Final Prep

Coronary angiogram, final prep before Omar's surgery. 

Woke up at 5am of January 30 for Omar's medication and left the room for the cath lab at 6am for the 7am angiogram. 

Kuya came, bought me breakfast and joined me as we listened to Dr. Habana with Omar's angiogram's result. 

Omar's right coronaries are clear from blockage. Unfortunately, with his big aorta, the catheter cannot reach the opening for the left coronaries. Due to the expansion of the aortic valve, both the right and the left coronaries are displaced. Based from the CT aorto gram, looks like the left coronaries are clear too. But Dr. Habana will discuss it first with Dr. Lee if the nuclear scan will still be necessary. 

Thank you for your prayers. 

Final visit

Hopefully the last visit before the surgery. 

Thankfully, only 1 tooth was extracted from Omar. The other tooth was saved. 

Now, we need to hurry back home, pack our stuff, and be admitted at The Medical City for Omar's angiogram tomorrow morning. 

Blessed

God is great! He has plans for us. 

Omar's dentist happens to be the dentist of Fr. Jun Roxas, a family friend. Fr. Jun is due to see the dentist too. 

I called Fr. Jun and asked if he can give the sacrament of annointing of the sick for Omar. 

At the clinic, the dentist stepped out of his clinic and graciously offered his clinic for Omar and Fr. Jun for confession. 

Fr. Jun then called us to join them for the Annointing of the Sick. 

Thank you Dr. Giron for being the instrument to meet Fr. for the sacrament. Thank you Fr. Jun for granting our request. Thank you Lord!

Now, we're ready. 

Schedule is out.

And so we met Dr. Habana for the final admission orders and schedule. 

So we need to prepare looooottttsss of blood as Omar will be hook into a heart lung machine where the blood running through it has a chance of it being destroyed. We will be needing 10 units each of RBC, platelet and plasma. 

With his big aorta, it is compressing his lower left lung defecting it. With angiogram, they will have to use a bigger size of wire.

The team will perform a bentall procedure with Omar. But not right after the angiogram. According to Dr. Habana, from recent studies, there is a bigger chance of complications with kidney risk during post op if surgery will be done together with angiogram. 

From his pulmonary function test, it was detected that he has small airway disease but that could be treated after the operation. 

The angiogram will last for 30 minutes to an hour. We have to temporarily stop giving Omar Losartan to minimize chance of renal side effects but will double the dose of amlodipine. He will be in IV once admitted for hydration. 

Prior to angiogram, he will be given Valium 5mg and Benadryl at the Cath Lab. Local anesthetic will be applied at his groin where they will insert a wire to the artery with a catheter. Dye will be used to view the coronary artery. 

We will be admitted tonight, January 29, 2014 to prepare Omar for his coronary angiogram at 7am the following day, out on Friday Jan. 31. We will be admitted on Sunday, Feb. 2 to prepare him for his Bentall Procedure on Feb. 4, 2014. 

Please keep on praying for us and please help us scout for his AB+ blood. 

Thank you and may God bless us all. 

Sinking in.

I truly appreciate people who ask me how i am doing and praying for my strength as well, aside from Omar's of course. Jenny said, with God's grace, I am in a bubble, protecting me from worry, stress, panic etc. I am still organized and can accept things as a blessing. 

But not this morning. 

Omar had his Carotid Duplex Scan on January 21, Tuesday and may claim the result on Friday, January 24. I came to claim it just now, January 29, Wednesday, a week and a day after the scan, 5 days after the committed day of result. 

Omar's result is missing. They have to reprint it. Have it signed with the doctor again. And since the doctor just signed the original copy a week before, Omar's results were familiar to him. He refuse to sign it until he can verify it from the worksheet in possession of the technician. And Omar's name was mispelled!  Took me a good half an hour to claim a 5day old result. 

And because of that, I wasn't able to bring Winter to the lobby for the dragon dance show. 

It's a minor thing but I wanted to cut their heart and squeeze their aorta! It was so annoying and so irritating, I was almost teary eyed with anger! Omar and I are always grateful to the technicians for every tests and scans he underwent. We are suki of a local bread store in Bulacan for buying pasalubong for these great people making things easy for my husband. But with that department, I did not even thank them!  

I said sorry to God for losing my patience. I need more. I'm okay na. 

Wednesday homily

I will never withdraw my presence. - God

Answered prayer. Thank you po. 

Come back

Omar did not get his teeth extracted.  He got his fillers instead. The dentist is slowly adjusting his body with changes with his teeth. 

He gave us a letter for the cardiologist if he can extract teeth from omar. Then we will go back again today. At the same time, meet with our friend priest, who happens to be his patient too, for the annointing of the sick. 

Omar's getting tired of going to the hospitals for check ups, scans and tests. More patience and strength for Omar please!

Clearance

Medical advisory: omar and i spent the day at st lukes today for his dental clearance. 

It wasn't that easy pala. He had to get his panoramic xray so the dentist can see how deep omar's germs are. It can penetrate the blood stream daw po kasi and hit the heart. 

Omar had his cleaning today and will go back tom for the fillers. The dentist would like to extract 2 of his teeth with approval from the cardiologist. I texted the cardio already and was given a go signal provided that omar take the prescribed antibiotics before and after the procedure and no aspirin. 

Sweet

It was so thoughtful of Kuya Olejoe and Ate Kaye to cheer for Omar. They gave Omar a cake. 

Thank you! You make things lighter. 

Blessed

Upon learning Omar's diagnosis, I invited my inlaws to visit Our Lady of Manaoag before Omar's surgery. 

Unfortunately, with Omar's condition, it is not recommended for Omar to travel far and get tired. Plus, with Omar's upcoming surgery soon and my long absence from work, I need to turn over some works to be done to somebody else, we really cannot make it to the church. 

But, Mother Mary came to us instead. 

A gift from Jenny's friend. So grateful. We will bring her with us to the hospital. 

Sometime soon, Jenny will bring the kids to Our Lady of Manaoag. 

Good hands.

Ojay and Yang brought us to their thoracic friend, Karl, at St. Lukes Global City. 

We got the same recommendation from Dr. Lee with Dr. Karl - replacement of aortic root and valve. 

Dr. Karl is nice. He is a friend of Ojay. But he wouldn't want to cause any friction with Dr. Lee so he won't accept Omar. He said we're in good hands with Dr. Lee and Dr. Habana. He worked before with Dr. Habana and he's a good post op doctor. 

He gave us the same risk percentage with the procedure - 10%. 

The younger the heart, the shorter the procedure will be, faster recovery. But he advised Omar to expect the worst in terms of recovery so he won't get frustrated in the process. 

Chinese Gen is a good choice too, according to him. He is also affiliated with Chinese Gen.   

Thanks Ojay and Yang! 

My other heart

I am posting my husband's heart from his CT scan. 

The lower right is his heart while the upper left is his aorta. The normal size of the aorta should be the big tube under the heart. 

So you can see his aneurysm. That will be cut and replaced with a new one. 

Praying with Odie

Odie came to give us a Bible study. 

Orland and Mitch joined us. 

God loves us. 

God is holy. 

We are sinners. 

We all wanted to have eternal life and yet we are scared to die. 

The Verdict

We finally got to meet Dr. Nelson Lee. 

Operability size of aorta is 6. Omar's is 8. No other choice with Omar's condition but surgery, making it at high risk. 

Omar is young and athletic so bawas na yun sa high risk. 

Complication includes bleeding. We will use bioglue. But we need 30 blood donors for 40 bags of AB+. 

Next step is coronary angiogram, scheduled on Monday at Chinese Gen. Hospital and surgery on Wednesday. 

Tomorrow, we will see Dr. Habana to finalize admitting instructions.

Panic call

It was 6am of January 23 when I got a call from Canada. 

Omar needs to take the surgery. ASAP. 

Option B: if doctors here in the Philippines cannot perform the procedure for Omar, we will fly to Canada, business or first class for Omar's convenience and any apparatus he may need to keep the travel safe for him. 

With that, we are moving our schedule with Dr. Lee from Monday to today. 

A visit to Padre Pio

From Mama and Tito Doc's recommendation, brought Omar today, January 23, at the Chapel of Padre Pio - wrote my petition and lit a candle. 

Please be with us Padre Pio. Maraming salamat po. 

Dinner with the Doc

We had dinner with Mama, Papa, Tito Doc and Tita Cora, and Rommel at East Cafe at Rustans. 

Learned something from Tito Doc tonight.  Prepare a list of instruction for Omar's driver in case of emergency. Write in his diagnosis, allergies, attending doctor, health card and my contact number. 

Consider it done. 

Test with a passing score

Omar had his pulmonary function test today. We got the 11am slot but was able to start earlier at 10:15am. 

He had retake the test. According to Omar, his score was at 65%. Until they gave him a spray of ventolin and after 15 minutes, his score went up to 75%. 

Got his ct aorto gram scan result too and forwarded it to our angels. 

Will be back on Friday to get the carotid scan and pft result then see Dr. Manabat. 

Scans

Omar had his CT aorto gram scan and Carotid Duplex Scan today. He was supposed to get his Pulmonary Function Test today too but no steroids one day before the test. He just took them this morning before his CT scan. 

Results from the CT scan will be released tomorrow while results for the Carotid Duplex Scan on Friday. 

More angels are coming.

We are not just getting second opinion, but even more. 

I forwarded Omar's 2d echo result to Kuya Archie, who works in a clinic in California, and he was able to have it checked with their cardiologist. 

My sister, Jenny, has been asking her friends for cardiologists. Through Mia, I got to speak with Dr. Daffy Morales and was assured that we are in good hands with his boss, Dr. Habana. He offered his line too should we have any questions and could not reach Dr. Habana. 

I forwarded it too to Daddy, who is in Canada. He forwarded Omar's case to his cousin, Tita Baby, a doctor practicing in New York. Now, she is in communication with her friend doctors here in the Philippines. 

Daddy forwarded it too to Tita Juliet, my mom's cousin who is a nurse in Canada. She then forwarded it to her sister, Tita Jackie, another nurse, who showed it to their cardiologist. 

I posted in my egroup my family's condition and asked for prayers. We are now banging the heaven's doors with all our prayers. 

My inlaws brought Omar to the healing mass of Fr. Suarez. 

With all these, how can I cry? I cannot. We feel so blessed and grateful. We feel so loved. 

Thank you. Thank you. Thank you. 

We can do this! I know Lord that we are in Your hands and You will never abandon us. 

Second opinion

January 17, we took our chance and went to The Medical City to see Dr. Habana, referred by Edhel, my niece who is a doctor. 

God is good, the doctor is Intellicare accredited and we were able to see him. 

Aortic aneurysm can be done in the Philippines. But Omar's LV and EF makes it to a very high risk surgery. 

Surgery is at very high risk at LV of 7 and above. Omar's is 7.9. Aorta size of 5 and above is at high risk too. Omar's is 4.6. 

Dr. Habana has looked post operation of the same case as Omar's but the lowest EF he has done so far was 32 while Omar's is 28. But the best thing about Omar is he is still young at the age of 40. 

Euroscore (European assessment of cardiac surgical risk) for Omar's case is 12.7%. In the Philippines, that will be 15-20%. In comparison, bypass euroscore is 1-1.5%. 

Dr. Habana are recommending the ff tcvs (thorasic cardio vascular surgeon):

Dr. Leo Rico of Heart Center

Dr. Nelson Lee of Heart Center and Chinese Gen. Hospital 

Dr. Manabat of Medical City. 

Among the 3, Dr. Lee is the best bet. Also, Chinese Gen. Hospital has the lowest mortality rate when it comes to heart surgery. 

We will have CT aortagram to evaluate the size of aorta, scheduled on Jan. 21 Tuesday at 8am at Medical City. 

We will also get pulmonary function test and carotid duplex scan on the same day. 

 

Best to see the tcvs with results of the scans and test requested. 

First cardio visit.

With Mama Olive, we saw our first cardiologist, Dr. Lingling Uy. 

He asked Omar what he was feeling, for any chest pain and checked if he was 'manas'. He then asked Omar to step out of the clinic while he discussed Omar's condition with us. 

Omar was diagnosed with aortic root aneurysm, severe aortic regurgitation and dilated left ventricle with low ejection fraction. 

He was afraid Omar's heart cannot take the surgery. Omar's aorta is almost as big as his enlarged left ventricle. His concern is to stop the leakage of blood back to the heart. He instructed us to get as much opinions as we can get from different thoracic cardio vascular surgeons. 

He limited too Omar's fluid intake to 1.5 liters. 

He referred us not only to see a tvcs, but an optha as well, just to rule out marfan syndrome. 

Second viewing.

Dr. Jimenez was sick and wasn't able to attend to his clinic, Dr. Varilla informed us over the phone. 

Van texted Omar and invited him for a second viewing, together with the doctor, for free, the following day. 

January 15, we had our second viewing for Omar's 2d echo. 

Dr. Varilla was having lunch at the canteen when Dr. Uy approached him and informed him of Omar's 2d echo. It so happened that Van texted Dr. Uy that we were already there for the second viewing. Dr. Varilla, unaware of the invitation for us, was able to join us. 

During the second viewing, I can already hear the word surgery coming from Dr. Uy. 

Dr. Varilla then invited us to his clinic to discuss with us what he saw at Omar's 2d echo. 

Omar's aorta is enlarged, causing the valve to expand. Therefore, the valve does not seal anymore, causing the pumped blood to return to the left ventricle part of the heart. The heart then is bearing much blood from the returns causing the left ventricle to enlarge as well. And they saw too severe aortic regurgitation or the leaking blood back to the heart. 

Aorta is not part of the heart but is connected to the heart. 

We will have to go back the following day to see Dr. Uy, the cardiologist. 

What they saw.

It was the morning of Monday, January 13, when Omar had his 2d echo. It was his first. 

Van, the cardio technician, asked a lot about his daily routine, what he does for a living, why the doctor requested for 2d echo, who was our doctor and the likes. 

I thought the questions were part of the SOP until a doctor passed by just to request for his patient to be scheduled for the day. Van requested the doctor to check on Omar and the doctor asked us for the requesting doctor. 

Right on the spot, he called Dr. Varilla on his mobile phone. I was bothered with his urgency and concern to notify our doctor with Omar's condition. 

Van recommended us to see a cardiologist right away. 

Dr. Varilla called Omar at the office. Result of the 2d echo is not good. He is just to stay at the office and not to tire himself. He instructed Omar to see his cardiologist friend, Dr. Rodny Jimenez, tomorrow. With strict instruction on not to postpone the check-up. 

It was like doomsday for Omar. Mixed emotions - sad, scared and worried. Of what? We don't know. We were just teary eyed and very scared. 

What was felt.

It was January 1, 2014 when we went to SM Aura to buy Winter's Furby. Unfortunately, Toy Kingdom was closed. 

From the parking to Uniqlo, Omar had cold sweat and got tired easily. We tried to hear mass at the chapel but was not able to finish it. The chapel was full and he needed to rest. 

The following day, after work, we then went to Toy Kingdom in Makati to get Winter's Furby and to buy our groceries from Landmark. He got tired again and just waited for me at the food court while I did the grocery shopping. 

We then decided to get our long planned check up with Dr. Varilla. He prescribed meds for acid reflux based from Omar's complains of easy fatigue and difficulty in burping. We were given requests for blood chemistry. Omar was given request for his usual chest xray and ekg. Dr. Varilla then requested for his 2d echo just to check on his heart, due to his hypertension. 

January 9, we even joined the procession of Nazareno at Bulacan and went malling. The meds were good for Omar did not experience any fatigue. 

January 10, we had our blood chem. he had his xray and ekg and scheduled for his 2d echo on Monday. 

I'm Back

I'm back. 

To document my journey as a wife. 

For my better half. 

We will fight. 

We will survive. 

We have faith in Him.