It Takes Your Breath Away

There are some days you dread as a parent. Immunizations at the pediatrician's office, the first time your child gets sick, or when they bash into the coffee table. You try your best to patch them up, give them a kiss on the forehead and send them back to do it all over again. And there are things that you can't handle without some help, for those occasions we call in experts.

When Cubby was born the pediatrician on call discovered a heart murmur. The standard of care is to consult with a pediatric cardiologist. Nine times out of ten the murmur is considered "normal", and is defined as an unusal sound heard during the beating of the heart. In Cubby's case it isn't such a normal murmur.

I don't remember what the cardiologist told us that day, the only thing I heard was "surgery" and my heart stopped. Since then I've become well-versed on Cooper's condition, which is known as Tetralogy of Fallot (TOF or TET). I would try to explain it, but this is the internet and why not just copy and paste? Below is what I found on a few websites:

Tetralogy of Fallot (TOF) is the most common congenital heart defect causing cyanosis, a bluish discoloration of skin caused by oxygen-poor blood reaching the general circulation. An embryologic failure of the right ventricular outflow tract to form properly results in the four cardiac abnormalities characteristic of TOF:

(1) Ventricular septal defect (VSD): An abnormal opening between the two lower chambers of the heart

(2) Pulmonic stenosis (PS): A narrowed area within the main pulmonary artery, at, above or below the pulmonary valve

(3) Malpositioned aorta: The entrance to the aorta overrides the VSD

(4) Ventricular hypertrophy: An overly muscular right ventricle

In the normal heart, oxygen-poor blood returns to the right side of the heart where it is pumped to the lungs to be oxygenated. In TOF, the pulmonic stenosis increases the resistance to right ventricular outflow. This can cause elevation of right-sided heart pressures that may result in oxygen-poor blood being diverted across the VSD to the left ventricle and into the aorta (“right-to-left shunt”). When the aorta carries “mixed” blood to the general circulation, less oxygen is available to the tissues and cyanosis can result. Without surgical intervention, most patients with TOF will not survive past early adulthood.

Here's a diagram of what is happening in Cooper's heart:

What all of this means is that Cooper will be having surgery. It's scheduled for Tuesday morning, but we'll be checking him into the hospital Monday afternoon. I feel uneasy announcing this on the blog, but there is a lot to understand about what is happening and I knew that if I had to explain it over-and-over that eventually I wouldn't be able to explain it anymore.

I'll be using the blog to update his condition over the course of the next seven to ten days. The procedure will last 5-6 hours, and then he'll be in the intensive care unit to recover for two or three days. From there he'll be transferred to intermediate care for another two or three days. If all goes well, we hope to be back home with him in time for Christmas.

The good news is that the surgery team is very well-known and respected for this type of procedure, and his prognosis for recovery is positive. The surgeons and his cardiologist have informed us that should the surgery go well he'll develop normally. That means he can run, jump, play, bash into coffee tables and all of the other things that boys do as they grow up.

I'll be sure to provide updates as the surgery approaches, and of course his condition as we move ahead over the next few days.

If you believe in a higher power, and if you wouldn't mind, please say a little prayer for Cubby tonight or tomorrow.