I’m thinking about Thanksgiving this week, and the way my mother’s side of the family always gathered at someone’s home for dinner in those long-ago times when I was a boy. For those of you unaware of the ways of rural southeastern Illinois, that was the meal we ate at noon. The evening meal was always supper.
The men ate first. Apparently, that was also the way of rural southeastern Illinois. The women were on hand to serve the food and keep tea glasses filled and to take dessert orders. I’m not really proud of that fact, but, alas, there it is. The kids ate at card tables in a nearby room. I was the oldest cousin, so I was the first to be invited to join the men’s table. There, my Uncle Richard insisted I sit beside him, and there he initiated me into the group by putting food on my plate when the serving dishes came round even if it was food I told him I didn’t want. My protests didn’t matter. He told me he was certain about what was best for me. At his side, I learned that sometimes it didn’t matter what I preferred; sometimes, I had no choice but to give myself over to someone else’s care.
Such is the case now with my cardiologist. Last week in his office, he told me that the second clinical trial testing a new device for PFO closure had shown the device to be more effective in preventing a second stroke versus treatment with medical therapy. But, he emphasized, the results of the trial hadn’t reached “statistical significance,” which, as I understand it, is the data the trial would have to produce to indicate that its findings reflected a pattern and not just a chance. Bottom line? No one really knows whether closing a hole between the atria of the heart does a better job of preventing a second stroke than managing the condition with anti-coagulants. Still, my cardiologist is confident that closure is the way to go.
“What would you do if it were your heart?” I asked my cardiologist.
He didn’t hesitate. “I’d close it,” he said. “In a minute. Wouldn’t even think about it.”
So on December 10, I’ll report to Riverside Methodist Hospital to have a a transesophageal echocardiogram done. This is the test that will confirm the presence of the suspected hole between my atria and also allow the cardiologist to access its size. If the hole is there and it turns out to be large enough to close, my cardiologist will do just that through a cardiac catheterization procedure. He’ll will thread a catheter through a femoral vein in my groin and deliver a septal occluder to my heart. The occluder is a small patch that looks something like an umbrella. It’s made of a polytetrafluorethylene material held inside a wire frame made of a nickel-titanium metal alloy called nitinol. Once the patch is in place tissue will begin to grow into the patch allowing the occluder to function as a permanent implant. My blood flow will return to its normal path, no longer able to shunt from my right atrium to my left, thereby significantly reducing my chances of having another stroke. I may be released from the hospital that evening or I may have to stay overnight. I won’t be able to run for a week, but I can walk right away, and after that week I should be back to full activity.
So, this Thanksgiving week, I give thanks for the love and support I’ve received from so many of you (keep it coming, please, as the days move on toward December 10), and I give thanks to the medical technology that has made such a procedure available for me, and I give thanks for my Uncle Richard who taught me all those years ago that sometimes your only choice is to keep quiet and surrender to the care of others. Happy Thanksgiving, everyone.