Tuesday, August 5, 2014

Evanna's First Cath/Angiogram

At our last cardiology appointment with Dr. Fruitman,  she said she felt it was time that Evanna had a cardiac cath (click here to read what a cardiac cath is) to get the process started for her first open heart surgery. She was to present Evanna at the next pediatric cardiology board meeting (these are held every Tuesday, and I believe it involves all pediatric cardiologists and surgeons in Western Canada where they discuss current/on-going cardiac cases), and we should get a call from Edmonton soon after scheduling a procedure date. I’m not a patient person, so waiting for that phone call was hard. However, I was expecting the cath would take place sometime in August. Well after waiting for about a week for the phone call, on Monday July 21, Edmonton called asking if we could come up that very week! They had a few cancelations, and Evanna was at the top of the list to be seen and wondered if we were able to come up that week for her cath (July 23 & 24). I said that was just fine and called Nick to see if he could get off work. Thankfully, Nick’s very understanding boss let him take off his last 2 nights and it was all set. The whole thing would require for us to be in Edmonton for a minimum of 2 days. I called the Ronald McDonald House up in Edmonton, but being such short notice and needing a room for just a few days, I kind of knew we wouldn’t get in (no big deal). They hooked us up at the Days Inn for the night where we got a good discount (it comes with breakfast too!).
The first day involved an ECHO and preadmission clinic. ECHOs are not that easy now that Evanna wiggles more than she use to. We had to take a couple of breaks, and I am so glad that Nick was there to try and put her to sleep every time she woke up. The very experienced (and patient) tech that did her ECHO also sang to Evanna which definitely helped.
After the ECHO, we had lunch and headed to the preadmission clinic. We meet with a nurse who went over Evanna’s history and talked over the procedure with us. Blood had to be drawn (which is seriously not an easy thing to do on a small baby) as they always have blood on hand in case of an emergency. We met with an anesthesiologist for a few minutes and then finally we were sent on our way around 3pm. We checked into the hotel, and went for dinner soon after. That evening wasn’t exactly the easiest for us. After being poked and prodded all day, Evanna was a little restless and it took her awhile to settle down. Thankfully she slept through the night.
Evanna’s cath was scheduled for 11:30 in the morning, so after grabbing a bite to eat, we packed up, checked out and headed over to the Stollery. They had us change Evanna into a hospital gown (Evanna swam in the smallest one they had). They put some numbing cream on her hands (for the IV), and walked us over to the Cath Lab. We meet Dr. Rutledge who went over what she was going to do and signed the consent form. We then meet the actual anesthesiologist (who was an interesting fellow – but extremely nice), and once the room was ready to go, had Nick walk Evanna to the back. It definitely was a little sad handing her over, but we knew she was in safe hands.
They handed us a buzzer that would alert us to when the procedure would be over (just like those ones you get at a restaurant), and told us it would be about 2 hours. Nick and I headed to the cafeteria and did what we could to help pass the time. We ate, and after 1.5 hrs our buzzer went off! We walked as fast as we could and checked in. They showed us to a room where Dr. Rutledge would meet and go over the results with us. We passed where Evanna was recovering along the way, and our nurse held her thumb up! Side Note: before Evanna had her Cath the nurse asked how old we were, because the staff thought Nick and I were very young. I laughed and said that we’re 25 and 26 years old – so not as young as they thought.
Dr. Rutledge walked in and said the procedure went well. She talked about Evanna’s collaterals (she counted 5), and that they all had stenosis (narrowing) as they got closer to the lungs. She told us that we should hear from our cardiologist a few days after the next board meeting and expect surgery within the next couple of weeks to couple of months (she also indicated that Dr. Rebeyka would probably be our surgeon). We thanked her, and she stated that she would check on Evanna a little later.
Finally we were able to see Evanna. She was still waking up when we saw her, and was a little groggy from the anesthesia. They said we could try giving her a little sugar water, but Evanna’s throat was very sore from being intubated. The saddest part was Evanna’s cries. Because of being intubated, you could tell it hurt her to cry. They were so soft and you could tell it took a lot of effort. They had me climb into the bed with her to see if she wanted to be held and hopefully get her to eat a little bit. They packed us up and transferred us up to unit 4 (with me in the bed holding Evanna) because the Cath Lab closes at 6pm. We arrived on unit 4 and we were met by our new nurse. The nurse said she was surprised at how big Evanna was! She had read her file and was expecting a much smaller baby.  It was so great to hear that.
We had to stay for a minimum of 6 hours as a precaution, and overnight if Evanna was having difficulties. Thankfully Evanna was a little rock star, and after a quick visit from Dr. Rutledge, we were able to leave at the 6 hour mark! We left at 8pm and after filling our car with gas, we headed back to Calgary. Though we were in Edmonton for less than 48 hours, it definitely felt a lot longer than that. We’re so thankful there were no complications and everything went smoothly.The Stollery and all its staff are so awesome, and we can't express our gratitude enough for all they do

Update: Dr. Fruitman called me about a week after Evanna’s cath (1 day after the pediatric cardiac board meeting), and explained that her and Dr. Rebeyka went over the results. They are definitely more favourable then what they were expecting (when Evanna was 1 day old, her CT showed that none of her collaterals were bigger than 1 mm, and if they didn’t grow, there would be nothing they could do). Dr. Rebeyka wants to do surgery in September (just like I guessed), and wants to bring her collaterals together (called “unifocalization”), insert a conduit, but leave her VSD open for now. She explained the reasoning for this to me, but the day Dr. Fruitman called was also the same day that Evanna had appointments at the Children’s Hospital all afternoon, so my mind was a little mushy by the time she called me, so I’ll ask her to explain it to me again at her next cardiology appointment this Thursday. She also said Evanna will require another cath a few months after her surgery to deal with the narrowing of her collaterals (ie. inserting a balloon or stent), but they will wait until she has recovered a bit before proceeding with that.

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