February 19, 2025

Doug's orthopedic doctors, having derived a plan for surgery and for anesthesia, performed the operation on his hand on Wednesday, February 5.  They were able to do the surgery with just a nerve block and sedation, so were able to avoid general anesthesia, which would have been high risk with Doug's weaker heart.  The doctor said Doug's attitude was the best he had seen, being at peace with the circumstance and relieved to have it over so he could move on.

The threat of infection from the hand, now having been eliminated, a barrier that still stands in the way of a potential heart transplant is the antibodies from the reaction to Heparin that are still causing clotting. These will diminish over a few months, and then the  plans for a heart transplant could be possibly reinitiated, but not before. Keeping Doug's heart stabilized in the meantime is a great concern. 

To help make this possible, doctors could install a defibrillator and pacemaker in his heart. 

For now, Doug is home in Boise recuperating. Plans are for Doug to enter the care network here at St. Luke's in Boise and enjoy home life for a season. ❤️

On Tue. Jan.28, the doctors determined that the infection risk on Doug's right hand was too great and possibly causing other complications, so surgery to remove it was scheduled for January 30. However, on Tue. evening, Doug was having atrial fibrillation. He became unconscious, then his heart stopped. With shocks and chest compressions, the medical team was able to restore a pulse. With the aid of sedation, a breathing tube, and medication adjustments the doctors have been able to stabilize Doug's condition. The breathing tube and sedation have been removed and Doug continues to be stable.

The doctors believe that being anesthetized at this point could cause more heart events or even death, so the hand surgery has been postponed.

 One doctor explained Doug's situation saying that they are studying all the possibilities, but what he needs is a new heart, and they can't provide that for him until the clotting reaction that lingers from his reaction to the Heparin resolves and the surgery for his hand heals.

We continue to pray for wisdom and insight for the doctors and for God's healing.

With Doug's weeklong return to the CV ICU on January 5, due to atrial fibrillation exceeding 200 beats a minute, which was only brought under control by unsustainable interventions, the doctors were working diligently to place Doug on the "express" transplant list which would have moved him near the top of the list to receive a heart. Then, by January 14, it seemed his heart was staying calm on a new medication, and so plans were begun to place a heart pump (Left Ventricular Assist Device), to help as an intermediate intervention, to allow more time before a transplant is needed. This surgery can be done sooner than a transplant, while providing increased stability for his heart in the meantime. However, Doug had, earlier in his hospitalization, developed a rare reaction to the blood thinner, Heparin, in which his blood platelet count kept dropping, and the platelets became sticky and formed clots. On January 15, having been directed by poor blood flow and increasing pain in Doug's right hand and arm, doctors discovered blood clots in two arteries in his right hand. This was considered a medical emergency. But attempts to correct it revealed that, though the Heparin had been removed, his body's clotting reaction continued. Until this complication is resolved_ this may take nearly six months_ (including a strong possibility that Doug will lose his right hand by amputation) a successful heart pump or transplant surgery is not possible yet. Doug will return to Boise, under the supervision of a doctor at St. Luke's Boise who coordinates care with the Univ. of U. Hospital. He will continue on his medications that are stabilizing his heart, while engaging in therapies to strengthen his heart on order to resolve the clotting complication and to be ready to receive a heart pump or a transplant. He will be at home requiring 24/7 caregiving.