Second post from Monday... Read the earlier post first, then return to this one.

Dad's emergency room episode was determined to have been a ventricular fibrillation... where the heart just vibrates and can't get back into a normal rhythm. The standard protocol in this case calls for the implanting of an ICD, or Implantable Cardioverter Defibrillator. The ICD also has a pacemaker feature so it's a combination of the two devices.

He was brought to the prep room at 12:30 where his monitor leads were switched from the portable monitor used on the 2nd floor step-down unit (a step down from the intensive care unit) to a more sophisticated monitor. Although keeping a steady 55 - 57 beats per minute, the monitor graph was rising and falling (?). (I'm not sure what this signifies but after the procedure, the graph maintained a steady horizontal line.)

At 1:00 the anesthetist discussed his role and what Dad should expect from today's procedure. Dad's only question was "When do I get to eat?" He was grumpy most of the day. He hadn't eaten or had a thing to drink since midnight Sunday and to make things worse, he was given a three hour dialysis treatment in the morning.

At 1:20, I wished him good luck and went to the waiting room and registered with the receptionist. She handed me an LED pager... it wasn't really necessary but I carried it around until the doctor appeared at 3:45. All had gone as expected. The ICD was implanted on the right side instead of the usual left side because of the dialysis port in his left arm. They wanted to stay clear of the left side so the leads into the heart are a little longer than they would like but it is not a major concern. He said there would be someone prior to discharge (later in the week) to go over detailed instructions about the care and management of the ICD.

I called Bob, Chad, Wilda and Ray to relay the news then went into the recovery room where Dad was already awake. He saw me coming from about 125 feet away and waved as if to say "All is well". He was wearing an oxygen mask and was very thirsty. He had to endure another 30 minute wait before being released to go back to his room where he ate and drank continuously for almost 90 minutes...

This is the first post to my renewed blog. Events of the past several months could have been documented easily if only I had thought to re-awaken such a useful tool.

Dad's been the family focus of late, just a few weeks following Mom's passing on July 2nd. He was complaining of a pain in the middle of his back between the shoulder blades. At his regular dialysis visit Monday, August 21st, he told the dialysis technician that he needed a nitro pill because he thought his angina was flaring up. One small pill and the pain subsided. Fast forward to the same evening -- His Bayada aid, Virgina, became worried because he had no appetite and went into the bedroom to lay down... totally out of character. Virgina called me and I stopped at the house after work.

When I arrived, Dad was lying on the bed restless. He couldn't get comfortable and didn't feel as though he could fall asleep so he got up and came out to the kitchen table. He ate a little salad and went in on the couch where he stayed until about 9:00. He said the pain had subsided and he was feeling much better. I told him to take it easy and get some sleep and I left for home.

At 2:30AM, the phone rang. It was Dad. The pain had returned and it was intense enough that he felt he should call 911.... I told him to call then I hung up and called Bob. Bob lives closer to Dad's place now and it would take me 35 minutes to get there. He managed to get to the house in about 5 minutes where he found the paramedics already had Dad loaded and were ready to take him to Christiana. He called me with the destination.

I met them at the emergency room entrance where Dad was awake and feeling fine except for the pain between his shoulder blades. He was joking with the paramedics and the admitting staff. We were escorted to ER 9 where Dad was hooked up to a small monitor with about six leads. We were there approximately 30 minutes while the nurses did basic checks and a paper work-up. At that point, only the three of us were in the room. Bob was sitting on a chair and I walked over to the counter to put down my phone and keys. Dad was extremely uncomfortable on the gurney and had tried to sit up straight with his back off of the mattress. I had moved over to the starboard side of the gurney when I glanced at Dad and saw him stiffen and begin to shudder. He stiffened his entire body and his arms went straight with his palms down. His mouth opened and his eyes rolled up and to the right and he went grey immediately. I put both hands on his face and yelled "DAD!". He went limp.

I called for help just as our nurse was coming around the corner. Her expression immediately went to a sad "oh no" look. She called for assistance and from that moment on, people just kept arriving until there was no room for me or Bob. The first male nurse to come into the room began to pound Dad's chest with his fist. One, two, three thumps but the monitor didn't change. He started chest compressions while another nurse started using a mask and air pump. They continued this for at least two minutes. Bob and I were asked to stand outside so we did. I had propped the door open about an inch with my foot so I could watch Dad. I couldn't see anything except his left ear and neck but I could tell he was in serious trouble. This was the moment that I realized I was shaking noticeably. I watched as they used the defibrillator and with a single hit, Dad's heart found its rhythm and began beating on its own. I could hear the nurses calling out various things then Dad tried to sit up or get out of the gurney. He let out several growls and loud groans pulling himself up off of the mattress. One of the nurses called his name a few times and told him to lay back down... "Mr. Davis, Mr. Davis, Don't try to get up..." As he was lying down again, someone pushed the door closed.

About that time, this huge guy came around the hallway and said we should wait in the ER waiting room. I looked at him in disbelief, shook my head and said I wasn't leaving. He didn't say another word and walked back the way he had come. A few moments later, a nurse appeared and said we could watch from the inner entrance to the trama room. We were escorted to the area just past the inside nurses station where we could see the crowd around Dad. They were winding down... moving away giving a few remaining staff more room to work but none of them were leaving. We all stayed between the small trama room and the nurses station watching the monitors. The worst was over.

For more information on Ventricular fibrillation (VF):

http://www.hrsonline.org/

http://www.hrspatients.org/patients/treatments/cardiac_defibrillators/default.asp