Fragile Lives: A Heart Surgeon’s Stories of Life and Death on the Operating Table

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This chart is meant for reference ONLY and should not take the place of a healthcare provider’s advice. Discuss any questions about medication with a healthcare provider. Symptom Julie is alive today, as is Kirsty, operated on as a six-month-old baby, with Westaby innovating as he cuts, and learning in both cases that, given a chance, the heart can heal itself: a groundbreaking discovery.

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To this point, the Food and Drug Administration (FDA) has not approved any drugs specifically for the treatment of Fragile X or its symptoms. But in many cases, medications are used to treat certain symptoms of Fragile X syndrome, as shown in the chart below. NICHD does not endorse or support the use of any of these medications in treating the symptoms of Fragile X syndrome, or for other conditions for which the medications are not FDA approved. Masterfully written and when Open Heart is recited, it rolls off the tongue like prose in its melliferous rhythm narrated by one of the world's leading heart surgeons. If you happen to favor Atul Gawande’s Being Mortal or legendary Henry Marsh’s Do No Harm you have found a read on the same level with added gore and "blut” pooling. The details in Fragile Lives are extremely in depth, especially with regards to the surgeries and various diseases/injuries that are discussed in the book. While it was descriptive, it was not by any means difficult to follow. It was very interesting to read about the anatomy of the heart and the various pathologies Westaby writes about. Fragile X results from a change or mutation in the Fragile X Messenger Ribonucleoprotein 1 ( FMR1) gene, which is found on the X chromosome. The gene normally makes a protein, called FMRP, that is important for creating and maintaining connections between cells in the brain and nervous system. The mutation causes the body to make only a little bit or none of the protein, which often causes the symptoms of Fragile X. An incredible memoir from one of the world’s most eminent heart surgeons and some of the most remarkable and poignant cases he’s worked on.Prepare the individual for any changes in routine by explaining these changes ahead of time, possibly by using visual signs.

Fragile Lives by Stephen Westaby | Book Review Fragile Lives by Stephen Westaby | Book Review

In medicine, life and death are constantly intersecting. Live are fragile. While doctors strive to save every life, there are still times when even their best efforts fall short. It is in times like these that it is so tempting to descend into a maelstrom of despondency. Yet, it is also in times like these that strength must prevail, and one must carry on in spite of regret and failure. The size of the mutation. Some people have a smaller mutation (a lower number of repeats) in their FMR1 gene, while others have big mutations (a large number of repeats) in the gene. If the mutation is small, the body may be able to make some of the protein. Having the protein available makes the symptoms milder. The promoter part of the FMR1 gene includes many repeats—repeated instances of a specific DNA sequence called the CGG sequence. The FMR1 gene usually has between 6 and 40 repeats in the promoter; the average is 30 repeats.

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Physical. Most infants and younger children with Fragile X don’t have any specific physical features of this syndrome. When these children start to go through puberty, however, many will begin to develop certain features that are typical of those with Fragile X. Some children with Fragile X begin talking later than typically developing children. Most will talk eventually, but a few might stay nonverbal throughout their lives. People with 200 or more repeats in the promoter part of the gene have a full mutation, meaning the gene might not work at all. People with a full mutation often have Fragile X syndrome. We were adrenaline junkies living on a continuous high, craving action. From bleeding patients to cardiac arrests. From theatre to intensive care. From pub to party.” The crimson fountain hit the operating lights, sprayed the surgeons, soaked the green drapes. Someone murmured “Oh sh..! I was good with my hands (an understatement). The battle was lost…Yet I knew about life and death.”

Fragile Lives: A Heart Surgeon’s Stories of Listen Free to Fragile Lives: A Heart Surgeon’s Stories of

An incredible memoir from one of the world’s most eminent heart surgeons, recalling some of the most remarkable and poignant cases he’s worked on.Treating patients with heart failure and other defects to this vital organ is like walking a tightrope between life and death; it is so easy to tilt and fall over to either side. In fact, in cardiac surgery, the heart is momentarily stopped, dependent entirely on external machinery to maintain blood circulation. A single misstep can cause irrevocable damage. Dr Westbury was obviously something of a marvel, and was masterful in his work. I think to do a profession such as that, you need to be of a certain character, and I know, that I certainly couldn't do it. Dr Westbury tells us of the many triumphs where his patients of all ages have gone on to live happy and fulfilling lives, but also the tragedies, where lives were lost way too soon. There was much jargon in here, and some of it went over my head, but it made for interesting reading. The narrator brings everything to life wonderfully with writing that isn't top notch. Not bad, just awkward and clunky at times... it didn't deter me from going on with the book though. Everything discussed in here more than made up for it me in this case.

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Westaby worked all over the world and experienced many levels of both staff competence and facility provision. When dealing with a patient who will surely die without intervention, risks seem a price worth paying. This is the way, the only way, that new techniques and treatments can be developed. It is raw medicine, meaning sometimes it goes really well and everything is amazing, but some others it does not. And I think it was really important to deliver that message as well. Because it is a history of a human being, and only success would have made it boring, dull, and not realistic at all. And well, if it was only failure, he would not have become the eminence he is at the moment in hin field. In general, there are three options for the classroom placement of a child with Fragile X, based on that child’s specific abilities and needs: Westaby’s mantra is: “Move on, learn, try harder.” Innovation, he argues, is the goal, not outcomes. Since 2013, performance has been measured in “surgeon-specific mortality data”. As a result, he believes that cardiac surgery is too risky today for young students. They are “downtrodden, defensive, uncertain of themselves”. He covers mostly his professional career and gives very little insight into his personal life. The book is written in such an empathic manner that one could rejoice with the author when a patient is saved. A very detailed account of every case but the author mostly focuses on the surgical procedure. I like the author's approach as a surgeon, he was empathic and at the same time with very tough nerves. This book is a little technical and you can get through it if you have a basic idea of the anatomy and physiology of the heart and lungs.Although the surgery details are not for the squeamish, I found them riveting. Westaby conveys a keen sense of the adrenaline rush a surgeon gets while operating with the Grim Reaper looking on. I am not a little envious of all that Westaby has achieved: not just saving the occasional life despite his high-mortality field – as if that weren’t enough – but also pioneering various artificial heart solutions and a tracheal bypass tube that’s named after him. Fragile X syndrome and its associated conditions are caused by changes (mutations) in the FMR1 gene found on the X chromosome. This mutation affects how the body makes a protein called FMRP. The mutation causes the body to make only a little bit or none of the protein, which can cause the symptoms of Fragile X. I loved this book. It's interesting, full of emotion, failure but also triumph, and you can really understand the author's passion for his profession. Of course, being on call and having such an amazing career has meant aspects of his personal life have inevitably suffered; Stephen says at one point "While I spent many hours striving to save other people’s children... I never spent enough time with my own.” If a child with Fragile X syndrome qualifies for special services, a team of people will work together to design an IEP for the child. The team may include parents or caregivers, teachers, a school psychologist, and other specialists in child development or education. The IEP includes specific learning goals for that child, based on his or her needs and capabilities. The team also decides how best to carry out the IEP. It reaches a consensus on classroom placement for the child, determines any devices or special assistance the child needs, and identifies the specialists who will work with the child.