Monday, September 10, 2012

Hearts, Lungs, and LVADs

When I think back on the past few years I know that I am beyond blessed.

I have had experiences and opportunities that are outstandingly phenomenal. I've done and seen things that most people never get the opportunity to do or see.

A few months ago I got a phone call and was invited to go on a procurement. We frequently use the term "harvest" but it's really not politically correct and is thought to be disrespectful. I think the term harvest is much more encouraging and sincere than procurement, but nobody asked me, and I don't work for UNOS.

A person had died. We were going to procure the heart and the lungs. We went to the local airport, got on a jet, and flew out to get the organs. When I got there I had to change scrubs and met the Liver team and the Pancreas team in the locker room. We chatted. We changed. We procured.

I minimally assisted in opening the chest and assisting with the removal of the heart and lungs. The heart comes out first, then the lungs, then the other organs. I was very proud that our organs were first, as though we were the most important team. Truthfully, though, it was amazing to observe the whole process. There were so many people in that OR. We were stepping on each other. I never looked at the donor. I did not need to see, to know.

We quickly left with our organs in coolers, boarded an ambulance that was waiting for us. They turned the sirens on and we swiftly went back to the airport. We boarded our jet and had a fantastic meal waiting for us. We landed just as we finished eating. The coolers were grabbed. Placed in the surgeons cars and they were off to graft them into the recipients. I was invited to go, but I declined. I'd seen the surgeries before.

Boarding the jet with the organs.
I never saw the donor, I never saw the recipients. I saw the process. I saw the heart. I saw the lungs. It was amazing.

The day after that, I went in on my day off and observed the placement of an LVAD. A Left Ventricular Assistive Device is a battery operated pump that is implanted into the apex of the patients heart and the out flow cannula is sutured to the aorta. This device helps the heart with contractility and helps perfuse the body in a efficient manner. (Essentially, it's a mechanical heart.)  It is frequently used as a destination therapy device or bridge to transplant. So, most of the patients who get an LVAD are waiting for heart transplants.
We frequently have LVAD patients and since it wasn't a surgery that I was completely familiar with, I felt like it would be beneficial to observe it. The resident who was assisting got called away. There I was with the Attending Surgeon. "Hold this", he said. "Pull that", he said. "Cut here", he said. And the next thing I knew I was assisting with surgery. I was doing heart surgery. The resident eventually came back and I stepped back and regained my position watching.

I read over the Operative Report the next day and the Attending of record placed me as the assistant. I assisted with surgery. I assisted with open heart surgery. I did that.

For the most part I have found that the surgical arena doesn't quite compliment me. We know what's wrong with the patient. They come to the hospital. We fix them. We get them ready for discharge. They go home. It's pretty cut and dry (no pun intended). But even in the midst of the most mundane of experiences, there are some pretty exciting and phenomenal experiences too.

Living a blessed life.

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