Tuesday, May 22, 2012

The Battle Against Cholesterol – Chapter 2 (Text Only)


If you tuned in to yesterday’s blog, you learned a bit about my husband who has been undergoing lipo-apheresis treatments since last year in order to combat familial hyperlipidemia. During today’s blog, I will continue to tell the story of how he got into the treatments, and what he had to endure to get them started. Keep in mind I am NOT a medical professional, so anything you read in my blog needs to be discussed with your doctor. 

Late last year, Kevin was enrolled in a treatment called lipo-apheresis. Once every other week a machine pulls his blood through very specific filters that remove all LDL and triglyceride components. He suffers from familial hyperlipidemia that led to three heart attacks (four interventions total) resulting in six stents. Kevin’s cholesterol levels have often been immeasurable because the serum is too turbid. In the past, his doctors put him on a variety of medications and diets. The diets didn’t work and the medication (statins and fibrates) left him unable to function. 

Cholesterol is necessary for certain functions inside our body (it is involved in cell membrane creation and repair among other things). The foods we consume give us about 20% of our cholesterol (called dietary cholesterol). The other 80% is produced in our bodies, predominantly by the liver. When we have too much and the body can’t metabolize the excess, it can lead to clogged blood vessels, heart attack, or stroke. This is why it is important to have your levels tested regularly, especially if anyone in your immediate family knows they have high cholesterol.

Despite the fact that Kevin is in great shape and follows a healthy diet, his cholesterol cannot be controlled without medical intervention. This is the frustrating part of familial hyperlipidemia. In order for Kevin to start his lipo-apheresis treatments, he first had to get a hemodialysis catheter installed in his chest. This pair of tubes goes through the neck, into the jugular and straight into the heart. The external part of the tube is channeled under the skin and the access ports come out just above the breast line (to make it easier to manage the dangling tubes). If you would like to see the pictures, go to the "photos included" version.

The process of getting the catheter into Kevin was a bit brutal. We went to the vascular access center on a Friday morning and the nurse took us into an office to discuss what would happen. Kevin had to fill out an endless barrage of forms. He points out that the paperwork must equal the body weight of the patient before they can be discharged. As the nurse goes over the whole procedure, we wonder what we’re getting into. This sounds pretty involved, but we’re thankful it is only temporary until the fistula can be created.
 
An hour after they wheeled Kevin into the surgical suite, I am called back to the recovery area. He had a huge dressing on his chest and neck and he was still woozy from the sedative. The doctor explains to me that Kevin will be sore since they had to jam the tubing through his very strong neck muscles. We are scheduled to come back on Monday to get the dressing changed and to do the vein mapping in preparation for the fistula.


Tomorrow, I will discuss the vein mapping and fistula surgery, and Kevin’s first lipo-apheresis treatment. I will also explain what it was like to take care of someone with a chest catheter installed. 

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