Life For Luke

Wednesday, February 11, 2015

The surgery is done! They just finished stitching Luke back up. We will see him in a few more minutes. All told surgery lasted about 6 1/2 hours. Most of the time (3 hours) was just cutting through all of the scar tissue.

The surgeon said that Luke has hundreds of collaterals all over his heart. But hopefully with this new blood flow they will decrease in size. Luke had to be paced for a while as they were taking him off the bypass machine because of a slow heart rate. This could be because of the anesthetics or it could be indicative of problems with the SA Node. If that is the case he will get a pace maker some day. I sure hope not (10-15% of kids with the Fontan get a pacer).

Here is the gortex conduit that they attached to the inferior vena cava and the right pulmonary artery. It is a 20 gauge size, flexible, and stretchable. See the small hole at the top. That is the size of the fenestration or small hole going through the synthetic inferior vena cava to the atrium, acting as a release valve for high pressures.

Fontan Surgery 2/11/15

We checked into Primary Children's hospital at 7:00. Luke was again fasting. He had to have a bath the night before, have a special antiseptic wipe rub-down, and a nasal swab. This was repeated this morning. All new measures to help cut down on infections post operatively.

Before surgery we had another physical, visited with Dr. Burch the surgeon, Dr Greenwood the anesthesiologist, the attending P.A., and other staff. Luke kept saying "I hate this" and "I want to go home now!" I guess yesterday's cardiac cath left some bad memories.

They gave him some Versed 20 minutes before taking him to he O.R. room. Mark and I hugged and kissed him goodbye. Here is a picture of our sleepy-eyed boy as he was leaving us.

Mark and I are in the waiting room. We have been told to expect 6 hours. We should get hourly updates. Thank you to everyone for your love and support!

Tuesday, February 10, 2015

Cardiac cath 2/10/15

Luke had a cardiac cath today. He had to be fasting food for 8 hours and no fluids 3 hours pre op. We got to the hospital at 5:45 a.m. And the procedure started around 8:00.

Doctor Gray was the attending cath surgeon. He said the atrial, ventricular, and pulmonary artery pressures were all high. He found multiple collaterals and closed about three off on the right side of the heart. He said he left the one on the left side of the heart there because of tomorrow's Fontan surgery.

Collaterals are small blood vessels that form as the body tries to compensate for low oxygen saturations. Luke's were running from his aorta to the pulmonary arteries. The attending physician said about 50% of post Glenn kids develop collaterals. So it was not unexpected.

Here is Luke after being checked in but before surgery.

Here is Luke in the postoperative recovery room.

Wednesday, December 24, 2014

Luke loves firemen!

At Crispy Creme Donuts

Luke and his siblings with our new horse Buddy.

Halloween- with brother Taylor.

Tonight is Christmas Eve. We just had a wonderful evening with family. Unfortunately Luke ended up sick as we arrived home. He just went to bed with a low grade fever, complaining of stomach pains. I hope he is not too sick to enjoy Christmas tomorrow.

Luke has been scheduled for his Fontan- February 11, 2015. He was supposed to have surgery January 7th but was rescheduled because I changed insurance companies. They need to get pre approval before the hospitalization and surgery can occur. We will go to Primary Children's hospital in SLC, Utah. Two days before surgery he will have a doctor's appointment, chest x-ray, and blood work. The next day is a cardiac catheterization and echocardiogram, and then surgery. I was told to expect a stay of 7 to 10 days post operative. I am supposed to keep Luke healthy until surgery. So far, I've scored a big 0. Wish us luck!

Enjoying the rides at the mall.

Thursday, February 27, 2014

Times Doth Fly

Time sure does pass by quickly. I have not blogged about Luke for almost a year now. That is good news! I want this blog to be about Luke's life with HLHS. Yet life for the past 2 years couldn't be better. Luke is growing, talking, running, playing, and as healthy as any of my other kids. He has had no hospitalizations, takes only Lasix and Asprin in the mornings, and interacts with our family and the world in a very appropriate way for his age. He is small (5th%) and he likes to be carried a lot. Yet he will run (short distances) and climb and he give wonderful hugs and kisses. His good health makes me happy. We have had summer vacations, celebrated his birthday and Christmas, and been involved in library and church groups. Luke does amazing in all of this. He is a boy full of love for life and those around him.

Friday, April 26, 2013

18 Months

Luke turns 18 months tomorrow and he finally started walking last week! He looks like a drunken sailor and falls often. Walking has added a new dimension to his life and he quite enjoys getting around. Luke is almost always smiling and loves interacting with people. He is starting to sleep a lot better and I couldn't be more grateful. Some nights he only wakes up once! We don't know when the third surgery will be but my guess is at in 6-12 months. Until then Luke continues to amaze us in his abilities. Here are some pictures- Luke and his siblings in their BSU shirts, Luke eating some Nutella (I don't know who gave it to him), Luke climbing the bunk bed, and Luke at the park.

Sunday, December 30, 2012

December 2012

December has been a great month for Luke. He had a sleep study December 20th at St. Luke's hospital. He and I had to stay the night while he was monitored with ECG leads, oxygen saturation checks, nasal and oral air flow monitors, arm and chest leads, and video. His head, arms, legs, chest, face, nose, and mouth had leads on them and he looked funny and felt awful. Needless to say, sleep did not happen often. I am awaiting the results to come in January. The only thing I do know is that he was desaturating to 75-73% every time he slept. I'm guessing he is going to have a tonsilectomy at some point. It will be nice to not be awakened every 2 hours every night of my life. Here are some pictures of Christmas.

Mark, Sophie and Luke.

Luke slept through the morning Christmas. I figured he and I would be happier if he could sleep in rather than join the other kids for present opening.

Two Photos of the Sleep Study.

Despite my best efforts, he was still cranky when he finally woke up.

Here he is, ripping some paper off. Taylor actually opened most of his presents. It was fun to have him home with us. It was actually a "normal" Christmas and we all enjoyed each other. I hope 2013 continues to be a great year.

Hypoplastic Left Heart Syndrome

Hyoplastic Left Heart Syndrome (HLHS) is basically a medical condition where a person is born without the left ventricle. The left ventricle is the part of the heart that pumps blood to the rest of the body. Without the left ventricle life is not sustainable.

All newborns are born with a patent ductus arteriosus (PDA). This is a shunt that takes blood from the right ventricle to the aorta. The PDA is part of a neonate's physiology because blood does not need to go into a fetus' lungs. The blood is oxygenated via the mother's blood. When a baby is born and takes its first breath the PDA begins to close. It usually closes within a few days of birth but can last weeks.

A child born with HLHS will die when the PDA closes unless medical intervention is done. The newborn is first put on prostaglandins via IV to keep the PDA open. Surgery is then performed within a week of birth. It is a staged surgery that is considered paliative, meaning that adventually a heart transplant will be encessary.

The first surgery is called the Norwood and Sano or BT Shunt. Luke had the Sano. It involves openning the chest via the sternum, closing the PDA, creating a hole in the right ventricle and putting a shunt through the hole to the pulmonary arteries (these go to the lungs), seperating the atrial wall to make one large atrium, and sewing the pumonary artery and the aorta together to make a neoaorta. So in simple terms, the blood comes into the body to the single atrium, goes to the single ventricle, and then flow half to the lungs and half to the body.

The second surgery is called the Glenn. It is performed between 3 and 7 months of age. In this surgery the shunt (Sano) is removed (that's the one that goes from the ventricle to pulmonary arteries) and the superior vena cava (SVC) is connected to the pulmonary arteries. So then all blood from the head and arms goes directly to the lungs. This procedure lasts while the baby has a large head. But eventually he outgrows it.

The third surgery is performed between 2 1/2 and 4 years of age. It is called the Fontan. The Fontan involves connecting the inferior vena cave (IVC) to the SVC and all blood goes to the arteries. Now the child's circulation goes from the superior and inferior VC to the lungs, then to the single atrium, then to the single ventricle, and then out to the body. It provides adequate perfusion to sustain life but will not allow for vigerous exercise. Mild, yes, but limits will exist. The right ventricle is not as strong as the left ventricle so eventually it will give out. At this point transplant is the only option.

Now HLHS is the most severe heart disease one can have and still be born alive. 30 years ago no babies lived. Even 20 years ago they had poor statistics. Now 40-50% of children make it through all surgeries. Even then some have to have transplants in their youth. However, many are living into their mid 20s before they require a tranplant. Transplants can last uo to 20 years in adults (60 percent of heart transplants are successful after 6 years). And given time perhaps they can grow hearts from stem cells that will last forever!