BARBARA ANN CLARK - PART 3

Well today is January 23, 2019.  Six months to the day since God called our Barbara home.  I thought that now would be a good time to finish writing about Barb and the end of her journey through life here on this Earth.

Barb successfully received her tissue valve in March of 2016 via the TAVR procedure and it worked great for awhile.  By the end of the summer though it began to show the first signs of failing.  By the end of October of 2016, she was having stamina problems once again as her breathing slowly became more difficult.  It was then that the Doctors and Surgical team began to look for causes that could be causing her to decline just a bit.

The first thing they thought was that a blood clot had formed inside of her heart partially blocking the intake of the new valve.  She was put on blood thinners to try to slowly break down any clot that might be there.  Because of her stature and the problems with her back and neck, they could not get a good image of her heart to tell what was actually going on inside there.

Soon she began to retain water early in 2017 and was put on a heavy regiment of diuretics.  While the medicine did seem to at least stop the continued retaining of fluids, it came to the point where it over taxed her kidneys.  She was admitted to the hospital for almost a week to try to get the kidneys back to as close to normal as they could.  It worked to a point with her kidneys recovering to about 90% of what they should be.

As we entered 2018, after several months on the blood thinners they came to the conclusion that there was not a blood clot in her heart. The blood thinners would have dissipated the clot by that point.  Meanwhile the fluid sack around her heart became the target of the doctors concerns.  They were able to do a few minor tests that led them to this conclusion and the symptoms made sense.  With fluid around her heart building, the heart was forced to work harder to be able to pump the required blood through.  As the heart continued to over work it began to harden and the walls of the heart were getting thicker.  The heart is a muscle and so it was over excersizing and like any muscle, excersize brings growth of the muscle.  It was also at this time that they discovered that her heart murmur was returning indicating that the valve was indeed failing.

In the spring of 2018, they, as well as Barb and myself, had a decision to make.  The heart valve was failing.  The heart was being overworked.  The proper course of action was to get into her heart and thin out the walls of the heart to make it more pliable and easier to do its job.  The tissue valve would also be replaced by a mechanical valve.  It was a procedure that the surgeons have done many times, but Barb was different.

We had already established that open heart surgery was extremely risky for Barb.  It was, however, the only option they had left to do what needed to be done.  It was risky enough that they gave Barb a very real option.  The surgery was risky.  Extremely risky.  IT was at BEST a 60/40 chance of success.  That was if everything went perfect.  If they ran into little bumps during the surgery the odds of survival went down.  If Barb elected not to do the surgery, chances were that her heart  would more than like give out in approximately a year.  If the surgery was successful, her life span would be unknown, but would be in the years, not the months.  The two of us discussed this a lot as we entered the summer of 2018 and eventually came the day when Barb decided to try the surgery.  The doctors set the date for the surgery at July 16, 2018.

Leading up to the surgery day, Barb began to prepare.  She prepared for both possible outcomes.  She planned on what we would need and how to set things up when she came home from the surgery.  She also planned things out for me in the case that she didn't come home.  She had Lori take Brett's and my suits to be dry cleaned.  She prepared a file on her computer desktop entitled "If" that I was to open if something went wrong.  This file listed things that she wanted done after she died and also listed her funeral requests.  When I think on her preparing for both scenarios, it makes me realize how incredibly strong and brave she was going into the surgery.  She was indeed a remarkable woman.

The surgery did not go well.  It started out fine but then it seemed like everything was going wrong.

I am not going to get into all the details of the ups and downs that Barb had during and after the surgery.  I don't think I can at this point.  It would be extremely difficult for me to write. I did however write an email to one of her friends outlining what happened during the surgery and afterwards.  I am going to share that email as a tool to describe what went on.  I will say this though.  The night of the surgery, no one on the surgical staff thought Barb would make it through the night.  She did.  She not only made it through the night but made it a week before her poor body gave out.

Here is the email I sent to her friend describing in a very sketchy way what happened that week.

Barbara's aortic valve that they had put in back in 2016 had failed and was getting worse.  in 2016 they had attempted to put that valve in via open heart but decided it was too risky.  They ended up putting the valve in through her aorta.

When that valve failed she was faced with two options.  Try to get a new valve in by open heart surgery which was extremely risky or wait until the initial valve would give out.  It would have lasted maybe a year but probably less.  She decided to try getting a new valve even though it would be open heart.

The surgery was extremely risky.  We knew that going in, which was probably why she kept it on the down low.  it was pretty much a 50/50 chance.

Her surgery was scheduled for July 16.  At first it seemed like things were going okay.  They were able to open her chest.  Then we got word that the new valve had been inserted.  I truly thought at that point that we had it made.  When they went to put her heart back together, however, the tissue in her heart walls would not hold a suture.  The tissue would tear every time and pretty soon she was hemorrhaging.  The surgeon did his best to try to get things back and ended up putting some packing in her heart to try to help the blood clot and stop bleeding.  What was suppose to be a five hour surgery turned out to be twelve hours.

During this time of all the bleeding her heart weakened substantially.   Damage was also incurred on the kidneys and her respiratory system.  He did get the packing inserted and was able to close, but the outlook was extremely grim.  They did not think she would make it through the night.  She was put on full life support.  Her heart was working very weak but she could not breathe on her own.  They put a "balloon pump through her artery.to assist her heart in beating.  She was on 100% ventilator.

The plan was to try to get her vitals stabilized since she had made it through the night.  She was put on about 12 different meds that they tried to tweak to get her vitals up to somewhat normal.  After a few days her kidneys began to fail and she started retaining fluids putting extra strain on her already weakened heart.  They put her on dialyses at that point.

On Sunday afternoon, July 22, all of a sudden every thing crashed.  Her heart rate raced upwards to 200 bpm and her blood pressure plummeted.  I came home that evening but couldn't stay away.  I went back to the hospital and spent the night talking to her and holding her hand.

At 10:00 Monday morning, July 23, the doctor came in and said that they had done everything they could.  They could keep her on life support for a little while but it was just putting off the inevitable.  I decided that she would not want that and so they began the process of disconnecting the ventilator and the heart  pump and turned the dialyses machine off and stopped all meds.  I was able to talk to her a bit and give her a kiss.  She passed away at 10:10 AM on July 23.

She never awoke from the surgery.  She went peacefully and quietly without pain.

We were prepared for either outcome but I don't think either of us really thought she would not make it through safely.  It was the saddest day of my life.

We had been married 42 years with two years of dating before being wed.  She was my life.

The world is a lesser place without her.

Thank you for your friendship, she treasured it.  She was the social one of the two of us.

I knew two days into her time in ICU that week the direction things were heading.  She never woke up but God gave me a week to spend time with her, day and night and to talk to her though she never answered.  The week that God gave me prepared me and helped me to develop the strength I would need in the weeks, days, months ahead as 2018 became one of the most difficult years of my life.

Barb was a gem.  She deserved and could have done much better than being with me all those years.

I thank God for that week in ICU with her.  I wish I could tell her that I did do my best for her during that time.

I am sorry for not being a better husband to you than I was over the years.  I did do my best though and I know that she did her best as we traveled on that journey together for forty two years. 

I love you Barbara Ann.  I miss you so very much.

This is a link to her obituary I thought you might want to have.   https://www.dignitymemorial.com/obituaries/kansas-city-mo/barbara-clark-7942486