Friday, July 29, 2011

Cardiology Followup

Kimble has been seeing his Cardiologist since he was a fetus.  These visits have gone from every 10 days or so, to every two weeks, to once a month, and now, we are at every three months.   At these appointments, an echocardiogram is done on Kimble's heart. This is a detailed ultrasound, which measures the size of Kimble's chambers, ventricles, valves and arteries.  They can see the wave points which measure the velocity of the pumping blood, how much blood is going through the valves, and all the other important stuff that doctors measure.  The important thing to remember, is that at every visit, the same things are measured, and then they are compared with the previous measurements.  Thus, we know how Kimble is progressing.

Since the last visit, we have seen progress.  Kimble previously had some narrowing where the Superior Vena Cava was redirected and attached to the pulmonary valve, which allows for half of Kimble's bloodflow to go straight to the heart, bypassing the lungs.  This narrowing, or blockage, was minimal, but it was something to keep an eye on. As we previously witnessed, a severe blockage could happen at any moment, and could be fatal (This happened after Kimble's second heart surgery, when he was just a few weeks old, and he almost didn't survive.).

So the good news is, there doesn't seem to be any more narrowing at that site.  Horray!  More good news:  Kimble's oxygen saturation measured at 99 percent!  Seeing as how he spent the first seven months of his life at about 75 percent saturation, we are happy.  If Kimble's energy levels are anything to go by, he is excelling. Top of the class!  Good boy Kimble!!  He is also a robust 25 pounds.  Not "bird-like" at all, which is how many cardiac babies are.  All good signs that he is thriving.

Some things to keep in mind:  Kimble's future surgical needs are still somewhat of a mystery.  I've always been told, since pregnancy, that Kimble is "unique in his cardiological defects".  Because of that, there isn't a lot of cases to compare him with, thus giving us an idea of what the future holds.  Basically, at this point, we see three options for Kimble.

1.  We can continue on with the third stage surgery (which would happen when he is three), which is to re-route the other half of his bloodflow, to go directly to the lungs, and thus only half his heart would be functioning, completely bypassing the right side of the heart, which is where his three defects are.  This was initially in the plan for Kimble, and still could be.  We don't know.

2.  We could reverse what was rerouted in his previous surgery, thus giving Kimble a fully functioning four-chamber heart.  However, would Kimble's heart be able to handle the workload of pumping his entire body's worth of blood, especially with the valve defects, and how small his right ventricle is?  At this point, it's not capable.  Possibly in the future, if his heart grows enough.  This is an idea to nibble on, but not quite ready to be tested yet.

3. We could leave Kimble as he is.  Currently, he has a one-and-a-half ventricle repair.  This is a unique situation to remain at.  For almost all of the world's population of those with cardiac defects, only a few go through life as Kimble is, with a one-and-a-half ventricle repair.  Our doctor told us that possibly five or six people, in the world, have what Kimble has.  So whenever we hear from our doctor, "Well, Kimble is unique, and therefore I can't really answer that question yet..." it really is true.  We just don't know what Kimble will need, in terms of surgery.

So once again, we are left with the "watch and wait" answer, and that is just fine.  If Kimble's abilities are anything to go by, he is, based on his doctor's words, "Doing Awesome!"  The plan for now, is to wait until Kimble turns 3, and then go have some specific tests done, namely an MRI and a 3D echo, both done under sedation, and possibly some Cath Lab procedures, to test pressures and velocity, and at that point, they'll know more what we should do.  Until then,we get to enjoy our little Mr. Kimble as he grows and explores the world around him.

Next cardiology visit is right after he turns 2, just over three months from now! Craziness!


Colleen said...

I love the good news and the confirmation that Kimble is a strong miracle boy! And your patience in all these things is inspiring. JOY!

linda said...

Great update. Way to go Kimble

Jennifer Magreevy said...

Thanks for the detailed explanation of an echocardiogram! My son has one scheduled for Wednesday. His genetic condition includes a large majority (70%) of people with heart defects...but he's almost three and hasn't ever had anything diagnosed. So we're doing an echocardiogram just to check. Prayers would be lovely...I really pray his heart is fine! Glad Kimble is doing so well!!!