Thursday, May 3, 2012

Six Month Cardiology Check-Up: Looking Good

Next month marks the one year anniversary since Levi's open heart surgery to repair his aortic valve.  It's been six months since his last cardiology appointment, a record length between check-ups.

the sternal scar is hardly visible almost a year after surgery
Today's echo showed that Levi's heart remains fairly unchanged from his last appointment in Nov. 2011.  That's GREAT news!  His aortic stenosis is still in the mild range, based on a variety of readings that show it's either the same or just slightly elevated. His aortic insufficiency (leakage) is still only trivial.  Prior to surgery it was severe.  Levi's ascending aorta looks fine (not dilated like before surgery) and he doesn't show signs of excessive narrowing below the valve due to sub-aortic stenosis either.  According to the EKG, His left ventricle does show a little hypertrophy, or thickening.  Because of the aortic valve stenosis, his heart is working harder to pump blood out to the rest of his body, so the muscle thickens.  This is expected with aortic stenosis, but it's nothing to be concerned about at this point.  So all in all it was a great appointment!
The doctor said Levi can go a year between appointments, but she also said if we want one in six months for peace of mind, she's fine with that too.  I, of course, want one in six months just to be sure things are still okay, and James is leaning more toward a year, since "if the doctor's okay with a year, then so am I."  I get it, but we'll see how I'm feeling around the six-month mark.  ;)

Sedation today, as usual, was difficult.  Levi is a typical 22-month old toddler, who won't hold still for an echo or any other poking or prodding.  I hear about other kids being fine with just distractions like TV, bubbles, music, toys, etc, but Levi is a mover and a shaker with a strong will!  So we opt for oral sedation.  However, he has a really difficult time (a) keeping the medication down--it's nasty tasting, and (b) falling asleep with ease.  We arrived at 8 am, but it took over two hours to get him mellow enough for an echo.  He was groggy and on the verge of sleep for so long, but just fought it so much.  We've tried two types of  oral sedation in the past, and neither are very easy on Levi.  So our appointment from start to finish stretched almost 3.5 hours.  Phew!  It was a very long morning and I always leave cardio appointments with the biggest headaches.  But, it's all worth it to get accurate readings and know how Levi's heart is really doing.  The nurse said that around age three, echos become much easier and sedation is rarely used.  We're almost there!

the boys LOVE riding bikes
Developmentally, Levi is a very normal almost-two-year-old.  He loves playing outside with his brothers and zooms around on his little push car or in his foot-powered "cozy coupe".  He likes dogs, trucks, buses, and frozen peas.  He's also our escape artist when he's outside, so momma has to keep a very close eye on him!  My mom suggested fastening a bell to him or making him wear squeaky shoes.  I'm really thinking about it!

The only area where he's behind is expressive language.  He'll be two years old on June 18 and he's not talking yet and doesn't make very many vowel or consonant sounds.  He'll say "mama" and "u" for "up" when asked to, but not much else.  He understands everything though, so that's a good sign.  He's enrolled in Early Intervention and has a teacher who comes out to our house to work with him twice a month.  We're not sure if this is just a typical language delay or if it is caused in part by trauma the first year of life, i.e. heart surgery and a cath procedure.  So we continue to support Levi in this area and hopefully he'll start talking soon.

What a relief to have today's cardiology appointment behind us.  We were anxious and nervous about what we might find out and I couldn't help but play the different scenarios through my head.  What if things have worsened?  What if he's facing heart surgery again? What if...?  What if...?  So if you just heard a big sigh of relief, it was probably coming from our house.  We are once again given the gift of a good report and a good chunk of time before the next check-up.  For now we can get on with living a life of normalcy around here.
"For I know the plans I have for you," declares the Lord, "plans to prosper you and not harm you, plans to give you hope and a future."    Jeremiah 29:11
                                                               
Jacob and Noah out for a bike ride with daddy

I turned on a yoga video and the kids took over!