Friday, October 3, 2008

Cardiologist and Perinatologist Appointment Outcomes




We FINALLY made it to the day of our fetal cardiologist and second perinatologist appointments!!


We LOVE our cardiologist. He was so very personable and very upfront, but supportive! He and his nurse performed a fetal echocardogram, which is just an ultrasound that looks specifically at the babies heart. They were able to give us more detail into our condition. Sam has a Hypoplastic Tricuspid Valve (smaller than normal valve) which has cause the under development of both the associated right ventricle (hence the Hypoplastic Right Heart Syndrome) and the associated Pulmonary Artery. Although we HAVE a Tricuspid, a right ventricle, and a Pulmonary Artery (which some babies with this condition do NOT have), we still don't have enough there to function at a capacity which will support life without surgical intervention. As expected, we will undergo three open heart procedures before the age of 2. The first, a Blalock-Taussig Shunt (BT shunt) will occur immediately after birth, as soon as a bed is available in the Sibley Heart Center at the Children's Hospital of Georgia. The doctor also found a Ventricular Septal Defect, which is a hole between the right and left ventricles. There is a chance that this will close on its own, but regardless, the combination of our other conditions and related surgeries make it negligible that there is a hole in the heart (so it is a condition that we don't have to worry about).


The best news to us was that we apparently won't have to DELIVER in Atlanta. We will be able to deliver here in Macon (it will still be an early induction) and when a bed becomes available at the Sibley Heart Center in Atlanta, they will transport us up there (which will happen within a few days of birth). According to our cardiologist we will have been delivered, transported, had the BT Shunt surgery, and be back home in Macon with baby in hand all within two weeks of birth. SUCH good news. Of course, he did have to tell us that there is no guarantee...but this would be a best case scenario to pray for!


After that appointment, we headed over to our perinatologist (who we already know is a jerk based on our first encounter). His tech did a full ultrasound, again looking for any anatomical abnormalities. She told us we wouldn't see the perinatologist unless she saw a major problem. That kind of made me mad....I had questions for him....if I can show up for an appointment for him, I kind of expect him to show up for an appointment with me. Oh well. ANYWAY, she didn't SAY she saw any problems, but it appeared there may be a slight issue with the tubes that lead from the kidney to the bladder (the left tube was markedly smaller than the right). She made a note of the issue on her computer, but failed to include us in on the problem. We can only assume that if it is a big deal, they will call us. Jerks.


She did provide us with a few fun facts. For instance, I have a big baby in me. At our gestational age (28 weeks and 6 days) he should be close to 2.5lbs. He is, however, 3.2 lbs. Also, all of the measurements she took averaged out to an expected due date of December 13......7 days before our original expected due date of Dec 20. Chris was over 9 lbs when he was born on his due date...dear lord I hope we are not headed for that.


So where do we stand now? Well, we still have the same heart defect with a little added bonus defect. We will induce in Macon, transfer to Children's Hospital of Atlanta, have the first of three heart surgeries (BT Shunt), and hopefully be home for Christmas (assuming we induce early and it only takes two weeks to complete the surgery). We have a follow up fetal echocardiogram with our cardiologist on Nov 7, and a follow up ultrasound with our perinatologists on Nov 10. Hopefully I can start getting a better grasp on induction date approximation at my next OB visit on Wednesday. All in all, there's no bad news so we will accept that happily.


The photos are from the perinatologist visit. She turned on the 3-D view for us to see the face. The chin and neck look like one big unit, but we like the first one where the baby seems to be smiling. He wouldn't move his hand out of the way of his face so we didn't get a super great view. The third photo, however, seems to look like Chris. Actually I think it looks a lot like Chris's sisters son (Ben). Enjoy! And thanks for all of the prayers and support....I don't have a clue how anyone could survive without the kind of love and help we have received from our friends and family!


~Kathy

1 comment:

Unknown said...

Kimberly and I are still praying. I am so glad he is growing alright. I am glad that you are relieved about the delivery site and the procedure of transporting to Atlanta.

With that said, don't let them make you feel bad for wanting to see your doctor face-to-face. There may not be many doctors of that specialty which might lead them to such behavior, but you have every right to see them and have questions answered.