I’m starting to think I need my own spin-off series.
I went back to see my cardiologist at Jefferson today, and discovered there were a few complications of which I hadn’t been aware. The key one to note is that in October 2006 the FDA rescinded their endorsement of PFO closure using trans-catheter devices, on the grounds that there had been insufficient medical trials.
Strangely enough, they have had difficulty enrolling patients in these trials. The patients seem to think that they should get a choice as to whether they have their PFOs closed or simply trust to blood-thinner medication. Strangely enough, so do I. The procedure is already recommended in Europe. I’m not sure it’s sensible to attempt to perform a trial when there is a belief that one of the therapies under assessment offers significantly more protection than the other. It is still possible to get trans-catheter closure using devices ‘off-label’ provided one gets (of course!) clearance from one’s insurance company or pays oneself. My cardiologist is going to Washington this coming Friday to argue the point with the FDA.
So where does this leave me? Well my cardiologist was keen to close the PFO before the ovary removal, but wanted me to make my OB-GYN aware that this would necessitate delaying the ovary removal for 6 months. Now I have had enough of being treated like a go-between by these disinterested professionals. After all, I would not ask my cardiologist to take notes on a lecture about prosody by Donald Hall and paraphrase them for Stephen Dunn. So I asked him respectfully if he would mind contacting my OB-GYN directly and having a discussion with her about the priorities. Who would expect it to be the poet whose common sense prevails? In that discussion they agreed I should get the ovary taken care of first, which means I needn’t worry about the FDA just yet, and indeed, their somewhat insular stance may be taken care of by the time I need to make that decision.
So, the only slight complication with this is that I am not allowed to stop taking blood-thinning medication before the ovarian surgery. However, there is an alternative treatment in the form of a self-administered injection I can perform for the few days leading up to the surgery. (Oh joy! Because I just love needles…) This will confer the same benefits as aspirin on a daily basis but will not remain in my system to interfere with healing after surgery.
NOW how does Patient A feel about this? Actually not too bad. At least we have a way forward and some degree of consensus between my medical professionals. Although, House? Are you around? Got any thoughts?