All in all, it was a good day.
Backing up a few hours, we started out the morning with Ethan's cardiology check-up. Let's start with the good...
He behaved so well. I talked about this appointment until I was sick of hearing my own voice, but I really think it helped! And, I'll tell you what; by the time we walked into Dr. I's office today, Ethan knew who would be putting stickers where and how many there would be. Too bad Dr. I's nurse was out, and he didn't need a 12-lead EKG after all. Oh well. I guess we'll just be super-prepared for next time.
The blood pressure cuff was the only thing that caused a complete meltdown, although they were able to get a reading this time. Albeit, high, but a reading nonetheless. I couldn't believe it as Ethan held out his index finger for the PulseOx, and sat perfectly still while Dr. I interrogated his pacemaker. It was an answer to prayer, for sure, and even more proof that my baby is really growing up!
Ethan's growth was also a topic of good news today. He has gained two pounds and grown an inch and a half in three months! Dr. I has always been in our corner with giving Ethan time to settle on his own curve, and I think he felt good about looking at his growth chart this morning and saying, "I knew it."
Fun fact about the gown Ethan is wearing: this is the hospital gown I wore on the day my sister was born. It's 25 years old!!
Ethan's heart function looks great, as well. This could have been questionable, given the not-so-good news we received, but his heart is squeezing nicely and that's always a plus!
The conduit, however, did not earn good marks. It appears that we have entered into "go-time", as the pressure gradient across the conduit, at the insertion point, measured a whopping 116 mmHg. This is not good; not good at all. (Remember, less than 20 is normal/ideal.) Dr. I is going to present Ethan's case to the Peds Cardiac Surgical Conference in a couple of weeks and come up with a plan.
This plan could involve sending Ethan back to the cath lab to see if the high pressure is caused by an obstruction in the conduit that can be ballooned open. The more likely scenario is that surgery will be needed to replace the conduit altogether. If that is the case, everyone will agree that it should be done before the fall (AKA cold and flu season), so he could be going back into the operating room sometime this summer.
We left the appointment kind of like you leave the car dealership. Three months, or three thousand miles ... whichever comes first. In our case, we'll go back to see Dr. I in mid-July, or we'll have a plan for surgery before then.
Oh, and Ethan's also hooked up to a Holter monitor for 24 hours. During the pacemaker interrogation, Dr. I noticed that his atria seemed to be functioning in some sort of atrial arrhythmia. It seemed innocent enough, but he wanted to monitor Ethan for 24 hours just to make sure. If Ethan's top chambers are entering into some sort of irregular beat, he's not showing any evidence of it, which is encouraging. I'm hoping the results will even be read-able. Trying to keep six leads, and a bulky monitor, strapped to a two-year old is not easy!
I'm feeling pretty good about everything. We know that Ethan will require multiple conduit replacements and, while we would like to have a little more time between surgeries, there's not much we can do about that.
I was reminded today of one of God's many names, El Roi, the one who sees (Genesis 16:13). How comforting to know that He watches over us, knows the numbers of hairs on our heads, and leads us through the deserts of life. I will choose to rest in this as we await "the plan" ... the plan He already knows, after all.
"From heaven, the Lord looks down and sees all mankind; from His dwelling place He watches all who live on the Earth - He who forms the hearts of all, who considers everything they do."