Cardiology Update

Today’s medical update comes in two parts.

First, we had a hip ultrasound to rule out hip dysplasia. This was requested by our pediatrician because of the Torticollis. The preliminary results look good, but we’ll wait to hear what our pediatrician has to say. Sheila, the sonographer, was great—she had the room warmed so that Charlotte wouldn’t get chilled during the exam. We had to dress/undress the baby 3 times because the Radiologist kept sending Sheila back for a more precise view. Charlotte was a trooper—aside from peeing on the exam table, she was the perfect patient. I wish I’d had the camera so that I could memorialize my view: I was holding her head to keep her lying on her side. From there I say her tiny tushy with Sheila’s gloved hand wielding the US wand. Too cute.

Next, Cardiology.
The fun part—during her 20 minute echocardiogram, Charlotte watched the screen (looking up over her left shoulder) and smiled and giggled. She didn’t cry at all and was absolutely adorable.

The not so fun part: The doctor is seeing above normal pressure in the right (pulmonary) ventricle. This may be due to a) pulmonary hyper tension or b) a minor obstruction in the pulmonary artery. Unfortunately, while the echocardiogram gives a lot of information, it cannot differentiate between these two causes.

So…we’ll be adding a new doctor to Team Charlotte: Dr. Steven Pophal. Dr. Pophal will perform a diagnostic cardiac catheter procedure that will allow the doctors to look at the arteries with a teeny-tiny camera and measure all of the pressures directly (which US cannot do). If he sees an obstruction, he may try to open it with a balloon procedure, if he deems it safe. (Charlotte is too little for a stent, so that’s the only procedural option.) If there is no obstruction and the problem is deemed, by direct measurement, as pulmonary hypertension, Charlotte may go back on oxygen.

This procedure will occur under anesthesia and Charlotte may or may not be intubated. In all likelihood she will be admitted to PICU overnight. (For our PICU RN friends who are getting ready to speed dial to get on Charlotte’s schedule, we don’t have a date yet :) )

We know this is the best thing for Charlotte. And we’re not surprised that this diagnostic tool is necessary—our surgeons considered it back in June. But, I, for one, am a bit saddened by it. It feels like a step backwards or a bump in the road. We’ve settled into a lovely routine and going back on oxygen would be a drag. As a result, I find myself hoping that Dr. Pophal needs to open a minor obstruction. I have a feeling that this wouldn’t be the better option for Charlotte and I’m a bit guilty that I’m hoping for an outcome based on convenience. I’ll try not dwell on that. Bottom line: whatever the outcome, it sounds like she’ll have to outgrow the cause and in the interim, her doctors will take good care of her.

Timing of the procedure: sometime within the next month. We’ll know next week.

p.s. Babies are like puppies--whenever we walk around with Charlotte, we meet people. Recently I met a mother of a 5 month old. The mother is also a cardiac nurse at Rush. She mentioned to me that if we would ever need a "cardiac interventionist," one of her favorite colleauges had just left Rush for Children's. His name? Dr. Pophal. So the word on the street, literally, is that he's good and he's good with parents.