Friday, January 14, 2011

Teetering Toward Normalcy


Yesterday we had another Cardiology appointment for Kimble.  He is now being seen every 2-3 months, which seems staggering to me.  Last year, at this time, we had appointments every few days, between his local Cardiologist, our Denver Cardiologist, and his Pediatrician.  I love that Kimble is doing so well now.

At (almost) every cardiology visit, we have an echocardiogram done (detailed ultrasound of the heart).  After his doctor analyzes everything, and compares it with the prior visit, he comes in the exam room and we talk about what he sees.  Normally, his "cautiously optimistic" outlook, pertaining to Kimble, doesn't allow for high hopes.  Rather, it is something like "Well, Kimble is so unique in his defects, that we really can't plan or estimate what his future holds.  We just need to keep watching him and wait and see what his heart is going to do."  However, yesterday's visit was a bit different, and changed the baseline "cautiously optimistic" to "surprisingly optimistic".

The ultrasound showed that Kimble's heart has grown!  His right ventricle, which is the pumping chamber that pumps blood to the lungs, has made major improvements on the growth chart, and now qualifies in the range of NORMAL.  This is astounding.  Although he is still undoubtedly on the (very) small side of "normal", he is within range.

Half of Kimble's bloodflow is still flowing through that right ventricle (with the other half redirected to the lungs via his last heart surgery in June) and all of that bloodflow has helped the muscle grow and get stronger, without the pressure of pumping an entire body's worth of blood.

The other two defects that Kimble has, relate to that right ventricle.  The valve going into it (tricuspid valve) is very small and defective, and the valve where the blood exits the right ventricle (pulmonary valve) was ballooned through when he was a week old, and although it isn't a "valve" by definition, is accomodating enough for the cycle of bloodflow.

More good news, is that the tricuspid valve is allowing enough bloodflow through to the right ventricle, to define it (meaning the bloodflow) as Normal.  Amazing.  All of this was shocking news, especially since two months ago, we were drowning in adjetives like "underdeveloped, small, dysfunctional, not-usable, defective, and restrictive".

There was another finding, however, which can be good, or bad.  It was discovered that there is some narrowing where the superior vena cava (the main blood vessel which carries blood from the top half of the body, back to the heart to get oxygenated) was redirected and attached to the arteries going to the lungs.  This means that less bloodflow is able to get through that area.  A clot could develop, or more narrowing could occur, and this would need to be adjusted or repaired via surgery, or in the cath lab.

Just like when you have a bad cold, and your nasal passages get swollen, making it hard to breathe....the same thing is happening in that area where the bloodflow was redirected.  Restricted bloodflow is not good.

Right now, it's small enough that we don't have to worry.  We'll continue to watch it for signs of growth.  Currently, because Kimble's heart has grown and is adapting, that means that plenty of bloodflow is actually going through his right ventricle, and because it is within normal limits, he is in no danger.  He has, in essence, a "safety" that is his heart, even if the superior vena cava gets more restricted, because of the better-than-expected amount of bloodflow that is being pumped by his right ventricle.  Hope that all makes sense.

Now, for the best and most unexpected news.  I had said that the narrowing could be "good news".  What I mean by that, is that if they find that they have to go back into surgery to have it repaired or adjusted, they would ask themselves "what is it that we are really trying to do here?"   The goal, of any heart patient, is to have a fully functioning four chamber heart.  If they find that Kimble's newly aquired status of "within normal limits" actually allows for his heart to be able to handle the workload that it should, then there is a chance that they could reverse The Glenn procedure (which was his last surgery) and actually re-route the bloodflow  BACK to his heart, and then his heart would function the same way yours and mine does.  Now, it would still have it's defects, but if it is still able to manage a healthy amount of bloodflow for his body's demands, then it would be alright.

Of course, this is just and idea to nibble on, all the while hoping that his heart continues to grow and is able to meet the demands of Kimble's more active lifestyle, as he progresses developmentally.  Our next appointment is in three months.  I'm excited to see what develops!

14 comments:

purejoy said...

that's super encouraging and it's interesting how quickly one becomes an "expert" in certain situations. i'm sure you'd rather be naive and clueless about such matters, but your understanding is so important as you are Kimble's biggest advocates.
thankful for favorable news and knowing that God has all of this safe and secure in His capable hands is a sweet balm.
congrats on a great visit and hope there's more good news in 3 months!

Colleen said...

Wow, so much good news, so many amazing developments! Kimble's story is like watching miracle after miracle occur.

Enjoying Life One day @ a Time! said...

Thank God! So happy for Kimble and your family. I will pray for Kimble, I know things are just going to keep getting better.

Shannon said...

That is a great news! What a miracle baby he is!

runningfan said...

Wow...congrats! Great news!

kdaygirl said...

Yea for Kimble! He is a special little guy and he is here for a reason. Hope it only gets better from here!

Jen Sue Wild said...

Prayers and blessings answered for sure!! I love when we can see the fullfillment of Heavenly Fathers promises even when they don't seem posible.
Love you guys.

COKE FAMILY said...

I'm so glad Kimble is doing so good. He even looks like he is giving a thumbs up in the picture. He is such a beautiful miracle!

Julie said...

What fantastic news! I can still vividly picture the setting when our cardiologist told me that Adam's heart is now "functionally normal." I actually teared up with joy.

We have our next visit in a few weeks. I hope the news is as good as yours, and I hope you continue to get good news along the way!

Ande said...

I am glad to hear that he is doing so well. He is such a cutie!! A friend of mine just told us last night that they think there is something wrong with her babies heart and I thought of you. They are doing another ultrasound this week on her to find out for sure, I think that I will refer her to your blog. :) Love ya tons!!! I really hope that I get to come to the girls weekend.

Nanci said...

I am so glad to hear all your good news and it's amazing how things can change in a year. What a blessing you have with that little one.

Adri said...

Wow! What news! The miracle man is in action!

Jed and Kera said...

posts like this are the BEST to read! I'm so happy for Kimble and all of your family! We'll keep him in our prayers!

SarahB said...

I'm late in responding, but I'm just catching up and am so happy to read Kimble is doing so well! What wonderful news!