We went to sleep last night expecting a freezing temperature at daybreak this morning.\u00a0 We are finishing breakfast while watching deer amble around the back fence just 30 feet away and the thermometer reads 40 degrees Fahrenheit (~5C).\u00a0 The sky was clear last evening and (apparently) expected to stay that way so we would have experienced rapid radiative cooling.\u00a0 Instead, the flow of the jet stream shifted unexpectedly our way from over the Pacific Ocean just off Washington State\u2019s NW corner.\u00a0 That shift brought enough moisture into our atmosphere to prevent the cooling we were told to expect.\u00a0 Either that or there is one huge forest fire sending a pall of smoke and warmth our way and covering the sky.\u00a0 Without further investigation it is hard to tell.<\/p>\n
Nancy\u2019s recovery is continuing but there too is an unexpected turn.\u00a0 I suppose it is unexpected for us but not for the cardiologists involved in her case.\u00a0 (Metaphor alert!)\u00a0 They, having been years at this, are not surprised by much and have gone down all the various paths, even those less traveled. \u00a0At our recent appointment, the receiving (or check-in) nurse was a heart patient and the doctor too.\u00a0 His pulmonary valve had been replaced by the same surgeon that replaced Nancy\u2019s mitral valve.\u00a0 About 8 years after the replacement that tissue valve began to fail and he then had an artificial valve implanted.\u00a0 The parts in our truck don\u2019t last that long but, still, when you fix something you like to think it will stay fixed.<\/p>\n
With hearts there are many things to measure besides beats per minute and the one at the top of the list today is called the ejection fraction<\/em>.<\/p>\n Below is a link that gives a clear explanation:<\/p>\n http:\/\/www.medhelp.org\/posts\/Heart-Disease\/EJECTION-FRACTION-\/show\/869616<\/a><\/p>\n \u201cEjection fraction (EF) is a measurement of how well the heart is pumping.\u00a0 It represents a percentage of the total blood volume in the left ventricle that is pumped (ejected) with each beat of the heart.\u00a0 As with any pump not all of the liquid is pumped out with each cycle.\u00a0 Normal EF is in the 50-60% range.\u00a0 Values higher than this are termed “hyperdynamic”, meaning that the heart is forcefully contracting.\u00a0 The lower the EF the worse the heart function.\u00a0 A general breakdown of values is as follows: 40-50 % mild dysfunction; 25 – 39% moderate dysfunction; < 25% severe dysfunction.\u201d<\/p>\n The most recent test of Nancy\u2019s heart (done when she went to the ER a few weeks ago \u2013 and under the stress of excess fluid) showed and ejection fraction of about 25% — note this is about half the normal as defined by the above statement.<\/p>\n Nancy\u2019s heart also exhibits atrial fibrillation<\/em>. The Mayo Clinic staff have a description of \u201ca-fib\u201d on the web:<\/p>\n http:\/\/www.mayoclinic.com\/health\/atrial-fibrillation\/ds00291<\/a><\/p>\n As I read that I think of the most recent truck repair \u2013 replacing all the wiring components that keep the spark plugs firing well and in proper sequence.\u00a0 I knew this work need doing and so, just before we went to pick up the new horses, into the mechanic we went.\u00a0 I hate breakdowns at any time, but with 3 horses that are new to us and on an interstate highway such an episode is to be avoided.<\/p>\n Well, the human body functions with electrical impulses also and those that are directing Nancy\u2019s heart are a little bit in need of help.\u00a0 The help comes in the form of a modern \u201cpace maker\u201d and is called an implantable cardiovertor defibrillator<\/em> or ICD.\u00a0 The link here is helpful:<\/p>\n http:\/\/www.nhlbi.nih.gov\/health\/dci\/Diseases\/icd\/icd_whatis.html<\/a><\/p>\n The very last paragraph of the above page mentions a special procedure called cardiac resynchronization therapy<\/em> (CRT) involving a device able to pace both ventricles at the same time. \u00a0Nancy\u2019s primary cardiologist suggested we discuss this route with the implanting specialist.\u00a0 His opinion, at the moment, is that this is a less traveled road and one she need not take.<\/p>\n","protected":false},"excerpt":{"rendered":" We went to sleep last night expecting a freezing temperature at daybreak this morning.\u00a0 We are finishing breakfast while watching deer amble around the back fence just 30 feet away and the thermometer reads 40 degrees Fahrenheit (~5C).\u00a0 The sky was clear last evening and (apparently) expected to stay that way so we would have … Continue reading “SUNDAY — unexpected turns”<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","default_image_id":0,"font":"","enabled":false},"version":2}},"categories":[6],"tags":[],"class_list":["post-493","post","type-post","status-publish","format-standard","hentry","category-surgery"],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p72iNf-7X","_links":{"self":[{"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=\/wp\/v2\/posts\/493","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=493"}],"version-history":[{"count":2,"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=\/wp\/v2\/posts\/493\/revisions"}],"predecessor-version":[{"id":495,"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=\/wp\/v2\/posts\/493\/revisions\/495"}],"wp:attachment":[{"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=493"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=493"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/rocknponderosa.com\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=493"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}