Thursday, September 8, 2011

And The Results...

Sedated Echo - Failure
Echo - Success
Echo Results - Mixed Bag

What exactly do I mean by failure of the sedated echo?  Well let me back up a sec.  Olivia is more than aware of what's going on when we walk into the Hope Echo Lab now, to the point that she actually walked over to my purse at one point, fished out my car keys and started walking for the door waving bye bye to the registration desk.  She didn't look back to see if Brian, Nonna or I were following her, she just wanted out and was happy to snag Mommy's ride to get her pass to freedom.

Okay - sedated echo failure; as in after 6 sticks by three different nurses each trying twice to get a peripheral IV going the next move was to take Olivia up to the PICU and do the oral sedation but she had to be in a bed on monitors with a crash cart near by.  No, we aren't crazy, we really let each nurse try twice because they were getting veins on every attempt but apparently Liv is extra special and has all these valves in her veins pretty near the surface of her skin.  Think of the valves as a fork in the road and they didn't have enough length on the needle of the IV to get around it to deliver the meds in her.  It was awful, heart-wrenching and took five adults (Brian and myself included) to restrain her.  The nurses were besides themselves and they were some of the best in the hospital - I will have to agree with that as this morning out of the six sites, only one has a little bruising.  Not bad for a kiddo that's on an aspirin regimen.

As we were calling up to the PICU for the transfer, Liv passed out.  I mean just OUT COLD, so one of the cardiologists on hand decided to try his hand at doing the echo and going for the money shots while we had a little bit of reprieve.  I asked him to specifically focus on her LPA which has historically been small and needed to be reviewed for growth and then he focused on the Aorta and Mitral valve because that's just standard practice.  Let's start with the not great news - the darn LPA is measuring 5mm versus the RPA which is looking closer to 10mm.  Aorta has a little narrowing but all within normal ranges and everything else looks great.  While not our primary cardiologist, the doctor did feel that the LPA is going to require a cath to balloon it or place a stent to permanently widen "the road".  We knew this was going to likely be the case with Olivia Pre-Fontan but I still didn't like hearing it even though it's what I built into everyone else's expectations.  The docs are going to get together next Wednesday, review findings and probably get us on the schedule within the next six weeks to go in and get 'er done.

On the plus side, the no sedation meant Liv wasn't foggy after the echo, could eat immediately and wasn't nauseated for the rest of the day.  Also good news from the echo was that they're probably going to push the Fontan back from her 2nd birthday even out a little further in the future.  Don't know when, I'm sure we'll get a better idea after the cath.  So that's it in a nutshell, I'll update more when I have more info from the staff once they have their meeting to review the data.  As for Olivia - she's doing really well actually, by the time she was on her stroller on the way out she was smiling and waving eating her Cheese-Its and drinking milk from her sippy.

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