Wednesday, April 1, 2009

The renegade blood vessle.

Luna is supposed to go in for her cardiac catheter this week. I say supposed to, because as of this writing she has a pretty nasty cold and cough. Adults who have any type of catheter (angioplasty is a similar procedure) are awake for the procedure. In fact, I just had a conversation over the weekend with the husband of a good friend of mine. He underwent an exploratory cardiac catheter in his early 20's-and was awake for the procedure. I was relieved when he told me he didn't feel a thing. Strange, to think that a tiny probe with an equally tiny balloon and camera is inserted into the femoral artery (the one located at the pelvis), then snaked-up through one's veins, and in Luna's case, through her heart, yet, no sensation of pain or otherwise is felt. Amazing.

But since Luna is just 13 months, and we can hardly expect her to lay still for the hour-plus-long procedure, she will be fully anesthestisized. And of course because of the precarious-and still largely unknown-state of the body during anesthesia, she has to go in to this procedure totally healthy. Later today I'll call the doctor to see what they say about her cough.

You might be wondering why Luna is having a cardiac catheter, and really the story is quite fascinating. For the past several months, her doctors have been trying to get a good look at things Post-Glenn. Because of the nature of her anatomy-that of course being the dextrocardia, and the fact that even for a dextro kid her anatomy is still unusual (her heart is not only located on the right side of her body, and flipped mirror-image, but also sits on a different plane than most people with dextrocardia), the doctors require all the tools they can gather so they may translate what they are seeing (in one case this resulted in a 3-D imagery taken during her last sedated which Anthem declared they wouldn't contribe to the $616 procedure because it was 'too specialized' and 'not in their contract').

The 3-D imagery did produce the pictures that provided some important clues about what Luna's team thought they were seeing. It was something that I had never heard of, something I certainly never considered could ever happen. A blood vessel had sprouted off Luna's aorta.

It's thought that some time before Luna went in for her Glenn Operation, when her sats would have been at their lowest, her body decided it was going to do what it needed to get more oxygen to her lungs. If you imagine the aorta looking like a candy cane-oh, and if you need a quick refresher: the aorta is the biggest artery in the body, it carries oxygenated blood to the heart, lungs and rest of the body. Well, Luna's sprouted a small blood vessel. Basically, imagine a small stream of oxygenated blood that shoots off her candy cane and connects directly to her lungs. As Luna's card explained this to me, I felt that familiar sinking feeling. "Is this a good thing or a bad thing?" I needed to quickly reduce the news to either good or bad. It turns out that though in a way it's good, because it shows just how incredibly resilient Miss Luna's body is; her doctors don't want her sprouting all kinds of blood vessels so when she goes in for her cath, this will be cauterized.

This also explains why her sats have been hovering in the low 90's. I expressed to Luna's cardiologist how about 2 months ago I heard Luna gasping and choking in her crib. She had a cold, and was struggling to sleep with a stuffed nose and no way to relieve herself. I brought her into our bed-fully expecting that his may be the first time we have to bring Luna to the ER-because, well she just seemed like a sick kid. After a lot of protesting-aka full-out screaming-I got the oximeter strapped to her tiny finger. The results were astounding. Her sats were ranging from 88-90. I couldn't believe what I saw, so I then tested myself and got the routine 98, 99 and 100. Luna was congested, yet her sats were high. I put her back in her crib, where she slept like, well a baby, and called her card in the morning to relay the incredible story.

That had confirmed it-there was no question that her aorta had sprouted a blood vessel which is why her sats are very. close. to. normal.

So, bearing Luna recovers by this coming Wednesday, she will go in to Children's Hospital Boston for the cardiac cath. The cath will serve three purposes: cauterize the errant blood vessel, enlarge her pesky left pulmonary artery, and provide a detailed map of what is going on inside Luna's veins and heart.

The procedure requires a night stay at the hospital, and providing all goes to plan we'll be home Thursday afternoon. Until then...


Anonymous said...

All our thoughts & good energy will be with you & Luna for this next hurdle. Lots of love...go LUNA RUTH!!
Amy & Charlie

Drea said...

Good luck...
My son is also going for a cath ( monday the 20 ). I hope all goes well for Luna....
can i post her on my heart friends page???( actually my son list...)