Tuesday, August 24, 2010

Successful Cardio Appointment

Sam had his regular 3 month cardiology appointment.  In case you have forgotten our history, Sam is a major doctor-phobe.  You could tell they were prepared for a fighting match.  The intake nurses closed the door behind us when we got into the EKG room, and talked over a game plan.  But Sam was surprisingly docile.  He still isnt a big fan of the stickers for the EKG, but he let them get all the readings they needed.  Pulse oxygen was at 83%, BP at 100, weight was 30lbs and heights was 36 inches (that's three feet tall people!). 

Sam even made friends with Dr. Cardis and his intern and kindly let them listen to his heart with little fuss.  Dr. Cardis ordered an echo which was unexpected on our part, but apparently it was time.  I totally thought Sam would nut up but he was near perfect for the echo nurse.  Dr. Cardis read the echo and said Sam looks great and very stable.  So stable that he wants to cut Sam back to once every 6 month visits after his second birthday.  YIKES...that feels like FOREVER between visits!

Let me take a moment and explain why Sam will be holding off on the Fontan as long as possible.  For one, his anatomy will allow us to do so.  Unlike many hypoplastic right hearts, Sam DOES have a pulmonary artery (even though it is small).  This assists in a small way with getting 'blue' blood from his lower body to his lungs (his anatomy is quite complex now...I'll save the drawings for another post).  But Dr. Cardis explained that in kids who don't have at least a minimally functioning pulmonary artery, the risk of developing small collateral vessels in the lungs rises, which leads to decreasing pulse ox rates and heart failure.  This puts the kids in for the Fontan earlier than with kids who have a pulmonary artery.

After the Fontan, the count down clock to transplant starts.  On top of that, there are consequences for other body organ systems due to the Fontan circulation.  If we can hold all of this off, we will.  Dr. Cardis told us we will go for the Fontan under 3 circumstance: 1)Sam goes into heart failure 2)Sam is unable to participate in regular daily activities due to poor oxygen levels 3)If we feel like we want Sam to participate in more advanced activities (like sports) in a greater capacity than he is currently able.   Well trust me, as much as I want Sam to experience sports, we will NOT be putting his life at risk just to do it.  Soooo, considering only circumstance 1) and 2) will lead us to surgery, Dr. Cardis thinks Sam could go YEARS before needing the Fontan...maybe up to age 10 or more.  He has told us this before, but he gave a great "Sam's Anatomy" review and I understand more clearly how we will accomplish this. 

All in all, a GREAT cardio visit.

Yesterday, a fellow heart mommy hosted a 'blog event' to help heart families link to each other.  Everyone was to share their "Heart Story" and post a link on her blog.  Our story is posted on Sam's Half a Heart page, and you can visit her web page (link below) to check out other families stories.

~Kathy

Every Heart Has a Story

3 comments:

Anonymous said...

Oh Sam..... we are so happy that you had such a wonderful cardio appointment today. As someone said at school today, you are most definitely the poster child of prayers answered. We love you and your very special little heart!
Hugs and kisses
Nana and Pop-Pop

Shannon said...

What GREAT news that Sam may be able to wait so many years for the Fontan! What a blessing! I'm so glad his appointment went well and that he was much more well behaved than you thought he would be. :)

Keep up the good work Sam!

Dawn Bent said...

this is wonderful!! you mentioned transplant..do the doctors think that will be necessary with Sam later on? not much of that has been talked about with Natalie..almost like it's not an option. It's weird.
So happy that little Sam is doing great!! =)