Day 14 and still here!

I realized after submitting my post this morning that it has been 14 days since Alexander came to the hospital for his heart cath and 12 days since his Glenn. Where has the time gone? The days in the hospital tend to blur together. I really don't know what happend last week.

 Tomorrow will be day 15 and Alexander will be heading back to the cath lab. This morning Alexander had an echo cardiogram which confirmed - what we didn't want to hear- that he has an abnormal venous collateral vessel. This is occurs when a vessel in his body is created and it attaches a vein to an artery, creating an alternate circuit for his blood to flow through that bypasses his heart, thus causing his inability to stabilize his oxygen saturations. I have learned that collaterals are common and in fact, Alexander had a collateral during his first catherization. The doctors have informed us that they believe the collateral formed after Alexander had his Glenn procedure.

To fix a collateral, the doctors put a coil in it that will collect blood cells and clot up to keep the blood from flowing through that vessel. While they have him, they will also investigate the site of the Glenn procedure, as they believe that scar tissue may be creating a restriction within one of the pulmonary pathways to a lung. This could result in decreased blood flow to that lung, which will in turn decrease his oxygen levels and cause one lung to under-develop, if left untreated. If they feel intervention is necessary, they will consult with Alexander's surgical team about possible treatment options.

Depending upon the severity of the restriction, they may treat it with angioplasty (inflating a balloon within the artery to stretch the vessel walls) or they may install in stent (a small metallic wire cage that supports the artery) if the angioplasty fails to open the artery sufficiently. These are both shown in the figure (click on it to enlarge), though Alexander would have scar tissue, not plaque. If treatment is required, we hope that there is no need for the stent, since it would have to be replaced or maintained as Alexander grows - meaning future trips to the Cath Lab! Additionally, since the intervention would be done at the site of the Glenn sutures, they may decided to hold off and ask us to come back after he has healed some more - which would mean at least one more procedure at some time in the near future! This would be done if they feared that expanding the vessel now could rupture the suture work that is holding in place the work done during his Glenn operation.

It has been a rollercoaster of emotions for me! I am not ready to to hand him over to the doctors especially since he has become his happy self again. During one of my crying moments, I looked at Alexander and told myself that I needed to stop and be strong for him. When I began making silly faces at him, he gave me a huge smile and began to laugh!! It was just what this momma needed.

There is a chance we may have to go back to CTICU because of  how Alexander reacts after surgery.  I'm praying tomorrow is uneventful and Alexander's pre-op assessment, his procedure, and his post operation all goes VERY smoothly! This momma isn't ready for it but I know it is what's best for him. Hopefully all goes well, that his recovery from it goes quick so that we can get out of here and show our Superman off!