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Heart Biopsy
A
routine part of a heart transplant is the heart biopsy. In this procedure,
small 2 mm sample of the actual heart tissue are extracted and tested
for rejection. Patients have this procedure done weekly for a month, then
every 2 weeks for a month, once a month for 4 months , once every 2 months
for four months, and finally just twice a year.
5:45
A.M. Walking to UCLA Medical Center for Heart Biopsy
6:00
A.M. NO food, NO drink, No meds after midnight the night prior to the
procedure.
It's first come, first serve for the biopsies. Three people arrived before me on this particular day. After a fun two hour wait, it's my turn.
Getting
ready to begin.
Thoroughly
cleaning the entrance site.
Two
shots to numb the area. One at the skin's surface and the second in the
deeper tissue. This is the most painful part.
While
we're in there, let's go ahead and draw some blood so the lab can test
medication levels among other things.
It's
important to hold very still.
Close-up
of the actual Biopsy Forcepts. This claw-like mechanism literally bites
into the heart muscle and takes out a 2 mm piece of tissue to test in
the lab.
A
kind and gentle doctor adjusts the angle of the forcepts to ensure accurate
placement.
Lining
up the X-Ray. Doctors and Technicians wear lead vests.
X-ray
of my chest. The black strings on the left are the titanium ties that
were used to put my sternam back together after my new heart was inserted.
These ties will be there for the rest of my life. The X-ray screen is
used in this procedure so the doctor can see the location of the biopsy
forcepts as they are threaded through a heart valve.
The biopsy forcepts enter the heart through a large vein in the neck. This process is repeated four times to obtain four samples of tissue. Sometimes more attempts are necessary.
Once
all intrusive devices are removed pressure is applied to the site to stop
any further bleeding. This becomes more of a challenge since most transplant
patients are on an aspirin daily to thin their blood.
Steve displays some of the tubing and catheters used for the procedure.
I
decided to ham it up for Jane and make her think she really hurt me. She's
not buying it.
After
a 30-45 minute biopsy, it is about 9:30 A.M. The next step is to walk
downstairs to get a chest X-ray. The X-ray goes pretty fast, and then
you can eat and take your morning medications. My mood is much better
with food in my stomach. After X-rays the next stop is usually an echocardiogram.
An "echo". This is an ultrasound of the heart muscle. The heart's
efficiency is assessed by taking volume measurements of the amount of
blood pumped etc. On this particular day I got to skip the Echo because
I had a recent one done and my numbers were great. This means I just shaved
off about 45 minutes of the total time at the Clinic for the morning.
I'm glad, and off to the next waiting area where I get a chance to visit
one on one with the Transplant Coordinators, Nurse Practioners, Social
Worker, and my main Transplant Doctor who oversees my case as a whole.
Walking
to X-ray just after the biopsy portion of the morning. 9:30 A.M.
Leaving
X-ray. 10:00 A.M.
11:30
A.M. Back in the elevator going home. Because "sick" people
go to hospitals there are a lot of germs floating around. I wear a mask
whenever I'm walking from one appointment to the next or in a waiting
room. Organ Transplant patients take a lot of immuno-suppressant drugs
to prevent the body from rejecting the new organs. This means my body
doesn't want to reject germs and viruses it comes into contact with.
To prevent a cold or the flu or worse we wear masks, wash our hands
all the time and avoid sick people whenever possible.