Monday, October 1, 2012

Tin Man Heart

It's a boy.
Well, I was flipping through some pictures of Christy's uterus and came across this one. It seems to have an inhabitant. As you can see from the boy bits, we're having a boy. Today, Christy is 24+5 weeks along. Prenatally for Christy, everything is going well. She didn't have much morning sickness and aside from a normal amount of swelling in her feet, she's doing just fine. The due date is January 17th which also happens to be my parents' anniversary.

Profile shot from 18 JUN 2012
Our parents have known for a while, and we were able to show them the initial ultrasound pictures through Face Time chats. Much excitement was expressed by all. We had the sex ultrasound on August 28th. Because it's heavily boy-dominant on her side of the family, everyone was hoping for a girl, so naturally, we had a boy. :) Everyone is still excited for a boy. Both of our parents probably thought this was never going to happen anyway, so boy bits versus girl bits don't really matter.

They say that having a child changes everything. Well, it's true. Even since before finding out, we had our baby furniture picked out from the Heritage Amish furniture store in VA Beach where we bought our bedroom set. We've pretty much been saving for it since we saw it. We made a baby wishlist on Amazon on the plane ride home from our Atlanta trip. We've broken the news to our dog Tricksy that she's just going to have to get used to the idea that there will be someone in the house who also requires our attention. We were even able to do some truly important things after we told Tricksy. We consulted with our respective jobs on the matter. Christy has already put us on the wait list for Navy childcare. Since she does training and consultations with Navy Child Development Centers and Child Development Homes, she can make the best selections of where to go. I was able to pick a pediatrician whom I have personally worked with and trust completely. We feel very fortunate that our education and career choices have prepared us as much as possible for being somewhat decent parents.

But even with all the details that you think you've planned for, you can never be fully ready...

The same afternoon as the sex ultrasound, we got a phone call from the nurse practitioner at the clinic. There looked to be some cardiac concerns as well as a double vessel cord. (There should be two arteries and one vein in the umbilical cord. We have one artery and one vein.) We had a follow-up ultrasound at my hospital. By the end of that appointment, all care at the clinic was being transferred to my hospital due to congenital heart abnormalities. Good thing Naval Medical Center Portsmouth is awesome.

So...without going into too much technical detail, this is where we are right now...

Normal Heart
Our diagnosis is Tetralogy of  Fallot. It's a combination of four things:

1.) Ventricular Septal Defect - a hole between the two ventricles
2.) Overriding Aorta - the aorta is basically in the wrong place
3.) Pulmonary Artery Stenosis - a skinny pulmonary artery
4.) Right Ventricular Hypertrophy - the right ventricle is too big

A consult was put in with Children's Hospital of Philadelphia (CHOP) because we'll definitely need a cardiothoracic surgeon either just after birth or, ideally, a few months later. CHOP is only one letter different than Chip, so I'm sold. We traveled up there on the 14th of September for an initial visit. We go again for a follow-up in November and then will stay there from roughly the 35 week point until delivery - and likely a little beyond it. Fortunately, most of the travel, food, and lodging will be covered for us. When we heard the costs associated with similar surgeries, I was even more thankful than usual to be an active duty service member. I've never - not one single time - thought about getting out of the Navy. If that decision could possibly be solidified even more, this would be the reason.

Baby's Heart
We've been seen by the finest pediatric cardiologist that NMCP (and in my opinion, the Navy) has to offer. We'll be doing frequent visits with her. These pictures were drawn by her, upside down, so we could visualize them on the other side of the table. I immediately asked her to sign them. The doctor whom I picked as our pediatrician took time out of her schedule to come to our cardiology appointment to sit with us and chat. That's one of about a billion reasons that I wanted her as our pediatrician. The leadership at my command is being very helpful and is working to accomodate me for appointments and travel.

One of the biggest stressors we've been facing was that this can sometimes be associated with genetic abnormalities - specifically DiGeorge Syndrome. Christy had an amniocentesis done a few weeks ago. As we learned, the results of an amniocentesis for genetic information come back in chunks over time. The initial results came back three days later. 46 chromosomes with no additions, deletions, or missing pieces and laboratory confirmation that the dangly bits we saw were indeed those of a boy. Good news. This meant no Down Syndrome or other major trisomies. We thought the rest of the results came back in 7-10 days, but the final results - the results that would tell us about DiGeorge Syndrome - wouldn't be back until the end of the month. We received a call on Wednesday clearing us of any genetic problems. Specifically, the lab results say: "The whole genome chromosome SNP microarray (REVEAL) analysis was normal. No significant DNA copy number changes or copy neutral regions within the 2.695 million region specific SNP and structural targets were detected." We'll take it.

After telling a good friend about our situation, she had this brilliant bit of insight to share with me: "Open heart surgery is serious and scary, but I think most of life is serious and scary, and maybe it will be good for him to get something like this out of the way so early on. I can't help but think it will help him to be a stronger, happier, more compassionate person later in life. Opening your heart to the world so early - it must mean something, right?" As a yogi who loves back bends and heart hugs, this is exactly the reassurance I needed.

Somehow, it's like Christy and I were groomed for this situation. Masters level teacher trained at SFA's East Texas Early Childhood Research Center + pediatric nurse with an affinity for the NICU trained at SFA's Richard and Lucille DeWitt School of Nursing = one complicated progeny. It's going to be a fun ride. At least on paper, we're ready for the challenge.


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