A Little Something Extra

Friday, May 9, 2008

AV Canal Details

Micah is sort of alert this morning. I walked in and his eyes were open (sort of rolling around a little, though). His blood pressure went up while I was there because he got rather "excited" to see me. I just wanted to scoop him up and make everything better. Oh, I hate not being able to hold him.

His pain meds are down. He's not as puffy today so his body is removing more of the excess fluid. More importantly, he's not on the pacemaker anymore and his heart rate is doing great (about 140 bpm). There's a possibility that they will try to take him off the ventilator later today. Please pray that he would be able to come off the ventilator the first try. That's one more step toward getting out of the PICU. After he's extubated (off the ventilator), the next step is to remove the chest tubes which are used to drain excess fluid from his chest. I'll try to update again later today after rounds. Oh, by the way, Santa is back today! :-)

AV Canal defined - Some of you have asked what was actually done in his surgery and why. Here's a brief summary in Jennie language (those who really know medical stuff will likely find this inadequate at best - Noel or Andy D, if I get something wrong, please comment). An atrioventricular canal defect (AV Canal) is basically where the inside of the heart does not completely form in utero. It's not as simple as your standard holes in the heart. He did have holes, both between the atria (ASD - atrial septal defect; the atria are the top parts of the heart) and the ventricles (VSD - ventricular septal defect; the ventricles are the bottom parts of the heart). But he also had a big hole in the center, meaning that rather than having two valves separating, top to bottom, the atria and ventricles, one on the left and one on the right, he had one big valve in the middle. This is referred to as a "complete AV canal defect." There was 100% mixing of good blood (oxygen-rich) and bad blood (oxygen-poor).

Micah's surgery was longer than initially planned because the middle part (creating two valves from one) was a bit messier than they appreciated on echocardiograms (ultrasounds of his heart before surgery). Dr. G spent a lot of time on the valves to minimize leakage and hopefully prevent future needs for surgical intervention.

Myanmar update - The news this morning said that the UN is halting aid to Myanmar because the Myanmar junta ("government" in a very loose description) has siezed everything coming in. Please consider sending aid to Asia Heartbeat since Bill is in the country and is able to distribute supplies to people who really need the food, etc.


Beth said...

Wow - poor little guy! We are praying that all goes well and he is able to come off the ventilator on the first try!!!

Happy Mother's Day, Jennie!

Melanie said...

I am so glad to hear he is taking positive steps in the right direction. We will all miss you tomorrow at the Mom and Pop Place. We can't wait to have you and your family joining us this summer!

Kate said...

While blog-hopping I came upon your blog. Just know that you have got prayers coming from Alabama. My first son was in the NICU for 2 1/2 weeks and I have known many other babies that have needed special care, so I can somewhat empathize. We will pray for you and your boys, doctors, nurses, and other caregivers.

Anonymous said...

I am thinking of Micah and praying that his extubation is smooth and completely uneventful. Poor peanut...and poor you too. My son has had 2 OHS and I don't think I have ever been through anything harder...a small price to pay for a fully functioning heart, but that doesn't change how hard it was to go through it all. Please know how many of us understand...

Just think about what it will be like once Micah is home again and this is all a memory. Thank god they magicians of medicine can fix our little boys' hearts.

Big love coming right at your beautiful Micah.