Quick update. We have a birthday and a plan! Luca will be born via c-section first thing in the morning on August 26th… aka 4 weeks from now (aka basically tomorrow). All of the doctors involved have met and planned for the c-section at 37 weeks due to my gestational hypertension (thankfully all tests came back negative for pre-eclampsia) and to have the team of doctors, surgeons, transporters, etc. ready and waiting. My OB has promised that 37 weeks is enough time for Luca’s lungs to develop as good as possible to prepare for the multiple surgeries. He has been growing as he should and is otherwise healthy, so he should meet the 6.5lb weight requirement for surgery by that time.
The neonatologists met with me separately from the OB and went over their role. They will have a team in the OR to stabilize Luca and pay special attention to his breathing. Upon delivery, he will be started on IVs immediately to administer a drug called PGE, which keeps circulation in the baby’s heart similar to the way it was in utero. A common side effect of this drug is it stops the baby from breathing. Given the fact that Luca will probably already have trouble breathing combined with potential of this side effect, he will most likely be intubated and on a ventilator right away. Once he’s stabilized, the transport team will take him next door to CHLA and I’ll move to recovery. AJ can go with the transport team right away and will be with the baby. I’ll follow once discharged, hopefully within two days, but was told to plan for three.
I was also able to get a clear answer on what the good stats meant at my cardiology appointment earlier this month. Below is a diagram – see if you can follow along. 🙂
The first good thing was a ratio that went from 3:1 to 5:1. The higher the better. Blood needs to flow through the right and left atriums (the upper red and blue sections) because it can’t go through to the left ventricle (bottom red section) as it is almost non-existant. The flow through the pulmonary vein (the middle blue tube) drains into the left atrium and pressure builds because there’s restriction in the flow from the left atrium to the right atrium. Blood flow through the pulmonary vein at a ratio of 5:1 means that the septum is moderately restricted versus severe.
The other number measures the different in pressure between the left atrium and the right atrium. I believe the scale is 1-5. The rating was originally a 3, but is now a 1. The higher the number, the more restriction of blood flow. Therefore, the lower the better.
No sonograms or baby updates at this appointment, but we have a cardiology appointment next week. We will see then how Luca is doing and are hoping for any positive news. We can’t wait to meet this little guy!
Here’s what you can pray for between now and August 26th:
- A complication free c-section. The faster I heal, the quicker I can get to Luca.
- That the neonatologists can quickly and successfully intubate Luca and get him any breathing assistance he needs right away. Any time spent without oxygen getting to his brain means brain damage. He’ll be checked before and after each procedure to monitor the size of his brain for damage.
- Continue to pray that Luca’s valves and lungs are not damaged from any pressure experienced from the restriction in utero.
- That this baby will grow, grow, grow. As you know, the bigger the better for surgery.
- The hands of the cardiothoracic surgeon. Luca’s heart will be smaller than a walnut and swift and steady hands can make all the difference. For each heart surgery, Luca will be on the heart-lung bypass machine which also carries a high risk for cognitive damage. Luckily, Dr. Starnes and CHLA have a record of short time spent using the bypass machine.
- All the doctors in general. I was told to expect “a million people” in the OR during delivery, and while it’s obviously an exaggeration, there will be a lot of people and a lot going on.
- Finally, for a miracle. It doesn’t necessarily need to be for Luca to suddenly have a totally healthy heart, but there’s so many hoops for him to jump through that we’ll take a miracle anywhere in the process.