"Um… is Karen there?" Andy asked Jake on the phone. "No… tell her that Lucas is in the hospital… 4th floor."
"Brooke, it is Jake… Lucas is in the hospital okay… if you hear from Peyt, tell her." Jake said.
"Okay… Jake… I will… Bye." Brooke said. She grabbed her jacket and rushed to the hospital.
"Andy, hey, I'm Brooke, is he okay… can I see him?" Brooke said.
"Yeah, his father is in there right now, but you can go in…" Andy said. Brooke went to his bedside and grabbed his hand. Dan was asleep on the couch.
"Lucas, I can't lose you, I just got you back… you have to wake up… I need you so much." Brooke said. She layed her head on his chest and soon fell asleep. Lucas woke up and saw her there. He smiled. Brooke woke up.
"Hey." Lucas said.
"Hey, missed you." Brooke said.
A/N: HCL stands for hypertrophic Cardiomyopathy, it is:
Cardiomyopathy is a condition in which the muscle of the heart is abnormal in the absence of an apparent cause. This terminology is purely descriptive and is based on the Latin derivation. There are four types of Cardiomyopathy: Hypertrophic (HCM), Dilated (DCM), Restrictive (RCM) and Arrhythmogenic Right Ventricular (ARVC). The main feature of Hypertrophic Cardiomyopathy is an excessive thickening of the heart muscle (hypertrophy literally means to thicken). Heart muscle may thicken in normal individuals as a result of high blood pressure or prolonged athletic training. In Hypertrophic Cardiomyopathy, however, the muscle thickening occurs without an obvious cause. In addition, microscopic examination of the heart muscle in Hypertrophic Cardiomyopathy shows that it is abnormal. The normal alignment of muscle cells is absent and this abnormality is called myocardial disarray.
IS THERE A CURE AVAILABLE?
At present there is no cure for Hypertrophic Cardiomyopathy although there is a slight possibility that some drugs may decrease the degree of muscle thickening. Regrettably, no treatment has yet been shown to return the heart to normal but research is continuing in this area. Developments are most likely to come from the early detection of persons carrying the gene for Hypertrophic Cardiomyopathy and from treating them to prevent the development of hypertrophy.
TREATMENT
Treatment aims to improve symptoms and prevent complications. Although the condition cannot be cured, there are many forms of treatment available which may improve the function of the heart and relieve symptoms. Many individuals who have few or no symptoms do not require treatment. For those who do, the treatment available is best considered under three headings:
1) Drug Treatment
2) Surgery
1. Drug Treatment
Drug treatment or medication is primarily given when a person has some or all of the symptoms described earlier. The choice of treatment will vary from individual to individual but the common groups of drugs used are as follows:
Beta-Blockers
Beta-blockers are drugs which slow the heart beat and reduce its force of contraction. These drugs usually relieve chest pain, breathlessness and palpitation. Beta-blockers are widely used in medical practice for other types of heart disease and for high blood pressure. Occasionally excessive heart rate slowing can cause fatigue. There are many beta-blockers: the most commonly used are propranolol, atenolol, sotalol and nadolol.
Calcium Antagonists
The second major group of drugs used are the calcium antagonists or calcium channel blockers. Within this group verapamil is the drug which has been most used in Hypertrophic Cardiomyopathy. It improves the filling of the heart by reducing the stiffness of the myocardium and, like beta blockers, reduces symptoms such as chest pain, breathlessness and palpitations. Also, like beta-blockers, verapamil can cause excessive slowing of the heart rate and lower blood pressure.
Anti-Arrhythmic Drugs
These drugs might be used when an arrhythmia such as ventricular tachycardia is detected and felt to be important in an individual case. Of these anti-arrhythmic drugs amiodarone is the most commonly used in Hypertrophic Cardiomyopathy in the UK. It is an extremely effective drug and is most commonly used to reduce the risk of sudden death. However it does have several potential side effects, especially sensitivity to the sunlight (which can be avoided with use of barrier creams) and effects on the thyroid gland, which are reversible, but require regular testing.
Other Drugs
There are a number of specific complications described earlier which are rare but which require the use of additional drugs.
Anticoagulants
Patients with episodic or persistent atrial fibrillation should take anticoagulants (blood thinners) to prevent clot formation in the atria. Warfarin is the tablet commonly used. It requires monitoring with a blood test, approximately on a monthly basis.
Diuretics
Occasionally patients develop fluid retention and in this situation diuretics (water tablets) which increase urine flow are administered.
Antibiotics
Although endocarditis is rare, persons who have turbulent blood flow in the left ventricular outflow tract or across the mitral valve should receive antibiotic prophylaxics prior to dental procedures and any other situations where there is an increased risk of bacteria entering the bloodstream.
Summary of Drug Treatment
In summary, a variety of drug treatments are currently used in Hypertrophic Cardiomyopathy and of course new drugs may be discovered in the future. The need for any treatment and choice of that treatment has to be made on an individual basis and may change in any one individual over the years.
2. Surgery
Surgical myectomy (removal of muscle) is successful in the relief of symptoms. It is considered in individuals with severe symptoms despite drug treatment, in whom the left ventricular outflow tract narrowing causes obstruction of the blood flow (Figure 10).
In this operation the surgeon removes a portion of the thickened muscle from the septum, thereby widening the outflow tract and relieving the obstruction.
Sometimes, together with myectomy, the mitral valve is replaced with an artificial valve. As described earlier, during obstruction to outflow from the heart, the mitral valve touches the septum and blood leaks back through the valve (Figure 10) if this mitral valve regurgitation is severe, then the valve may be replaced.
These are major operations which carry a definite risk and are therefore reserved for patients with severe symptoms and certain forms of Hypertrophic Cardiomyopathy.
Non surgical myectomy is a new procedure, pioneered in the UK, which has been devised to reduce hypertrophy of the upper septum without the need for open heart surgery. This technique involves injecting a small amount of alcohol solution down a minor branch of the coronary artery that supplies the upper septum, thus destroying this part of the myocardium. This is performed during a cardiac catheterisation and can be done under a local anaesthetic. Although only in the early stages of development, this strategy should provide a useful addition to the non surgical therapies available to patients with symptoms associated with Hypertrophic Cardiomyopathy.
Heart Transplantation
For a small minority, heart transplantation is necessary for those individuals who have a severe impairment of the pumping action of the heart.
A/N: Sorry about all the info about Hypertrophic Cardiomyopathy(HCM). I just have noticed that all the people writing these stories don't know what HCM really is and I figured I'd clear that up. Back to the story:
"Yeah, I missed you, too." Lucas said.
" So, um… I am going to go get a doctor." Brooke said. She got up and the doctor came in.
"So, Mr. Scott, how are you feeling." Dr. Yen said.
"Like I got my spleen taken out." Lucas said.
"You are going to be sore for a while, but you should be better in about six weeks." Dr. Yen said.
"Thanks, doc, can I go home now?" Lucas asked.
"Yeah, you father is releasing you now." Dr. Yen said.
