Care4Conway: Not much sleep (Weds nite/Thurs morn)

Thursday, June 18, 2009

Not much sleep (Weds nite/Thurs morn)

Connie did go back to sleep for about 1.5-2 hours last night but then has been awake and squirmy ever since. Altogether he's had about 4 hours I'm guessing. He even had some 4am crackers and juice (no dinner last night) and wanted more but I want him to eat something at breakfast so I told him to lay back down. He's being very good and cooperative other than pulling on his little IV house (cover) and taking his sat monitor off a few times. He's been wetting diapers and the doctor came in around 5am and assessed him and says he looks good and his liver is barely noticeable. The plan was for him to go to the floor around 10 or so if he tolerated coming off the milrinone that they turned off at 4am (have to watch him for 6 hours before sending him out) but after the night he's had with the questionable heart rates, they turned it back on at 5:15 until such time as they interrogate the pacemaker to find out what was the cause of those times where he's stuck at 100 bpm.

I'm trying to get him to go back to sleep now but it's almost a lost cause since they'll be up to take blood sometime around 6am.

1 comment:

H. James said...: I just caught up. I'm sorry its a longer hospital stay, but hopefully they will get this all figured out & you won't have another unplanned admission for a LONG time.
Great job asking them to interrogate the pacer! You are the only one who has been there for every single aspect of Connie's care and 'reminding' the team that the aflutter was only discovered with pacemaker interrogation (after he was in severe heart failure) will help make sure he get the best care possible!!

We'll be keeping up with your progress!

Heather; June 18, 2009 at 7:32 AM

Conway's Heart Story

Conway's Heart Story

Conway David Beckemeier was born on March 3, 2007. His heart defects went undetected during pregnancy and he was diagnosed at two days of age with L-TGA, a large VSD, sub pulmonic stenosis and Ebstein’s Anomaly. Just before turning six months of age, he underwent open heart surgery to reroute the bloodflow in his heart. Called the "double switch", this procedure is the most technically challenging for pediatric cardio-thoracic surgeons to perform. The version of the double switch that Conway received on 8/28/07 was called the Rastelli-Senning with VSD closure and sub pulmonic resection. He suffered a grand mal seizure following the surgery that lasted over an hour and had several other post-op setbacks including surgical heart block, which required another operation on 9/18/07 to insert a pacemaker. Following surgery and such a long hospital stay, Conway developed an oral aversion (he would not eat) and he was 100% NG tube fed for eight months. He also lost muscle tone and required both physical and occupational therapies. In April 2008, he had a cardiac cath and attempted balloon angioplasty on his pulmonary arteries that did not work. Although his recovery was very long, he had a solid year or so of being a "normal" kid . Then in May of 2009, it was discovered that Conway was having rhythm disturbances, specifically atrial flutter. His pacemaker allowed it to go undetected for several weeks until he showed signs of heart failure and was admitted to the ICU for a week to be placed on IV heart meds and undergo cardioversion on 5/6/09. He went home and his heart function started recovering when he had another episode of flutter (6/16/09). This time, he was again hospitalized and put on IV milrinone, but he converted back to normal sinus rhythm by himself. At that time he was placed on the anti-arrhythmia drug, amiodarone. On 7/22/09 he had to be cardioverted again for yet another episode of flutter. The following week, he got worse instead of better. His cardiologist did a full work up and it was determined that his aortic, mitral and tricuspid valves were all leaking worse and were felt to be the cause of his heart failure. On 8/24/09 he had a cardiac cath and attempted ablation. The electrophysiologist was unable to induce a single arrhythmia. Then, just two days later, he went into atrial flutter on his own. He was placed back in the cath lab where he underwent mapping and a total of 17 burns were made to try to knock out his arrhythmias for good. The next day, 8/27/09, he had his second open heart surgery to repair his mitral valve called ring annuloplasty. He also had a partial Maze procedure done. His surgeries are performed at C.S. Mott Children’s Hospital at the University of Michigan (Ann Arbor). This time he was discharged just six days later! His Left Ventricular function improved drastically. In December 2010 we noticed he began getting more winded during physical activity. A January 2011 cath showed that he is outgrowing his RV-PA gortex conduit, but he was not symptomatic enough to warrant intervention. In April 2012 Conway’s fatigue increased and an echo at the end of May revealed that the ratio between the right and left sided pressures has gotten too high and it is time to replace the homograft that was placed when he was five months old. He had a cardiac cath on 5/25/12 which confirmed the echo findings. He had surgery on 8/8/12 to replace his pulmonary valve and RV-PA conduit, add an additional pacing wire to his left ventricle, and change his generator to a bi-ventricular model which is shown to preserve function and help the heart muscle pump more efficiently/effectively.