Chief Professor of Surgery. He usually conducted the classroom lectures, with Thomas running the surgical labs. The labs is where medical students learned how to operate – you learn by doing, and it was Vivien Thomas who was showing them how to cut.

Blalock was possessive, and felt that what was his was… well, it was his, and if he though you deserved special treatment he would share. As shown in the movie Something the Lord Made, Blalock really did brew his coffee in a graduated cylinder heated over a Bunsen burner. He figured that was one way he could insure no one bothered his coffee. After all, who’s going to drink a liquid out of a scientific instrument in a hospital lab, even if it does smell like coffee? One thing the movie doesn’t mention is Blalock’s stash of Cokes hidden in a box he had labeled “medical waste”!

I’m not a fan of Coke, but Cheerwine… I can see myself keeping a few cans of that under lock and key! Obviously, Alfred Blalock was a hero to a lot of us. But better still, he was just as human as you and I.

The Secret Origin of the Funky Heart!

January 1, 2009

I’ll be in Washington DC for the Adult Congenital Heart Association‘s (ACHA) Lobby Day on February 10, 2009. The 10th is fine, but in a way I wish it was scheduled for a week later. February 17th, you see, will be the 42nd anniversary of my first heart operation.

I was born in the fall of 1966 and it wasn’t long before my parents realized that there was something wrong with me. My Pediatrician picked up on it fairly quickly, realizing that I had a heart problem, but he wasn’t sure exactly what the problem was. After seeing several doctors who were also stumped, my folks  took me to the Medical University of South Carolina (MUSC).

The doctors at MUSC figured out the problem – I had been born with a Congenital Heart Defect known as  Tricuspid Atresia. In Tricuspid Atresia, the Tricuspid Valve, located inside the heart between the Right Atrium and the Right Ventricle, never formed. But instead of there just being a hole with a missing valve, I have a wall there. Blood flow is completely blocked.

Blood normally flows into the Right Atrium and down into the Right Ventricle; then is pumped out to the lungs. It return to the heart through the Left Atrium, then to the Left Ventricle, and is pumped out to the body. Block the blood flow through the heart and you kill the owner.

What keeps me alive is the fact that there are holes in the wall that seperates the left and right sides of my heart. My blood literally takes the senic route to get through my heart, and on its journey oxygenated blood and deoxygenated blood are allowed to mix. That normally doesn’t happen, and because of it I am Cyanotic – the amount of oxygen in my blood is lower than normal.  I gasp for breath and tire easily;  and my fingernails and lips have a slight bluish tinge. The blueness really becomes pronounced in cold weather.

The doctors at MUSC told my parents that I had Tricuspid Atresia, and that they should take me home and love me, for I was not long for this world. That didn’t sit well with my parents, who went back to my local Pediatrician and said “We need to try something,” even though they had no idea what “something” was. The Pediatrician gave them four places that could attempt a surgical repair: Houston, Texas; Mayo Clinic in Rochester, Minnesota; the University of Virgina; or Johns Hopkins Hospital in Baltimore, Maryland.

Houston and Mayo were eliminated because of the travel distance. The doc threw out Virgina, the medical school he had graduated from, because he felt they didn’t have enough experience with the operation. That really left one choice, and the doc said that he’d get the wheels in motion with the doctors at Hopkins.

That night all hell broke loose. I went into heart failure, with a pulse of 200 and a temperature of 103. It took them five days, but they were able to get things under control at my local community hospital. Meanwhile the doctors at Hopkins were taking the information from my local doctor over the phone and telling him they wanted to see me as soon as someone could get me there.

The folks hit the road, driving into one of the worst snowstorms to hit the East Coast in memory. Things were OK for a while, they finally stopped somewhere in Virgina to rest (this was long before Interstate 95 was completed). During the night, my mother got up to use the bathroom, glanced out the window… and saw it snowing. She woke up my father; we were in the car and moving within 15 minutes.

Every few miles Daddy would pull off the road long enough to wipe off the windshield with an old rag he had found in the trunk. The snow was getting deeper and more and more cars were stalled along the highway, and at one point my father thought about putting Momma and me on a train for Baltimore and catching up to us later. It never came to that, thankfully.

The Hopkins Admissions Office expected three families from out of town to arrive that day, we were the only ones who made it. The doctors at Johns Hopkins examined me not long after I arrived and Cardiologist Richard Rowe gave my parents the news. “He’s down to hours. We have to operate tonight.”

Dr Alex Haller, the Pediatric Cardiac Surgeon, should have done my operation. He was in Washington DC, trapped there because of the snow. Dr. Vincent Gott, Chief of Surgery, stepped in for him. The surgery was known as the Glenn Shunt – a variation of the operation, known as the Bidirectional Glenn Shunt, is performed every day in operating rooms around the world. But at that time it was new, so new that I was the 5th person to survive the operation.

And sometime over the next few days, my father picked up a copy of The Baltimore Sun and gasped. The snow had been so heavy, it reported, that train service into Baltimore had been halted. If he had put us on that train, I would have died.

When I went to Baltimore for the ACHA a few months ago, I had hoped that the schedule would allow me to go back to Hopkins and look around. Not that I expected to know anyone – doctors retire or move on, especially after 42 years. In fact, I don’t remember a single person. I vaguely remember a statue. I’d like to see Him again.

Ten and a half feet tall, standing on a podium, a statue of Christ greets visitors to Johns Hopkins Hospital. His name is Christus Consolator, or The Divine Healer.

I think we’d have a lot to talk about.


What good is a deaf cardiologist?

November 30, 2008

Not much.

I’ve written about Vivien Thomas and Alfred Blaock; so it is time to write a few lines about the third person involved in the Blalock-Taussig Shunt: Pediatric Cardiologist Helen Brooke Taussig.

For those of you who may not know, Taussig’s my personal hero. When I was a patient at Johns Hopkins in 1967, Taussig herself examined me. From what my parents tell me, she was officially retired, but still lived in the Baltimore area and “stopped by the office” occasionally. I was five months old at the time, so I don’t remember it.

Her father was Frank Taussig, a prominent economist who taught at Harvard. Imagine his frustration when his daughter tried her best in school but still seemed to just not get it. I think every parent has shared that frustration at one time or another. It wasn’t her fault – it turns out that Helen Taussig had Dyslexia. Finally after a lot of patient work with her father everything just “clicked” and she was able to graduate. She went to the University of California at Berkley and then applied to Harvard Medical School.

The problem was, Harvard didn’t accept women into its medical program, so Helen tried Johns Hopkins Medical School instead. After she graduated, she took the job as head of the Cardiac Clinic at Hopkins’ children’s hospital, the Harriet Lane Home for Invalid Children.

Ironically, after becoming a doctor, Helen Taussig began to lose her hearing. And what good is a doctor – especially a cardiologist – who loses their hearing?

Thankfully, it wasn’t a sudden event. Helen Taussig lost her hearing slowly, and was able to compensate. Obviously a hearing aid would help, and she took full advantage of them. The movie Something the Lord Made is inaccurate in one respect: Mary Stuart Masterson (the actress who played the role of Helen Taussig) chose to use a more advanced hearing aid than was available at the time. The earpiece available in the early 1940’s was the size of an earmuff, and Masterson thought that such a large, bulky prop would distract from the character. (Look at this 1940’s era photo of Dr. Taussig examining a child in a wheelchair. The black box balanced on the edge of the chair is not Taussig’s medical bag, it is the amplifier for her hearing aid.)

As her hearing faded, she lost the ability to hear some of the chest sounds that a Cardiologist needs to hear to make a diagnosis. So she taught herself how to feel heartbeats by placing her fingertips lightly on the patient’s chest, and for years her hands were her “second stethoscope.” (Click here for a close-up photo of Taussig’s fingertip examination.)

Known mainly for her work in Pediatric Cardiology, few remember that Helen Taussig also played a critical role in averting the Thalidomide crisis in the United States. While Frances Kelsey receives credit (deservedly so) for not authorizing the drug for sale here, Taussig got involved when one of her German students commented that there had been a marked increase in the occurrence of Phocomelia in her home country. Taussig began to study the problem, and before long had determined that the morning sickness drug Thalidomide was causing birth defects. Because of Kelsey’s and Taussig’s actions, only 17 American children were affected by the drug.

So, what good is a deaf cardiologist? It all depends on who that deaf cardiologist is!

Teamwork

November 28, 2008

blalock-thomas1

These two men did pioneer work on blood loss and shock. They developed heart surgery procedures that are still in use. Odds are, you have only heard of one of them.

Vivien Theodore Thomas was born on August 29, 1910 in Lake Providence, Louisiana. After graduating high school in 1929, he planned to attend Tennessee Agricultural and Industrial State Normal School, (Now known as Tennessee State University) with hopes of becoming a doctor.

He had been in school two months when the stock market crashed, causing him to lose his part-time carpentry job. Forced to drop out of college, Thomas still found work as a Lab Assistant at Vanderbilt University Medical School, working for surgeon Dr. Alfred Blalock. Although hired to sweep floors and clean out cages, Vivien Thomas impressed Dr. Blalock with his intelligence. Blalock was so impressed that he trained Thomas to be his Surgical Technician.

Thomas began assisting Blalock in the study of shock during surgery. Shock is caused by a sudden drop in blood flow through the body, and can be fatal. Working together, Blalock and Thomas developed ways to prevent shock from occurring during an operation. By World War II most of their theories were in use, saving the lives of countless injured soldiers.

In 1941, Dr. Blalock was hired by Johns Hopkins Hospital in Baltimore, Maryland, to serve as the hospital’s Chief Surgeon and as a Surgical Professor in the Hopkins Medical School. The doctor asked his trusted assistant to go with him, and Thomas agreed. But while Blalock was responsible for training every surgeon in the school, Thomas had to enter the building through the service entrance. He was also listed on the hospital payroll as a handyman.

The two men respected and trusted each other, but were hardly equal. At one time, Blalock was paid ten times more than Thomas. Often the doctor hired Thomas to serve drinks in his home during a social event. And never was Thomas allowed in the Operating Room.

It was at Johns Hopkins that the two men met Dr. Helen Taussig. Taussig had been hired in 1930 to oversee the Cardiac Clinic of the Harriet Lane Home, (Hopkins’ children’s hospital) and quickly grew interested in “Blue-Baby” diseases.

Usually, blood coming into the heart is routed first to the lungs, where it absorbs oxygen. The oxygen rich blood then goes back to the heart, where it is pumped throughout the body. Blue Babies are born with a badly formed heart or blood vessels that cannot provide enough oxygen to the blood. Their skin has a distinctive blueish tinge, especially in the fingertips. At that time Blue Baby diseases were incurable, and almost all of the patients died very young.

Dr. Taussig approached Dr. Blalock with an idea: if a Blue Baby’s heart couldn’t provide  oxygen to the blood naturally , then why couldn’t a surgeon re-route the major blood vessels? Taussig’s plan was interesting but extremely dangerous. The operation would have to take place near the heart, and heart surgery was so risky it was almost never recommended. Any accidental damage to the heart would have to be repaired within 4 minutes, or the patient died.

Busy with his teaching duties, Blalock asked Vivien Thomas to work out the details of how such an operation could be done. Thomas began by studying medical textbooks, drawings and diagrams of hearts, and even real hearts taken from dead bodies. Then he operated on dogs, intentionally creating Blue Baby hearts in them. Later he would operate again, repairing the heart and making careful notes of everything he did. It was a slow process, learning exactly what had to be done.  Many dogs died, and several of the surgical tools he needed didn’t even exist. Quite often, Thomas would invent them.

X-rays of the patient were another problem. X-ray films provide a good still photograph of the workings of the body. But Taussig preferred to use a fluoroscope. A fluoroscope image is best described as “X-ray TV”– It provided moving images of the interior of the body. If the patient accidentally moved, so did the picture. There was no way to record the fluoroscope image, so the three doctors would have to study their patient’s fluoroscope scans carefully and commit them to memory.

At last they felt they were ready, and Taussig began to search for a proper patient. On November 29, 1944, they operated on a little girl named Eileen. Although fifteen months old, Eileen only weighed nine pounds.

Thomas had planned to be in the observation room, watching the operation. Blalock said no – he felt more comfortable with Thomas close enough to give him advice. In preparation for the operation, Thomas had performed the procedure over 100 times on animals. Blalock had been taught the procedure by Thomas, but had actually done it only once. Breaking all the rules of the time, Thomas entered the operating room and guided  Blalock through the operation.

Eileen’s heart never stopped beating and her blood vessels were only as thick as a  matchstick. After about 90 minutes, Blalock was finished. Everyone held their breath as he removed the last clamp from a blood vessel. After a long pause, Helen Taussig said “Al, the baby’s lips are a glorious pink color.”

Proven to be a success, Blalock’s team performed nearly 300 operations in less than a year. Surgeons came from around the world to study Blalock’s new surgical procedures, only to learn that Thomas was the expert, not Blalock or Taussig. Still, the operation was known as the “Blalock-Taussig Shunt,” named for the surgeon who performed it and the doctor who suggested it.

Blalock retired in 1964 and died four months later. For six years, Thomas continued to teach but took on no major project – almost as if  he were in mourning. But as the 1970’s began, more and more African-Americans were entering the Hopkins Medical School. To them, Vivien Thomas was not just one of their teachers, he became their mentor. And just as he had guided Blalock so many years before, Thomas’ advice and support guided a new generation of doctors through medical school.

Thomas died in 1985, just a few days before his autobiography was published.* Today, Vivien Thomas is almost unknown to the general public. But Dr. Alfred Blalock never forgot him. If someone stood too close to his right shoulder during an operation, Blalock would tell them to back away. “Only Vivien may stand there.”**

* Thomas’ autobiography has been reissued with a new title: Partners of the Heart: Vivien Thomas and his work with Alfred Blalock. A hardback copy of the original title, Pioneering Research in Surgical Shock and Cardiovascular Surgery: Vivien Thomas and his work with Alfred Blalock is usually valued at over $100.

** This photo has been identified by Johns Hopkins archivists as being a photo of the third Blalock-Taussig Shunt taken in early 1945. Dr. Helen Taussig normally would have been in the operating room but is not identifable in this photograph.

On the Street Where You Live

November 6, 2008

This past week I’ve spoken a lot about Katie, sometimes I wonder if I’ve said a little too much. I’ve been asked, both online and in real life, if maybe I’m paying just a little too much attention? It’s not really a surprise, as I thought about it myself.

I’ve never met Katie or her parents. All I have learned about them, I’ve read on their website. It’s been a hard thing to try to follow the recent news about her, because it hits so close to home. Katie is five months old – the same age I was when I had my first heart surgery.  She’s had the Bi-Directional Glenn; I’ve had the original version of that operation. Katie is at Yale New Haven Hospital, where Dr. William Glenn himself lived and worked. I’ve read that Dr. Glenn, despite being a world famous heart surgeon, would leave his home on Saturday mornings and walk to Yale’s football field to cheer on the home team. He sounds like my kinda guy.

Katie has Hypoplastic Left Heart Syndrome (HLHS). I have Tricuspid Atresia, which is occasionally referred to as one of the defects that make up Hypoplastic RIGHT Heart Syndrome. (HRHS) The term HRHS wasn’t even invented when I was born (I don’t think anyone had thought of HLHS, either) so I’ve always just referred to myself as having Tricuspid Atresia. But when you think about it, Katie’s heart and mine are nearly mirror images of each other.

Spooky. As the title of this post notes, it hits you on the street where you live.

After my surgery at Johns Hopkins in 1967, one of the doctors mentioned in passing that we were one of only two families who had made it in that night. The other child had been born premature, and despite being healthy in every other respect, hadn’t made it. The doctor shook his head. “Some children…they just aren’t fighters.”

There’s no doubt about it, little Katie is a fighter. She’s hanging on for all she’s worth, clawing and spitting and digging her nails in. Keep fighting, Katie! I’m pulling for you!

My Glenn Shunt is worth more on eBay!

October 13, 2008

Yeah, you read that right. My Glenn Shunt would bring a higher price on eBay! Yours? Not so much. I have a classic vintage model, so the price would be higher!

I’m kidding with you, obviously. If you happen to need a Glenn Shunt (or any other heart operation) then the true cost is out of your reach; it’s priceless.

The Glenn Shunt is one of the oldest heart operations around. It was first described in 1951, and Dr. William Glenn of Yale University first reported performing the procedure successfully in 1958. Since he was the first person to routinely have success, the operation bears his name. (If you or someone you know has a Glenn shunt, please click THIS LINK and download and read the PDF file. There is a lot of important information here that you need to know!)

When I tell people I have a Glenn Shunt, the ones who know what I’m talking about will nod their heads knowingly. Most of the time, though, they are still wrong. My Glenn was done in 1967, and I am a proud owner of a Classic Glenn Shunt. Most of the Glenns done today are the Bidirectional Glenn Shunt.

So what’s the difference? Before you describe the Glenn, it helps to have a diagram to help you visualize it. Click HERE for a useful diagram of the heart.

In the Classic Glenn, the Superior Vena Cava (The large vessel that leads into the Right Atrium) is closed near the Right Atrium (usually, it is not cut, but rather sewn closed.) The Pulmonary Artery (the “T” shaped blood vessel that runs under the “loop” formed by the Aorta) is also cut… the right branch of the Pulmonary Artery is disconnected. The hole left by cutting the right branch of the Artery is sewn closed, and then the right branch is connected to the side of the Superior Vena Cava.  By doing this, the Right Atrium is completely removed from the blood flow. Blood coming to the heart through the Superior Vena Cava now goes directly to the Right Lung, and flows back to the Left Atrium normally. Then it goes through the Left Ventricle and back out to the body.

The Bidirectional Glenn was invented, surprisingly, in 1966. While it was around when I had my Classic Glenn in 1967, my operation was the fifth Glenn Shunt (of any kind) that had been performed at Johns Hopkins; so it is a safe assumption that the surgeons weren’t prepared to try the new version just yet. In fact, the Bidirectional Glenn really came into its own in the 1980’s, when it became the second step in the three operation Norwood Procedure used to combat Hypoplastic Left Heart Syndrome (HLHS).  It’s also part of the Fontan Procedure, sometimes performed as a seperate operation as part of a Staged Fontan.  The biggest difference in the two operations is that in the Classic Glenn, the Superior Vena Cava is completely cut and sewn into the right branch of the Pulmonary Artery. In the Bidirectional Glenn the Pulmonary Artery is not cut, which allows blood flow to both lungs.

It’s important for someone with a Congenital Heart Defect (CHD) to know what “version” of an operation they have had. For years, I told doctors “I have a Glenn Shunt,” not knowing that the operation had been changed. After I had told a new doctor that I had a Glenn Shunt, he slapped my X-Ray on the lightboard, took a long pause, and finally said “I don’t know what the hell this is, but it ain’t no Glenn Shunt.” Only after the head of the Cardiology Department came in and said “I haven’t seen one of those in a while!” did I realize that simply saying “Glenn Shunt” wasn’t good enough. Thankfully that snafu occured during a routine office visit and not a crisis visit to an Emergency Department.

Anna saved us all

October 6, 2008

I’m leavin’ in a minivan,

should be back Wednesday night…

Wait a minute, that doesn’t rhyme. I guess my career as a songwriter isn’t going anywhere.

I’m packed for the trip to Atlanta, the laptop is also packed and the batteries are charged, so I should be able to post tomorrow night. Of course, you’ll get a full report once I return home. I’m feeling good and not expecting any problems, though my weight is up a little bit. So the doc may wave his finger in my face. He won’t have to crack the whip too hard; I don’t like for it to be up either. When you have heart failure, your weight creeping up might mean there is a problem brewing. And even if it doesn’t, your heart has to work harder. That’s not good.

First, here are a couple of links that you need to read: Researchers have discovered that a new type of drug can trigger a heart defect in unborn mice. The chemical in question is fairly common, so if you are planning to have children (or more children), clicking these links would be beneficial!

But let’s not get ahead of ourselves; the sky isn’t falling (yet). Taking the results of a research study using unborn mice and saying that we’ve found a way to prevent heart defects is a giant leap, but it is certainly worth continued study.

Is animal research necessary? I have to answer with a resounding “YES!” When he was designing the first congenital heart surgery, Vivien Thomas first had to study the effects of Tetralogy of Fallot (ToF) in a test subject, then figure out a way to correct the defect. Conducting experimental surgery on children with ToF was completely out of the question, so Thomas first had to surgically re-create the defect, then devise a corrective procedure to counter it.

His test subjects were dogs, most of them supplied by the Baltimore City Pound. Thomas is said to have performed heart surgery 200 times or more before Alfred Blalock attempted it on a child, so we must assume that most of those operations were failures. The dogs almost certainly perished.

Finally Thomas figured it out, and not only did the dog (a “mutt” named Anna) survive the procedure that “gave” her a defective heart, she made it through the operation that corrected it. Thomas then taught Blalock the operation (again, on a canine test subject) and on November 29, 1944, with Thomas standing behind him giving him guidence and advice, Blalock performed the first operation designed to relieve a Congenital Heart Defect. (Click this link for a “Who’s Who” in the operating room!) The operation eventually became known as the Blalock-Taussig Shunt. Anna became the mascot of the Johns Hopkins Surgical Lab and lived there until her death in 1957. She even had her portrait hung in the Hospital.

While animal research may be necessary; animal cruelty is not. My personal rule of thumb is “Would I do this to my family pet?” If the answer is no, then that test is not done. (And this standard can be subjective; my dog is not my pet, she is a member of the family. A neighbor who owns hunting dogs does not think of them as his pets, rather they are “tools”. Their main purpose is to do a job: Tracking deer.) So even going by my own rule, Thomas would have never invented cardiac surgery. Because I couldn’t do that to my dog.

So now, all I’ve done is muddied the water! While you are contemplating the fine line between animal research and animal cruelety, carry a couple of doggie biscuts in your pocket and be sure to toss one to a stray. Because if it wasn’t for a mutt named Anna, none of us with a heart defect would be here.