Thank you all so much for your collective prayers, thoughts, messages, love and support!! Lucas is so loved, and we feel surrounded and lifted up during this extremely challenging phase. Please continue to pray for comfort for his donor family. They will also need to be surrounded by love. Our gratitude for their gift is beyond words. 

We’d maybe been “lulled to sleep” a little by how smooth the operation and following evening was. Recovery is unlikely to be linear, and we got a big dose of that reality. 

Yesterday (Friday) was excruciating for us. Because of COVID restrictions, our exception to be together expired a few hours after Lucas came to the ICU. I’d just switched w/ Corey on Friday AM after a smooth post-op night, and she quickly got hard news from the Cardioligist. It’s so difficult to be in our circumstance, and to feel alone without your most important supporter. A few hours later I was fortunately granted another exception for 24hrs. 

Beginning Friday overnight, Lucas has shown signs of improvement. We’re feeling relieved and encouraged for the moment. Lucas was heavily sedated and immobile, so we were actually able to get some good sleep, which helped us a ton. He’s still very sedated, but they’ve lifted the nerve block so he can now move a little.

Before you continue, I try to use plain language, but this short video may help: Youtube – Heart Circulation

Lucas has remained continuously stable post-op, but yesterday’s imaging showed a lot of pressure in Lucas’ right heart. The right side of the heart pumps blood into the lungs to be oxygenated. This should be the lowest pressure flow in the whole system. There’s a valve (tricuspid) between the top (atria) and bottom (ventricle) halves of the heart, which prevents blood from flowing backwards. Well, Lucas had “significant” backflow (leakage). This wasn’t our team’s expectation, and it really concerned them. The right side of his new heart was enlarged (dialated), and the 3 valve leafs weren’t even touching. 

Lucas has a continuous pressure reading catheter in the right atria of his new heart. Yesterday it read “20” all day. They wanted it under 14. We came in this morning, it was at 11! Our cardiologist told us that she didn’t expect to see much change in the imaging today, but she was pleasantly surprised to find that the pressure had gone down, and the tricuspid valve leaflets were touching. 

This challenge for the right side of the new heart wasn’t totally unexpected. Lucas’ high lung pressure (pulmonary hypertension) is the reason he was on the clock for transplant in the first place. It’s been the main “injury” his original heart inflicted on his circulatory system. His heart was very stiff (restrictive) – the anatomy wouldn’t let the left side relax and correctly fill with blood from the lungs. The blood backed up and pressurized the vessels in the lungs, which then created “resistance” to the right side of the heart pumping blood into the lungs. The body adapts over time (remodeling) by thickening and narrowing the lung blood vessels to accommodate the pressure. If this state persists long enough it becomes permanent.  The right side of a transplanted heart is used to low pressure, and may struggle to adapt. The hope is that by now having a healthy functioning left side, the lungs will be able to relax. They have drugs to help, but reversal takes time. 

Whatever tomorrow may bring, we’re thankful for today.