An Ottawa man who has a blood pump in his chest to do the work of his diseased heart is able to spend time at his beloved Clayton Lake summer home, thanks to training provided to Almonte General Hospital (AGH) staff by the University of Ottawa Heart Institute (UOHI) perfusionist team.
Ottawa resident Michel Casson, 63, has cardiomyopathy, a severe deterioration of his heart muscle. Earlier this year, he spent 42 days in the Heart Institute, where a Left Ventricular Assist Device (LVAD) was implanted in his chest. The LVAD performs the pumping function of Michel's left ventricle, so that his lungs, organs and tissues get the oxygen-rich blood they need.
"The LVAD is three or four inches long, with a propeller on one end that goes 9,200 revolutions per minute," Michel explains. "It is powered by electricity, so I must wear a battery pack at all times and plug a cable into a wall electrical outlet overnight. Because of the work it does, I have no pulse."
Perfusionists have expertise in heart-lung machines and other circulatory support devices, such as the LVAD. Before Michel was discharged from the Heart Institute, the UOHI perfusionist team that helps him look after the LVAD inspected his Ottawa house to make sure it could provide the electricity supply the pump needs. When summer arrived, Michel asked if he would be able to spend time at his home on Clayton Lake.
The perfusionist team inspected the power supply and gave Michel the go-ahead. They then contacted the Almonte General Hospital, which is the closest hospital to Clayton Lake, to arrange an education session in early July for AGH doctors and nurses on what to do if Michel is brought to their Emergency Department.
"I need to go to a hospital where they know what to with a patient who has an LVAD," says Michel.
UOHI perfusionist Debbie Hubble trained Michel and his wife, Nicole Langis, on using the LVAD when it was implanted earlier this year. "We arranged the educational session at the Almonte General Hospital in case Michel has to go to the Hospital for any reason," says Debbie, who lives in Almonte. "Hospital staff need to know how to do an assessment on a patient with an LVAD, because Michel has no pulse and you can't take his blood pressure in the usual way."
LVAD failure is very rare, Debbie says, adding that patients with the device always have backup equipment and power supplies. "We would not expect the Almonte General Hospital staff to troubleshoot any problems with the LVAD, but they need to assess him, stabilize him and arrange transport to the Heart Institute."
Debbie said the session at AGH went very well. "It is one of the best-attended sessions we have ever conducted," she said. "Everyone was very enthusiastic."
Dr. Michael Dolan was one of the AGH physicians who attended the educational session. "We need to be prepared for any problem Michel might have, and it is much better knowing about his condition in advance," Dr. Dolan says. "The educational session was worthwhile and interesting, and it is another example of the Heart Institute reaching out to area communities, which it is very good at."
AGH Emergency Department Registered Nurse Debby Elder, who also attended the session, said the LVAD is "amazing". "These devices have come so far," she said. "It is good that we were able to meet Michel and the session told us everything we need to know."
Michel cannot drive or be in or near water, but he walks and participates in rehabilitation exercises. He is currently on the waiting list for a heart transplant. "When that happens, the LVAD will be removed and the new heart will take over."
While it took some time to get used to the LVAD and the limitations it places on his activities, Michel says that, "20 years ago I wouldn't have survived this condition. I feel good and I expect to feel better as I get stronger. The most important thing is to have a support group and I have the most fantastic wife and caregiver in Nicole."
He also has high praise for the "incredible" Heart Institute, for Debbie Hubble's training and support and for the AGH team. "It was a great meeting with the doctors and nurses there," he says. "I feel very confident about the staff at AGH; they are beautiful people."
Michel and Nicole will travel back and forth between their Ottawa home and their 44 x 12 foot trailer in Clayton Lakeside Trailer Park during the summer.
"It is right on the lake and we have our own dock," says Michel. "Maybe I can't swim or go in the boat, but it is a beautiful place, and I love looking at the lake and hearing the loons. I am very lucky; I've got everything covered, from the support of my family right up to great medical professionals."