Showing posts with label cardiologist. Show all posts
Showing posts with label cardiologist. Show all posts

Friday, May 23, 2014

Heart Doctors & Expectations

If you follow me on Facebook or have spoken to me (even in passing) in the last week, then you are well aware that today was Roo's annual cardiology appointment. I can't say that I've been exactly worried about it--in fact, I really expected it to be rather uneventful--but it was something that has been on the forefront of my mind.

So let me start by giving you all some background. When Roo was diagnosed with Down's, one of the first things they asked us to do was see a cardiologist. Approximately half of all babies with Down syndrome are born with heart defects, so although we hadn't had any outstanding concerns up to then, a checkup seemed like a good idea.

At our first appointment, Roo was diagnosed with an Atrioventricular Septal Defect (ASD) and a Ventricular Septal Defect (VSD), two of the most common heart issues in babies with DS. You can read more about them here, but they are essentially holes in the heart. The ASD, usually the cause of greater concern, was quite small, and the heart had already started to grow tissue around it. The doctor was confident it would close itself completely within the next few months. The VSD, though, he believed was too big to close on its own and would need to be repaired. Fortunately, it wouldn't affect him for several years, so he told us to expect the repair to happen around age 5--AND it could be done without open heart surgery, but would simply involve a heart catheterization and an overnight stay. Until then, he just wanted to see us about once a year. All-in-all, it was much better news than it could have been.

The following year, the doctor also discovered a cleft mitral valve. This essentially means that a valve between two of the chambers wasn't/isn't closing all the way, which allows a little bit of blood to leak back into the incorrect chamber when the heart pumps. It was a minor leak, and again he just wanted to monitor it. The best news out of that appointment surrounded the VSD, which had shrunk to less than HALF of its original size. He said that was quite unusual for a hole of that size, and told us if it continued to shrink, Roo may not need to have it repaired at all.

We went back again when Roo was 2 1/2. At that point, Roo was the fun-loving (ahem, non-stop-moving) child we all know and love, and the cardiologist recommended against doing an echocardiogram. He knew that the idea of getting Roo to lie still for 45 minutes was laughable, and since he wasn't overly concerned about any of the defects, he told us to just come back again in a year.

Which brings us to today. OK, it was a year-and-a-half. Somebody I know is a procrastinator. Just deal with it.

Anyway, we went to the appointment this morning, and as some of you know, it did not get off to the best start. He completely flipped out when the nurses tried to take his blood pressure and do an EKG, making the results absolutely worthless. He cried so hard he was shaking, the poor baby. It's funny to me, since they weren't doing anything that hurts, but I think he's been to enough doctor's visits that he just hates being messed with.

And then we waited for the cardiologist. Fortunately, Nickelodeon must somehow have been made aware of this impending appointment, and they released several PAW Patrol videos for the Leap Pad last week. I may or may not have spent an hour-and-a-half last night getting them downloaded just for this morning. Whatever. It was worth it.



When the cardiologist came in, I thought, "Oh good, we're just about done!" If he didn't want to do an echocardiogram on 2 1/2-year-old Roo, there was no way he'd attempt one on 4-year-old, already-freaking-out Roo.

I was wrong.

After going over Roo's history (which began with, "I remember you, Buddy! You're bald!" :-) This kid is rocking that bald head, I tell ya.), he listened to his heart and told me that he could still hear some leakage from the cleft mitral valve. He explained that this could be repaired, but it would require an open-heart surgery--and if they did that, they would probably just repair the VSD at the same time. That was a little disconcerting, since my big comfort for this whole surgery was that his chest wouldn't need to be opened.

And THEN he said, "You know, we didn't do the echo last time, so it's not a bad idea to try it this time. I mean, I know it may not work, but it's worth a shot. If we can't get it, we'll try again next year."

Are you kidding me? You think this kid, who lost his ever-loving mind over a blood pressure cuff, is going to lay still for 45 minutes while they rub gel and a wand all over his chest?

OK, if you say so.

I might have been a little skeptical.

At first, it seemed like a total disaster. Roo laid down on the table, they put a TV with a baby signing video right by his face, and asked me to hold his hands. As soon as I did that, he started arching his back and kicking and crying and... it wasn't pretty. BUT I managed to hold both of his hands in one of mine, then I used my other hand to hold down his legs. And although he would periodically remember that he was supposed to be unhappy and give a half-hearted cry/struggle, overall he got pretty entranced in the video and was relatively still. Still enough for the tech to get every shot he needed in about 25 minutes. Hallelujah! (I would have taken a picture of this, but A-both of my hands were fully occupied in HOLDING MY CHILD DOWN on the table, and B-there was a big sign in the room that said, "No pictures or videos, please!" Gotta love us snap-happy moms...)

And then back to wait for the cardiologist. At this point, Roo finally find something that made him happy...



 
He would stack the blocks, count them (I know!!!!), and then say, "Woo-hoo! Yeah!" for himself. Over and over and over. But hey, he was happy, so I wasn't arguing!


But back to the appointment. I'm not gonna lie. At this point, I was preparing myself for him to come in and say, "So, I think we'll go ahead and schedule the surgery now--there's no real need to wait until he's 5."

INSTEAD...

He said that BOTH holes in his heart have completely closed! He doesn't need the VSD repaired at all! I know... I know I should have half-expected this, since it had started to shrink already... but I just can't tell you the relief. I just. I don't even have the words.

And the mitral valve, well, that's still leaking. BUT it is small, and the leak is minor, and it is not causing any enlargement in either chamber (which is the biggest concern). He said, "It can be repaired, but right now I don't see any need to." He asked us to come back in a year, and I'm guessing he'll want to check on that every 1-2 years until Roo is an adult, since he and his heart will be growing. But he seemed quite confident that this would need be an impediment. He cleared Roo for all activities, sports, etc. No worries.

I managed to wait until I got in the car to cry.

I am still a little astounded at the relief I feel from all of this. It really isn't that different from what I had expected going in. But when I told Mr. Fantastic about it, he reminded me of why I may have gone to that appointment holding my breath. Because 4 years ago, we walked into a doctor's office and expected a quick blood draw and a "everything is fine, you guys are good to go!" And instead we left with a diagnosis and our world turned upside down. So now with every single doctor's appointment, even when we don't expect a problem... part of us does. Part of me is waiting for the other shoe to drop, waiting to hear about that something that we missed. That's something that changed for me that day in the geneticist's office.

I expected to leave the cardiologist's office with no real news. And then again, I expected to leave in tears, calling my hubby with news of surgery to schedule or another defect found or... worse.

But I didn't leave with either of those. I left with good news and relief and a reprieve. And it felt wonderful. I did leave in tears, but good tears.

To celebrate, I took Roo (who was nonplussed by the good news, and recovering from the traumatic experience of being touched by doctors and nurses) to his favorite restaurant for lunch. Then I ran into Target for just a couple of quick things. Apparently being a major grump all morning gets all of the grumpies out at once, leaving lots of room for giggles and silliness...



And then, exhaustion.



A much-deserved nap, my little guy. It's been quite a day.

Monday, September 26, 2011

Matters of the Heart

Last night Mr. Fantastic and I watched a movie, and as the main character's flashbacks started, I thought, "I know flashbacks are a great tool for movies, but it just doesn't happen that way in real life." I don't think I've ever relived a moment in my past so vividly just by thinking about it. I have memories that can be triggered by certain sights, smells, words, etc, but that doesn't mean that I relive them, I just... well, remember them.

And then today I took Roo to the cardiologist, and as I pulled up to Children's Hospital I had a vivid memory of arriving at the ER there with our 3-day-old baby, who had jaundice--and then issue after issue, which we now know were just signs trying to point us to the ultimate diagnosis of Down syndrome. And I truly did relive the moment. And as I walked in and saw all the same sights, I could almost audibly hear the words I said to my husband over a year ago, "This all seems huge right now, but I know that someday we'll look back on this and laugh. We'll drive past Children's and say, 'Remember when we had to go there? Gosh, which kid was it? And was it for... jaundice or something?' In the long run, this will be nothing." (Ha. God must have had a little chuckle over that one.)

And now the murals at Children's are familiar to me. I know how to get everywhere I need to go. My big kids (when they're with me--and thankfully they were not today) know where the big ball maze is. It's part of our lives. And as much as I am growing and changing and accepting--and even embracing--our new life, there's a part of me that hurts every time we walk through those doors. It's a love-hate relationship--I am so thankful that we have a Children's Hospital just 20 minutes away, but I really wish we didn't need it.

But we do.  We do need it, and today we were there for a quick check of Roo's ticker. And by quick, I mean it took roughly half of an eternity longer than I had anticipated.

If you're not keeping close tabs on Roo's heart issues (which of course you all are, I'm certain), here's a quick recap. He was diagnosed at his first appointment last year with two holes in his heart, an Atrial Septal Defect (ASD) and a Ventricular Septal Defect (VSD). The VSD was very small, and the doctor actually thought it may close up on its own. The ASD was "moderate" in size--one step above small--and would likely require a small procedure to repair it. The procedure wouldn't be done until Roo was around age 5, and it would  not require open heart surgery, thank goodness. There was a chance it could also repair itself, but most likely it wouldn't because of its size. For a child with Down syndrome, the doctor told us, Roo's heart issues were very minor. He just asked that we follow up about once a year to keep an eye on the ASD until it could be repaired.

So it was the annual checkup that took us back to the doctor's office today. Next year I will remember when I call to schedule our appointment to ask for an echocardiogram. Both times we've gone, the doctor has wanted one but it wasn't on the schedule, so our appointment took much longer than necessary because we had to wait for a chance to be squeezed in for the echo. By "longer than necessary", I mean that we spent approximately 15 minutes with the doctor, 30 minutes getting the echo, and an hour and forty-five minutes waiting. Did I mention that Roo's appointment was at 12:30, and that his naptime is at 1:00?  He did fall asleep while we were waiting for the echo, but woke up about 20 minutes later when I laid him down for the test. By the time we were done, the poor kid was toast.  (And then he went to bed for the night at 6:00--he was exhausted!)

ANYWAY, we finally got the echo and all of the waiting out of the way, and here's what we heard: GOOD NEWS. It looks like the VSD pretty much has closed itself up!  The doctor said there's a chance that there's still a pinhole leak, but he really thinks it is closed and is completely unconcerned about it either way. And the ASD has shrunk by over 50%!! This is HUGE, especially since Roo has been growing--and his heart along with him.  :-) Last year one side of his heart was enlarged because of the extra blood flow (due to the hole), but thanks to the shrinking of the hole that is no longer the case either!  And the cardiologist even said there's a good chance that Roo won't need the procedure to repair this hole!!! That is a huge relief for me.  HUGE.

There was one other defect that he hadn't seen last year. It's called a cleft mitral valve leafleft.Yeah, I only remember because I had him write it down for me. Basically there's a little divet out of the tissue of one half of a valve, so every time the valve closes, a tiny little bit of blood seeps back through. But did you notice the key word there? Tiny. He said it is very minor and should not require any intervention. This is, however, probably my biggest prayer request coming out of this appointment. This is the only of Roo's defects that could worsen on its own--and while it is repairable, this particular defect would require open heart surgery to fix. Again, the cardiologist really didn't seem concerned, so I am not going to lose sleep over it, but you'd better believe I'm going to be praying that it doesn't progress into anything bigger!

But all-in-all, GREAT news from our appointment today. It was definitely good for my heart. And by the way, I do know that it seems a little melodramatic for me to feel so strongly about being at Children's Hospital. The truth is, Roo has been blessed with amazingly good health for a child with Down's and almost all of our appointments there have been "just in case" checks--not sick visits. And I am so, so thankful for that. But I just remember how... blissfully ignorant I was in that first week we spent at Children's when Roo was born. Don't get me wrong, I was unbelievably--and perhaps disproportionately--worried about my baby (I had, after all, just given birth, and was very sleep-deprived and maybe just a tad hormonal...); but I was also certain that once Roo got released, we'd never see the inside of that building again. We wouldn't have to be one of those families who is at Children's all the time because... well... that just wouldn't happen to us.

I remember being that person. But I'm not her anymore. I miss her sometimes--I mean, it's called blissfully ignorant for a reason--but I wouldn't want to be her again. She might not have known as much about Children's Hospital as I do, but she also didn't know sweet baby Roo like I do either. And I wouldn't trade that for the world.