Ricardo's Journal

I visited Dr Sue Ann R. Locnen at St Luke's at Global City at 3:00 pm today, Oct 18, Friday with Ling and our grandsons Paolo and Patrick. My weight increased by 4 kilos since July and was advised to go on a strict diet and exercise regularly. Representatives of Medtronics examined my pacemaker using their monitoring equipment. I was told that the pacemaker is functioning well as a back up at 6 percent of the time and added that the battery may last for about 10 years or more. Dr Locnen explained that just after it's insertion the pacemaker functioned at a much faster rate because the artificial aortic valve has not fully settled yet within my natural aortic valve due to inflammation. As days and weeks pass by, the artificial aortic valve and my natural aortic valve should jointly function more efficiently and the need for the intervention of my pacemaker becomes less urgent. The representatives of Medtronics said that they will examine again my pacemaker one year from now or in October 2014.

We arrived early Tuesday Aug 27 morning from San Francisco after our trip to US. Visited Dr Posas last Saturday, Aug 31, who gave me a clean bill of health. I was asked to undergo 2D echo & Doppler procedure at St Luke's this coming Friday as part of the regular post-TAVI monitoring protocol.

I am here now at Jersey City for a 2-week vacation with my wife Ling and our daughters Lanie and Weenie. I am doing early morning walk along Hudson River overlooking Manhattan. During the last two days since we arrived I have walked for about one hour each day. I plan to do this for the duration of our stay.

I went to see Dr Posas and Dr Locnen last July 25. They examined me carefully and both intimated to me that the stent, artificial aortic valve, and pacemaker are all functioning properly. They said that I can go back to my normal routine. They asked me to see them on August 8 for further monitoring.

I was discharged from the hospital 7 days ago. Upon leaving the hospital I was instructed to visit the clinics of two members of the team and undergo 2D Echo to monitor the status of the hardwares implanted on my chest. I visited Dr Ruth Divinagracia (Pulmonologist) and Dr Salvador Abad Santos (Infectious Disease) yesterday and both of them gave me clean bill of health. I had my 2D Echo this morning. On July 25 I am scheduled to see Dr Posas and Dr Locnen for final evaluation.

This noon (Sunday) I was discharged from the Coronary Care Unit (CCU) and was brought to a regular room for further monitoring for another 24 hours. My TAVI was completed last Wednesday with a minor hitch. Initially Dr Posas inserted an aortic valve (CoreValve from Medtronic) which opened prematurely. This was withdrawn immediately and another one was inserted. The second attempt was successful since the contraption fitted snugly in my aortic valve. After TAVI I was brought to the CCU for close observation. After about 36 hours, Dr Posas and Dr Locnen intimated that my heartbeat is a little bit irregular. After consultations with the other members of the TAVI team Dr Posas decided to secure my permission for the insertion under the skin of my right breast a small pacemaker which will serve as stand-by prompter. Dr Stan de Castro, a member of the TAVI team did the insertion. Dr Posas and Dr Locnen told me that I maybe discharged from the hospital tomorrow.

I checked in at St Luke\'s at about 2 pm, Wednesday July 10 accompanied by Ling, Lani & Paul, and Rowena. It is now 2:50 am Thursday and my TAVI procedure is scheduled to start at 7:00 am.

Early this afternoon today (July 8, Monday, Manila time) I went to St Luke\'s for readmission with my wife Lilia and daughter Lani. We were met by Dr Locnen at the receiving section and informed us that certain critical items for the TAVI procedure from Netherlands have not arrived yet. In view of this I have to delay my admission by two days.

Today July 8, Monday, I will be readmitted at St Luke\'s Medical Center under the care of Dr Sue Ann R. Locnen and Dr Flavio Posas. I am scheduled to undergo TAVI tomorrow July 9, the 25th anniversary of my triple coronary by-pass.

As scheduled, Dr Posas interviewed me in the presence of my wife Lilia and daughter Lani, MD, who also holds clinic at Asian Hospital & Medical Center. Dr Posas said that I am a candidate for TAVI procedure and continued that the aortic valve implantation could be done actually through open heart surgery or by catheterization. He added that as suggested earlier by Dr Locnen, they are opting for TAVI. Before scheduling this however, they have to evaluate carefully my coronary grafts (triple by-pass done in 1988) and the stent inserted in 2003. On June 30 I was admitted at St Luke\'s Medical Center for this mandatory evaluation. I was accompanied by my wife Ling and daughters Lani and Rowena, son-in-law Paul G. Hinlo, and family friend Rev Fr Joseph Diamanté, priest from St. James The Greater church at Ayala Alabang Village. Last July 1st Dr Posas inserted additional stent on my coronary artery thru catheterization. After several laboratory procedures I was discharged from the hospital on July 5 Friday for re-admission on July 8, Monday.

My appointment with Dr Flavio Posas at Asian Hospital and Medical Center, Alabang, Muntinlupa City is on Wednesday June 26, 2013 at 3 pm for consultation/interview. Dr Sue Ann Locnen, my cardiologist, and a close friend of my daughter Lani Venturina-Hinlo, MD, earlier prescribed that I undergo two procedures: CT-Scan of my abdominal aorta and CT-scan of my thoracic aorta. Based on the results of the two procedures Dr Locnen suggested that I undergo Transcatheter Aortic Valve Implantation (TAVI) which could be done by Dr Posas.