Monday, June 09, 2008

the next episode of o's heart

Originally we were scheduled to have his cath sometime next week, but Dr. Perry wanted to do the cath himself and since he will be out of town next week—and waiting until he comes back will be to far in the future—o's cath was moved up to monday at 1pm. 

The concern when o was admitted in march was that his pressures in his RA continue to be elevated despite the extensive repairs (placement of a big-a$$ pulmonary valve (19mm) and repair of the tricuspid valve and removal of the BT-Shunt). The fact that he took so long for his chest tubes to drain fluid, fluid collecting in his lungs, and a descended liver were a signs that his heart was not relaxing and that the load on his right side may be elevated. But, a threat from Dr. Perry (after two weeks of waiting for his chest tube to stop draining), "If his tubes don't stop draining over the weekend, well cath him on monday." one day later, o suddenly had no more drainage and a clear cough in a matter of days. so were we discharged  home with monthly cardiology visits. 

fast forward to now, the last two echo's have show o's atrial wall (where he still has a PFO) bulges into his LA. this could be yet another sign that his RA pressures are elevated. the only real way to find out actual RA pressures is in a cathlab with a pressure probe sitting in his heart. o's atrial wall has always bulged out onto the left side, but then again o always had a elevated RA pressure due to his anatomy and heart defect (but now that his anatomy is more "normal" is less-special, the pressures should theoretically be a lot lower). If the pressures are high, he will need another surgery—the bi-directional Glenn, depending on how high will determine how long we can put the surgery off (2 heart surgeries in 4 months is not ideal). If his pressures are low or close to normal, they will close up his PFO in the cathlab—further making his anatomy less special—and keep him overnight for observation (similar but more advance technique to this).

orion is currently only allowed to take clear liquids until 10 am, after that he is NPO. he has a cardiac cath today at 1pm. the plan is to arrive at LPCH by 11am, goto registration, be up at PACU at 11:30 am, have orion checked by nurses and doctors, then go to the cath lab at 1pm. This will be o's 4th cath in his 15 month career as a heart patient.

So we find out tomorrow: Will the doctors be bamboozled by the curving atrial septal wall that is actually o's normal anatomy (similar to his dad's strange EKG's that go off the charts and makes nurses reach for the defibrillators)? Will o need another surgery, if so how long will we have until the next surgery? How are all of o's repairs holding up. Will o become less special? How many cups of free starbucks coffee will tawny and bo drink in surgical waiting area? 

find out tomorrow on the next episode of o's heart. (tomorrow, we promise=)


Diana Shieh said...

wow, that was hard to follow. lots of acronyms. but i got through it, after clicking your links for medical-term-dummies, and the bottom line is - i hope orion won't need another surgery right now! he is just getting back to normalcy and he needs more time playing with his toys in the comfort of his own home! it breaks my heart to see him constantly on a tight rope but thank God he has two strong, devoted parents looking out for every little detail. your little family holds a special place in my heart and i will be praying for the best! cant wait to see you all soon.

Kenny said...

Keep us updated guys ... You're always in my thoughts!