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Yesterday I went to see Dr. Garabedian, a pediatric
heart surgeon referred by my regular cardiologist,
Dr. Goldberg. Garabedian's office is located at the
Northwest Center for Congenital Heart Disease at Sacred
Heart Children's Hospital.

I thought the trip would be interesting and fun, so
I decided to blog it.

First off, Dr. Garabedian's office is the funnest
office of any of my doctors — although I did miss
the great bottled water machine they have at Spokane
Cardiology, which serves really great cold water.

First I decided to build a house out of Legos.
Unfortunately I forgot to put in any windows
— well, I'll do that next time.

Then I decided to turn the house into a
Gothic cathedral.

I spent a few minutes playing with this roller
coaster toy, but lost interest when I couldn't
really figure out what the thing was supposed
to do.

They also had big orange trucks to play with, but
I didn't want to get down on the floor and get my
pants dirty.

Well, I guess I'd better get to the medical
stuff. After a preliminary ECG and exam, Dr.
Garabedian sat down with me to talk about my
heart and the various options. He made a diagram
showing my heart at birth, what they had done
in past surgeries, and my current problems.

The main problem now with my heart, besides
general heart failure, is that the pulmonary
artery is narrowed right at the point of the
pulmonary valve and also farther up as it exits
out of the heart. As for the valve itself it
is only 11 mm in diameter and does not really
function. Dr. Garabedian explained that normally
in a case like mine that they would perform open
heart surgery and go in and widen the narrowed
places in the pulmonary artery, which would lower
the high pressure in my right ventricle and make
it a bit easier for my heart to beat. Unfortunately
my heart is so weak at this point that he thought
that the chances of them not being able to restart
my heart were only about 75 percent — atrocious
odds and ones that he felt were unacceptable. And
I quickly agreed with him. He is going to consult
Tuesday with the cardiac group, but he feels that
they will almost certainly agree that open heart
surgery is not an option.

The second option would be to perform a minimally
invasive procedure that would not involve stopping
the heart. For years now they have installed shunts
into the veins of the heart muscle in cases of arterial
disease. This one is similar but involves putting
shunts in the artery instead. The procedure is still
considered rather experimental and there are FDA
criteria for that type of surgery, criteria which
I didn't quite meet. Nevertheless Dr. Garabedian felt
that in my case, where a transplant has been ruled
out and given the weakness of my heart, that he
could get exceptional FDA approval.

I should know more about all this next Tuesday after
he breakfasts with the other cardiologists and they
discuss the matter.

In any case it looks like this candle is going to
be lit quickly — something I am very happy about
as I didn't want this hanging over my head for month
after month.

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