Appointment with Dr. Baker-Smith

Dr. Baker-Smith is our assigned pediatric cardiologist and she is absolutely AMAZING.  She's very upbeat and caring as well as brilliant.  Adriana sees her once a week for routine checks.  Luckily, her office is in Westminister, MD and not in Baltimore.  Although it takes an hour and a half to get to her office, distance-wise it is actually closer (and more scenic) to us than Baltimore.  Also, it's nice not having to pay $7 for parking for every single appointment!

Today Adriana received an ultrasound of her heart, her oxygen saturation was checked, and she was weighed.  She is now 7 pounds, 11 ounces!  Her goal was to gain 15-30 grams a day, but she is actually averaging about 38 grams daily!  Her goal for eating is between 2.5-3 ounces every 2-3 hours:  She has been eating 3-5 ounces every 2 hours!  This is extremely important because the bigger Addy is when she goes in for surgery, the better.  It is very encouraging that she has developed such a "talent" for eating, because that will make for an easier recovery as well.  As for her saturations, they have dropped, but not by a significant amount.  Dr. Baker-Smith says that she will put Adriana on beta blockers next week if her oxygen level drops any more.  The medication will slow her heart rate, giving her ventricles more time to fill up with oxygen-rich blood to go out to the lungs.  This will buy time for her to grow and fatten up before having surgery.

Since Addy has been born, her heart has changed a great deal.  She still has two ventricular septal defects (VSDs or holes) as well as a hole between her atriums--hence the mixing of oxygen-rich and oxygen-poor blood.  She also still has double-outlet right ventricle, meaning her two valves are pulling from the one ventricle on the right (they should be pulling from opposite ventricles).  However, the concern before was that TOO MUCH blood was going to the lungs and not enough to the body.  Well, our special girl decided that she was going to form defenses inside her pulmonary artery to slow blood flow to her lungs.  Her cardiologist worries that she developed a little too much obstruction in that artery, unfortunately.  Because of the change in her physiology, this affects surgical options.  Surgical option #1 is closing one of the VSDs to make sure her two arteries pull from different ventricles and then doing some "patch work" in her pulmonary artery to allow more blood flow.  These are straight-forward procedures with great statistical outcomes.  Option #2 would be closing the aforementioned VSD, and installing a shunt in her pulmonary artery to allow more blood flow.  Like the other procedure, the installment of shunts is relatively common, and statistics are promising.  However, if Addy's heart requires a shunt, she will have to endure other surgeries down the road to install bigger shunts as she grows.  Obviously we would like to avoid that.  We hope that option #1 is viable, and it will be Adriana's only surgery.

The hole between her atrium will not affect her, and the second hole between her ventricles will most likely close on it's own.

I hope that I haven't confused anyone!  Basically, it's a "wait and see" situation, as before.  We cannot wait until we can put this all behind us and move on--we have no idea when that will be.  Surgery could be a few weeks or a few months from now.  Until then, we will be fattening her up... and she is not opposed to that ;)