4 weeks to go!

It's amazing how quickly time flies by...4 weeks from today is the big day.  Had another "weight check" ultrasound today and our big guy is estimated to be about 5 lbs 10 oz (putting him around 7 lb 10oz by 2/21)!!  He had no edema (no sign of heart failure) and overall all the measurements looked good.

As an aside, always interesting to be in medical training and get the experience of what I feel like are the most awkward encounters with other medical trainees...there was a resident helping with Addy's csection and long after my OB left the room, the resident was there sewing me up instead of throwing in some staples and being done with it (at my OB's request).  Sutures are much better so of course I told her thank you but got a pretty snappy "your welcome" -- sucks to be the loser I guess but then it's weird when she comes and checks your incision every day.  This time around I have been seeing a lot of perinatology fellows - some are really good and you can tell this easily because they truly appreciate how fantastic most ultrasound techs are at what they do and they ask them a lot of questions/rely on their opinion.  Not so much the guy today..."I'm having some difficulty getting good views of the heart."  Really?  Why not try the thing beating with the big echogenic thing bobbing around in it...  He could find the kidneys really well - I know because he pointed them out three times "this is just a really beautiful view of the kidneys".  If you say so buddy.  I told him about baby Newman's procedures in Boston (important that more perinatologists think of this valid option for possible treatment of hypoplastic left heart) and I explained that the stent was now lodged in the ventricle.  "Cool"  "I mean, it's so cool what they can do" (Good save doctor).  It was very nice of him to try and get a 3D pic of our little warrier's chubby cheeks but it was a fail.  I did see a cute hand though!

We couldn't be more thankful that the last couple months have been very peaceful and relatively uneventful aside from all the appointments.  Despite the awkward way today's perinatology fellow put it - a good reminder that though not "normal" our little guy's heart is amazingly woven, just as it was planned to be and it is pretty cool that there are people bright enough to come up with ways to "adjust" it a bit to make it work more effectively once he enters the world.  If he comes out crying, stays a little pink and we get to hold him before he goes to the NICU- that will be the most amazing thing of all!!! (and we will be praying for those couple minutes!!)

Ultrasound pics

Lots and lots of ultrasounds...baby Newman's profile and a face view - getting some chubby cheeks already!  The first non-stress test yesterday went well, apparently he is the only one not stressed - a blessing!!!

ECHO & Surgery Appt.

We met yesterday with part of baby Newman's care team.  Since his arrival date is 'tentatively' scheduled (assuming he doesn't have his own agenda) the cardiologist, cath lab, etc. should be ready for him.  We also met with one of the Mercy neonatologists, very helpful as now we know the general sequence of events for the morning...if all goes as we are hoping we will hear his first cry sometime shortly after 730 am, he will get whisked next door for his umbilical lines and prostaglandins and if he is stable we get to see him (and maybe even hold him!!) before he goes to the NICU. 

For the next few hours he will either get settled into the NICU or will go to the cath lab to get a bigger atrial septal defect (enlarging the one they made in Boston even more now that there is easier access to his heart).  Ross will be at his side as much as possible and I will be arguing with my 2 nurses that there is really no reason that I have to lay in a bed until I can move my legs when hospitals have wheelchairs (I could be wrong but pretty sure that's why someone came up with that idea, right?). 

The first big surgery is called the Norwood Procedure.  There are several varieties but at Mercy they do the classic Norwood (the newer procedures don't have any better data for them really).  It will likely be sometime between day 4 and 14, mostly depending on how stable he is and OR scheduling, etc.  In this surgery they enter the right atrium (top blue chamber) and use a piece of tissue graft to make a new aorta out of the old pulmonary artery (where the stitching is) so that it can be used to carry blood to the body.  Then they put in a temporary shunt (BT shunt) that will take some of the used blood from the body to the lung to get oxygen.  It returns the same way as normal through the pulmonary veins (in this picture the little red vessels).  Lastly they cut out any of the remaining atrial septum so the blood can freely move across from the red to the blue side so some of the blood that goes back to the body has oxygen from the lungs in it. 

When we asked about if they thought the stent could be retrieved at this time (it is now stuck in the bottom blue chamber)...the answer was "that will take some more thought" - good.  It is REALLY scary if people tell you they know exactly what to expect from something - you can't be confident what to expect from anything!!  After his heart surgery he will most likely go the the pediatric intensive care unit (with the bigger sick kids) as that is where they routinely do the post-surgical care.  He will have a ventilator, some chest tubes and a bunch of IVs at that point.  He will [obviously] still be adorable!! 

We also had a follow-up ECHO and though the blood flow in the pulmonary system looks like not quite as much blood is getting across the atrial septum hole as it was a month ago overall it still looks much better than it did at the beginning of November. 

We have 1 more ECHO the week before, and 1 more ultrasound to measure his weight.  In the meantime, I will be having twice weekly non-stress tests to make sure his heart rate is responding well to stress.  I am guessing he will do fine--Addy has been poking him for 8+ months and he usually kicks back :)