Monthly Archives: March 2011

Sunday evening – Incessantly Isoucient

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I’m finally semi-vertical again after another night and half a day of flu.. (@#$# flu shot) .. I went to bed about 11.. and next thing I new it was about 11AM.. I know I had a high fever.. I’d had wicked chills for part of the night.. . and for other part I was roasting.. My mind was in one of those weird dream states that only comes with a high fever.. I kind of like it.. I had swirls of family stuff. geek project stuff , work stuff.. and stuff from the books I’ve been reading mixing in to a strange kind of opera..

I woke with the  sudden realization that the word iscessant and the word insouciant were evel twins of one another and were really the same word masquarading.. that feeling persisted until about 6 this evening when I actually sat down to wrte.. and realized that made no sense.

I managed to stay in bed until about 2.. which allowed me to read a new book cover to cover..(if that image is appropriate on an eReader).. it was ‘The Art of Racing in the Rain’  by Garth Stein.. I really enjoyed it . It a story of death, deceit. parenting and autoracing as told from the perspective and an old dog.. There were two major deaths in the story .. that kinda got me sobbing a bit.  but overall very uplifting.

Last night I finished the book ‘Tinkers’  by Paul Harding.. I liked it.. though a little less than the other.. It was also about death.. at least 2 major ones.. told from one of the dying men’s perspective.. .. and earlier in the wek I finished ‘Old Filth’  by Jane Gardam.. also about folks dying..  again told from one of the soon to be deceaseds perspectives. I quite like that book as well

What happens, though. when I dive into a book, I get maybe too involved.. Not sure how to describe this.. but these past 4 and a half years.. since Sam died I’ve had to work very hard on piecing back my sanity.. I’m not all there.. but getting there..    When I read.. I feel some of the ‘unhingedness’ taking hold and dragging me back down.. It’s the same reason I don’t watch movies or watch news or tv anymore.   I didn’t really read a book for the first 3 years.. which was a change.. I usually am always working on 2 or 3 books..   It’s strange now that I’ve started.. not sure it’s good for me.    I think I don’t have room in my head for other peoples stories.. especially if they are sad.. even a little bit sad.. And / the thing is.. I don’t read stuff that’s about happy people doing stuff.. I like reading books where  nothing happens.. to lots of people..

Should I stop reading again ?

note all, nite sam

-me

Saturday night – sick as a dog

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I’m sick as a dog.. now .. where does that phase come from.. Most dogs I know are healthy as horses.. Now .. where does THAT come from.. ? I haven a ghost of a clue .. now where does that come from…search me.. now where does that come from.

Didn’t do much today because I was kinda glued ot the couch.. I got soem work done on a talk for later this week. did soem other work.. and finished a prototype of a musical instrument project I’m doing for freinds..

I was going to higher ground tonight.. but I wasn’t feeling anywhere close to good enough to go..

I think I’m hallucinating now.. my eyes feel like they’re sunk down way in my head.. and everyone’s voice is in slow motion. .. I have a high fever and I’m shaking.. Believe it or not.. I kinda like nights like this on is goin to be.. there sort of a journey..
Never sure whom you’ll meet..

But I’m going to go see now.. .. I i have wicked bad chills.. and need to get some covers on..
hopefully better tomorrow..

nite all, nite sam…
-me

Friday night – heart pics

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Home with a bug of some sort.. got lots done.. now in one of those kinda fever zoneout states..

Just got off the phone with Billy.. Mr Lewis continues to do well. He’s able to communicate by drawing.. he’s watching lots of TV and getting stronger each day.. What must be going through his mind ?

Billy just posted some pictures from the development of the artificial heart.. part of which he made in his garage (not kidding !)

Here’s the starting point.. a heartmate left ventricular assist device.. these are used to boost the output of someone with a sick heart.. until they get better or get a transplant.. some folks walk around with these attached to their heart for  as much as 6 years..

Here are the dacron patterns for the input and output cannula.

sewn around a form

Mid assembly (I think this is an older model.. that’s an older heartmate, I think)

the valves at the top

The two heartmates next to each other.. one for pulinary flow, the other to perfuse the body

just like a real heart…

Compared to one of the most successful artificial hearts to date.. the abiocore..

note how much smaller.. and only 2 moving parts !!!

Here are Billy and Bud putting the heart in Mr Lewis.. or in a cow.. I can’t tell

and here is Mr Lewis’s xray right after..

I’m just so amazed at this..

Billy.. We’re all so proud of you… Tell Mr Lewis that we’re all rooting for him !!

note all, nite sam

-me

Thursday night – Craig’s heart

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So.. now I can talk about something I’ve known for weeks. On Mar 10th. my brother Billy and his colleague Dr. Bud Frazier implanted a an experimental artificial heart in the body of Craig Lewis.. a 55 year old man with Amaloid heart deistic. Mr. Lewis was near death.. his hear twas choked with a rogue protein mass. Billy had been experimenting with using two existing LVAD (left ventricular assist devices) turbine pumps to replace the function of both the left and right heart in animal studies. He’d fashioned the device out of two Heartmate turbine pumps, some titanium structural components and some dacron grafts.. The use of these two assist devices a as full artificial heart is really novel . it’s much smaller and simpler .. and probably more robust than other mechanical hearts.. it basically only has two moving parts, the pump rotors.. and, since they are turbine pumps, the recipient has no pulse.. only a steady flow of blood. Billy has done a total of 37 animal studies and had bee telling me for the last year how well they’d been working..
When Mr Lewis came in.. he had less than a day to live.. and his disease made transplantation impossible. Billy and Bud decided that there new pump was Mr Lewis’s only chance.. Billy called me right after the operation. He said it had gone well. 2 days later he called to tell me that Mr Lewis was sitting up in bed talking..

This is history ! And it can make such a change in the worl

Bud and Billy.. you aguys re truly amazing..
And so are you to Mr. Lewis.. Your a brave man.. You and your family are in all of our thoughts !

nite all, nite sam
-me

Successful Implantation of a Continuous-Flow
Total Artificial Heart
in a Patient at The Texas Heart Institute

HOUSTON, TX. (March 23, 2011) –  Doctors at the Texas Heart Institute (THI) at St. Luke’s Episcopal Hospital (SLEH) have successfully implanted the first continuous-flow total artificial heart in a desperately ill patient facing imminent death.

On March 10, 2011, Drs. Bud Frazier and Billy Cohn removed the heart of 55–year-old Houstonian Craig A. Lewis and replaced it with the artificial heart, which had been developed at THI over the last 5 years in collaboration with industry and funded by grants from the National Institutes of Health and the Dunn Foundation.

“medical history in the making”

Mr. Lewis had a rare condition called cardiac amyloidosis, a disease in which the heart is infiltrated by an abnormal protein produced elsewhere in the body. Patients with this affliction are not candidates for heart transplantation because the amyloidosis would probably recur in the transplanted heart.

X-ray view of dual turbine-like blood pumps implanted to replace explanted heart.
Dual turbine-like blood pumps
replace explanted heart.

The continuous-flow total artificial heart consists of 2 turbine-like blood pumps implanted to replace the 2 sides of the explanted heart. The turbines used in Mr. Lewis’s device were modified left ventricular assist devices (LVADs) manufactured by Thoratec Corporation (Pleasanton, Calif.) and approved by the US Food and Drug Administration in January 2010 for assisting the failing left ventricle (the heart’s main pumping chamber) in patients suffering from terminal heart failure. Mr. Lewis was not a candidate for an assist pump because his left ventricle was too badly involved with amyloidosis. His right ventricle had also failed.

Mr. Lewis had been supported by an external blood pump, a dialysis machine, and a breathing machine for 2 weeks before doctors decided to try this approach.

Because the device produces continuous flow, Mr. Lewis does not have a heartbeat, or a pulse. An EKG records no rhythm because the heart has been removed. Extensive research performed at the Cullen Cardiovascular Research Lab has shown that this unusual physiology is well tolerated by mammals. Based on their results over the last 5 years, Drs. Cohn and Frazier believed that this device was an option for Mr.Lewis. Less than one week after device’s implantation, Mr. Lewis was able to sit up in bed and speak with family members.

The Texas Heart Institute has played a pivotal role in the development of implantable blood pumps to treat end-stage heart failure. Under Dr. Frazier’s leadership over the last 40 years, many of the devices currently in clinical trials were first tested and perfected at THI. The newer generation of continuous-flow turbine-like pumps, first introduced 10 years ago, are smaller, quieter, and much more durable than their pulse-producing predecessors. These technically sophisticated pumps have accelerated the progress in the field of implantable devices. They also gave Frazier with the idea for a continuous-flow total artificial heart.

“This really is medical history in the making. The demonstration that one can support the human cardiovascular system with 2 implanted continuous-flow pumps is remarkable and very encouraging. With this new concept in cardiac replacement, we are much closer to realizing a meaningful off-the-shelf replacement,” said Dr. James T. Willerson, THI president. “The Texas Heart Institute is extremely proud of Drs. Bud Frazier and Billy Cohn and their entire team. This is an impressive step forward, following in the legacy of Dr. Denton Cooley, who in 1969 first implanted a prototype artificial heart in a human with a severe heart injury.”

Bud Frazier, MD, and Billy Cohn, MD, with the Heartmate II pumps.
Drs. Bud Frazier and Billy Cohn with ventricular assist devices.

Added Dr. Cooley, founder of THI: “Forty years ago the first total artificial heart was implanted here in a patient dying of advanced heart failure. The device served as a bridge to cardiac transplantation maintaining the patient’s life until a donor heart was procured. Since then, a major focus of research at THI has been the development of a total mechanical heart that could overcome some of the problems presented by the previous pulsatile devices, including patient discomfort. The continuous-flow design of this device promises a major advance in the effort to replace the heart in patients with terminal cardiac failure. I applaud Dr. Frazier and Dr. Cohn for their contributions. This is a further milestone.”

Read the Houston Chronicle story by Eric Berger:
New Artificial Heart “A Leap Forward”
http://www.chron.com/disp/story.mpl/front/7486853.html