"For I know the plans I have for you," declares the Lord, "plans to prosper you and not to harm you, plans to give you hope and a future."
--Jeremiah 29:11

Monday, March 17, 2008

Cardiology Update

Happy St. Patrick's Day to ya! Our little Irish prince went to see his cardiologist this morning. His last check up was exactly three months ago. At today's appointment they did his vitals and we recapped what meds he's on, what he's doing activity-wise and what kind of symptoms we are seeing at home. He's doing great. Blood pressure was a little elevated but the nurse said it was fine. His weight is 22 pounds, 8.8 ounces. Then they did his echo. It took three of us to keep him entertained. It seems as though our little TV loving boy wasn't the least bit interested in watching the Mr. Rogers episode playing on the wall. He wanted to grab and explore the equipment. His hands were full of ultrasound gel--yuck! One tech kept running out to get new toys (the noisier the better) for him to play with. The thing that worked best was my cell phone. He also enjoyed the bubbles and the light wand. The news from the echo was that the pressure in the right ventricle is about the same as it was after the surgery, about 50%. Normal pressure is 25%. When the pressure gets to be 2/3 (66%) of what it is in the left ventricle, then it is time to intervene (surgically or otherwise). Thankfully, we are not at that point and don't seem like we're heading to that point. Also, his left ventricle function is still great. This means that his ventricle is handling the severe leak in his aortic valve very well for now. Dr. Bromberg was very encouraged by this and said he was "a lot more hopeful about the prognosis" than he was after our last visit in December. The leak is not any better (we didn't expect it would be) but it's not any worse and he's asymptomatic for now so that is the best news. He said he can see him possibly making it five years before needing a new valve and he's really hoping that Dr. Bove could just repair that valve rather than replacing it. What wasn't very clear on the echo were the branch pulmonary arteries. They know there is some stenosis (which is why he has high pressures in the right ventricle), based on the cath he had in Michigan last September. The question is, how much stenosis (i.e. blockage/narrowing)? To find this out, they will do another cardiac catheterization next month. It will be done at Children's in St. Louis by Dr. Balzer. Dr. Bromberg will call him and tell him about Connie and specifically what we are looking for and some background on what's happened so far. This cath should let them see what the echo can't and get some more measurements on the pressures in the ventricles. If necessary, they will balloon open some of the narrowing, but Dr. Bromberg doesn't even think that would be necessary. He says that if we are the first case of the day, we may get to be outpatient. If he's not the first case, or if they have to do anything while they are in there, he will stay admitted overnight. Even though I had a good idea this was coming I am already dreading it. All those feelings seem to be rushing back and the thoughts of, "Will they find something and want to do surgery?" Praise God that as far as we know at this time, his heart is doing well and is handling the switch okay. His medications were changed a bit. We are going to try him completely off lasix. That means he is on NO MORE DIURETICS!! He's been on them since he was one month old. This is great news!! I'm glad because hopefully he can stay off them--at least until we're done potty training down the road. I can't imagine a kid learning to potty train while on diuretics! His Enalapril (blood pressure med) has been raised from 1.5 mL 2X/day to 2 mL 2X/day. We are bumping him up slowly until he gets to the max dose for his age/size. Dr. says that the more the better. We want to help that left ventricle as much as possible to maintain good function from the leak.

So, now we wait to hear our date from Children's on when the cath will be. We'll let you know when we find out.