Heart Cath Recap

Finally getting the chance to update everyone about Eli's heart cath!  Normally we can get a wifi connection at the hospital, but for some reason we couldn't this time so I didn't update while we were in Indy.  Once we were home it was just non-stop business!

We left Washington at 4:15am Wednesday morning.  I had only slept an hour the night before so I slept while Eli slept and Bryan drove.

We had to check in by 7 and made it in plenty of time.  We were worried that Eli would be very fussy because he couldn't have anything to eat or drink after 2am but he did really well.  He got a little peach hospital gown and cute little socks that he kept pulling off and putting on his teddy bear.  They had some toys on the bed for him while they did his vital signs and we went through his history and paperwork.  He loved the Sesame Street doctor's bag (Cookie Monster stethoscope, Elmo thermometer, etc).  When he got restless we put him in a Peyton Manning Children's Hospital car and pushed him around the hallways.  He wasn't cute at all!

Right before they transported him to the heart cath area he was given a dose of Versed.  Maybe I shouldn't laugh at my baby being drugged up, but it was so darn funny.  He was sitting up playing just fine and then he'd just slump off to the side.  Then he'd let out the goofiest laugh as his eyes were closing.  Then he was fine for a couple minutes before it started again.  We were both laughing at him and he obviously felt pretty good.  The following is a few pictures showing the progressive effects of the medicine:

Just before the medicine was given

About two minutes after the medicine and right as he was falling over the first time.

He just fell forward a second time after laughing at himself for falling the first time.

"whaaat's uuupppp?"

"Mommy, this is kinda weird."

"I can't keep my eyes open!"

By the time we were wheeled into the cath lab he was waving at everyone.  He yelled hi to the nurses who were waiting for him and they all just melted.  Eli was taken into a room and Bryan and I were escorted to the waiting area.  We were given regular updates by the staff and a little over two hours later Dr. Parikh came in to talk to us.

It's been almost a year since Eli's hemi-Fontan and this is the time frame Dr. Parikh likes to do the cath to make sure the arteries haven't narrowed or grown incorrectly.  The next surgery (Fontan completion) isn't for a few months yet so there's time to correct those things if necessary by placing stents or coils.  Dr. Parikh was very pleased with what he saw during Eli's cath.  He said things are growing as they should, the arteries look great and there's no need to do anything at this point.  He said he feels very comfortable saying Eli's Fontan completion can be tentatively set for spring/summer 2013.  What a relief!!!

We were taken to another waiting area and about 20 minutes later we got to see him.  He was asleep on the gurney and his lips and nose were very blue/grey.  However his vital signs were good with his oxygen saturation being in the low to mid 80s (his normal).  As time passed he pinked up, but it was strange to see him that color for so long.  One thing we noticed was how big he was looking on the gurney compared to last time we saw him on one.  He really is growing.   I guess he still looks pretty little in the picture, but he's more than 3 times the size he was when we started this incredible journey!

After a cardiac cath, it's very important the patient keeps their legs as straight as possible for 4 hours in order to decrease bleeding at the insertion site.  Have you ever tried to keep a toddler still for four hours?  That's where more drugs come in handy.  Actually Eli didn't need much, he was pretty groggy from the anesthetic.  However, he did manage to pitch a huge fit on the way from the recovery unit to his room on the peds unit.  I was reclining on the gurney with him on my lap.  His feet were between my legs so I could hold him fairly straight.  He got mad and started lifting his head and legs at the same time and using his left hand to pull at the IV in his right hand.  Somehow the nurse managed to keep pushing while adding tape to his IV site.  After we got to the room it was at least an hour before he fell asleep.  He was in one of his favorite positions -- on Daddy's lap with a bottle in one hand and the other hand rubbing Daddy's chin.  Again, he is so stinkin' cute!

Tired baby after putting up a big fight.

Holding my little man and Happy on Wednesday evening.  Love this groggy little man!

He looks mean here, but he was very sweet and just wanted held a lot.  He's always been a first class snuggler.

As the day went on we just laid around and answered to his every need.  It was actually a very relaxing day.  Once I finally accepted the fact that the computer wasn't going to connect to their wi-fi, I watched tv and read when the two boys slept.  Later, my sister came and brought us Chick-Fil-A for supper.  No, we weren't supporting anything, boycotting anything, or taking any sides; we simply wanted chicken sandwiches and Coke (the hospital is a Pepsi facility, that's the main thing I would change about that place if I could!).  If our eating there offends anyone, please send your comments to Colonel Sanders.

They're both pretty goofy, but Eli's excuse is that he had been under anesthesia earlier in the day and Ashley's reason is that, well, she's Ashley.

Eli got to order from the hospital's kid menu and he actually ate pretty well.  It was obvious his throat hurt a little from being intubated during the cath, but he still managed to eat and drink well enough to have his IV fluids shut off before bedtime.  He and Ashley played with her phone for a while (that's why he loves his aunts, they all have cooler phones than us).  He fell asleep in my arms about 10pm and slept until 4:30am.  He drank more milk, watched some totally ridiculous cartoon I wouldn't normally allow at home and was back to sleep by 6.  I showered and went back to bed.  Dr. Parikh woke us when he came in at 8 to check him over.  He said we were definitely ready to go home and to follow up with Dr. Kumbar (Evansville cardiologist) in 3 months.  Eli was extremely upset to be woken up by anyone and just wanted to snuggle and sleep more. 

My snuggle bears!

We ordered breakfast for him and started packing.  By the time breakfast arrived, Eli was awake and acting more like himself.  We had even had a visit from two dogs touring the peds unit in a wheelchair.  They were very calm and cute.  Their names were Macey and Gracey and Eli enjoyed watching them.  Our nurse for the day was Cari and we've had her several times before.  She always remembers Eli because her son is only a month older.  Eli wasn't happy with her at first because she removed the tape from his IV and the tags for his heart monitor.  I know it hurt, but it's got to come off!  He was fine with her by the time we left and was giving his famous high fives and fist pumps.

Showing the "ip" (dip) for his breakfast pancakes

"These shoes are made for walkin' and that's just what they'll do.  One of these days, these shoes are gonna walk right out of this hospital room."  Okay it doesn't rhyme, but that's the song that was going through my head as I was dressing him to leave.

As you can tell from his expression, he's still not quite back to normal.  His eyes were very heavy all day.  Incidentally, I'm standing just outside of the frame of this photo, please DO NOT LEAVE YOUR LITTLE ONES STANDING ALONE ON A HOSPITAL BED NO MATTER HOW CUTE THE PICTURE IS!

After a quick visit to the hospital gift shop (I am addicted to PMCH t-shirts, they should pay me to advertise) we drove away.  We stopped at a party store to buy a few supplies for an upcoming birthday party for two little boys (a joint dinosaur/Elmo theme is in the works).  Then we headed HOME!!!!

Hugging his giraffe who travels with us to every procedure/hospitalization/surgery Eli has had.  Zachary gave it to Eli the night before his first surgery and I held it the whole time he was in the OR.  Since then it always goes with us and I hold it when he's having something done because it reminds me of both my little guys.

I was worried about Eli's first night at home but he did really well.  Once he finally decided he could go to bed he slept well.  During the day Friday he was really fussy, but played a lot too.  It was obvious he and Zachary had missed each other and their toys a lot.  At one point they had nearly every toy in the living room spread across the floor.

Zachary said, "Are you angry, Mommy?"  All I could do was laugh and tell them not to pick up until I took a picture.  They were having fun and being silly together, who could be mad?

If anyone is wondering more about the cath itself, it's a procedure used to view the vessels and structures of the heart from the inside with a tiny camera.  It's inserted into the groin and travels to the heart.  While there, the doctor can also take measurements, blood pressures within the vessels and chambers, check the velocity of blood flow and lots of other stuff I don't understand.  They started in Eli's right groin, but couldn't get as far as they wanted so they pulled out and used the left groin.  Because Eli's heart is special and his flow has been altered through surgery, the doctor wasn't able to access the upper portion of the heart by going through the groin.  This was explained to us prior to his cath.  After doing all he could through the groin, Dr. Parikh found a vessel in Eli's neck, just inside his collar bone.  He started on the left side, but was unable to access it sufficiently so he went to the right side.  In total, Eli had four dressings, one in each groin and one on each side of his neck.  That means a lot of bandaids to remove and a lot of sticky residue left on his skin.  He can't have a bath for a week so I had him in the shower with me tonight.  We've been using some adhesive remover from the hospital but he's tired of us messing with him.  So if you see him in the next couple weeks, this is fair warning that you may stick to him.

It's normal to have some bruising around the sites and Eli is no exception.  Dr. Parikh told us he didn't leave any of those bruises on him, it must've been the nurses who pulled the sheaths and held pressure.  That was said with a twinkle in his eye and a smirk on his face because he knows I'm a nurse.  Anyway, here's what Eli looked like about 36 hours post-cath:

The right side of his neck where they went in.  You can see his bruised jawline and neck.  It extends around to the front of his neck a little and the right side has a small amount of bruising as well.  

The right groin looks pretty good, but his left side is very bruised up.  It's darker and bigger today (Friday).  This photo is also good for showing his lack of hips.  He's almost 22 months old and wears 12 month pants.  The other day he was wearing a pair of 3-6 month shorts.  The boy has no butt.  We may inquire about butt implants next time he has to be put out for a procedure.

 I guess those look terrible, but frankly, it's the result of something that had to be done.  And we got good news from it.  The bruising looks a little darker today, but it hasn't spread any. 

Zachary spent Tuesday night with my mom.  He decided it was a sleepover and took his sleeping bag.  He slept on the bag on Mom's bed.  She really enjoyed having him spend the night; it was her birthday and she got to have a  Birthday Sleepover with the cutest blue-eyed four year old.  The two of them stayed busy during the day Wednesday and then he spent the night with Mamaw & Papaw Veale.  Thursday was spent hanging around with Aunt Kendra and eating lunch at Granny's.  He had fun and felt secure which is all that matters to me!

Thanks again for all the prayers and support.  We're so lucky to have so many people who care.