Friday, May 21, 2010

And now we play the waiting game

"Aw, the waiting game sucks, let's play Hungry Hungry Hippos!"
~ Homer Simpson

So Thursday's appointment with the pediatric cardiologist from DuPont was fine. E did NOT have a 40 minute screamfest when they removed the EKG stickers this time, so in that way alone it was way better than the first appointment. Oh yeah, and no other nasty surprises. Aside from a poopy diaper.

We found out no more than we were told to expect: E needs to have the PDA closed. Her doctor does not want to let it grow shut on its own, as it is very large and causing her heart more than a few problems. He also doesn't want to wait longer to make sure she's old enough for one closure procedure over another. He wants it done within a month or so.

He is going to take the echo cardiogram pictures of her heart that he got two weeks ago compare them to the ones he got yesterday, and discuss her options with a team from DuPont. The team includes both a catheter specialist and a pediatric cardio-surgeon, because E has those two options for closure. Either perform a surgery that will snip the PDA closed forever, have her in the hospital 2 days or so, and leave a small scar under her arm, OR perform a catheter procedure that will send a small metal coil up through a blood vessel in her groin to her heart, closing off the PDA.

Ligation Surgery:

Catheter procedure:

Sounds crazy, but I'm pulling for the surgery option. Itty bitty preemies have this surgery and do beautifully. Yes, it's more invasive and yes, the recovery time is longer. But in my mind, it works better. I realize, of course, that I know nothing compared to these specialists. They are going to do whatever they want and I'm going to, of course, shut up and pray that it all works fine. But the surgery makes more sense to me. That's just the way my mind works. Metal in my kid's heart? Um... This is probably in the same realm of skewed reasoning as my distrust of airplanes. I know they're very safe overall, but in my mind it doesn't make sense that that giant hulk of steel can fly.
As far as closing this PDA, surgery would be an extra-permanent fix. Her doctor assured me that they wouldn't perform the catheter procedure if there was a chance that the metal coil wouldn't fit the PDA and would therefore dislodge and hang around in her heart, possibly clogging it and - OH MY LORD...yeah, see why I like the surgery better?

A quasi-third option is to go ahead with the beginning of the catheter procedure, taking pictures through the catheter, to find out in detail how the PDA looks. They would then proceed from their findings at that point: complete the implant procedure via catheter, or stop and do the ligation surgery.

So now we get to sit around and wait for them to look at the pictures, take measurements, and weigh the risks and benefits of each option. Yay. I looooove waiting.

I absolutely can't complain, though. She's in decent shape; She is eating better, and we need the medicine syringe less lately (made it to 20 oz. twice this week!!!). She is awake and active more, with actual naps, instead of her previous routine of being asleep most of the time with a few waking periods a day. She's a happy baby. If her doctor feels he can give the whole pediatric cardiology team the time they need to decide, clearly it's not a "Nurse! Get me a PDA ligation kit! Stat!" situation.

:-) Sorry, everything I know about medicine I learned from watching "Scrubs".

So now we wait to find out their answer. Cue the Jeopardy music.

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