My Grandfather...

As a preface... I wrote this a couple of months ago. The situation has since changed, but this was my reaction that day...

Even though medical technology can create life-altering and life-extending miracles, it can still be incredibly frustrating. My grandfather's aortic valve function has been deteriorating over the past several years and is only currently functioning at about 10% of normal aortic valve capacity. Due to his previous heart surgeries, he isn't eligible for a traditional aortic valve replacement. Due to such poor valve function, his heart is not able to circulate enough blood and oxygen to his brain and body. Up until about a year ago, he was a voracious reader/ crossword puzzle enthusiast and went to the gym three times a week. Now, his short term memory is failing and he has become too frustrated to even attempt his daily crosswords. Not only has he had to give up the gym, but he doesn't even have the energy to walk from the living room to the dining room table and instead must be wheeled around in a wheelchair.

At times, his frustration has been so extreme it's almost palpable. He's completely aware of his diminished mental and physical capacity and feels helpless about it. However, a promising new FDA clinical trial has enabled him to keep up hope in the past 8 months or so.

When we first first found out about the trial, it sounded like a perfect fit for him. The procedure, transcatheter aortic-valve implantation, was developed specifically for high risk patients like him who are unable to undergo traditional valve replacement surgery. But two days before he was scheduled to go in for the first of a series of tests to determine if he was a candidate, my grandmother found him slumped on the floor next to the breakfast table. After getting him to the hospital, the doctors determined that he had had a stroke.

Of course, for many people, the stroke would have ended all hope. Not my grandfather. Only days after my grandmother found him slumped on the kitchen floor, he was asking me about my job and reminded me at 3:30 that I better leave on time if I wanted to make it to work at 4. When the nurses asked if he knew where he was, he told them "outerspace" and then looked my way and gave a knowing smirk.

The stroke delayed the tests for many months. After spending a few weeks in the stroke unit at the hospital, he was transferred to a rehabilitation center. His rehabilitation from the stroke (which was in part caused by his poor aortic valve function) seemed miraculous to us. He kept telling everyone that he just wanted to go home. The nurses, doctors and physical therapists said they had never seen a patient as hardworking and dedicated as my grandfather and in about six weeks, he was able to go home. After that, he continued outpatient physical and occupational therapy until he was strong enough to undergo the tests for the valve replacement.

When I saw him for Rosh Hashanah dinner, he was in high spirits and he told me that the next day would be the day he found out if he was a candidate for the FDA clinical trial. He said that he was keeping his fingers crossed and asked me to do the same, but that no matter what happened, he knows he's had a wonderful life and is grateful for every extra moment he gets.

The next day, we found out that he is a candidate, but his heart is too big. They don't currently make a valve big enough to replace the rusty one he's got right now. His doctors assured him that a new, extra-large valve is being developed right now and that they predict it will be ready by the end of this year.

I don't know if there's a higher power or not. I don't know if the engineers, scientists and doctors who are working on the extra-large valve can work any faster. But for my grandfather, the man with extra-large heart, I'm keeping my fingers crossed that they finish developing the new valve in time for it to help my grandfather.