Back Again!

Well, here we are back at the hospital. Not exactly how I envisioned my Valentines' Day. What started as a "routine" visit yesterday ended with an unplanned stay here at Yale. I should have realized it was Friday the 13th and we were in room 13. We originally had a visit scheduled Friday that included a checkup, a visit to discuss his upcoming catheter, and inserting a "g-tube". The visit started well - initial vitals were taken and we were talking to the Doctor about his upcoming heart catheter. During the discussion, they noticed the initial nurse had not recorded his oxygen saturation so they hooked him up later in the visit and noticed it was in the "60's".  We thought it odd, since the initial nurse saw it was in the 80's (but hadn't recorded it) We checked and rechecked - the 65 was right. The Cardiologist was not comfortable with that number and wanted to admit Declan. We can be thankful that the first nurse failed to enter the first readout. Otherwise the second test would not have been performed. After discussion with the doctors and monitoring we discovered that when at rest his saturation levels were such higher, such as when we take them at home.  Similarly, he was resting when the first nurse took the reading. But when he is more alert, it is much lower. So we are grateful the first recording of his level was not charted by the nurse and had to be measured again; otherwise it could have been days or longer before we caught it.

Immediately, they performed an echo test and discovered that his shunt is narrowing; which is causing the lower saturation readings. The narrowing tends to happen as babies "outgrow" the initial shunt placed from the first operation. So in a way, we knew this would happen, but just not this quickly. Our plan going into our Friday visit was to schedule the catheter at the end of February with the second stage heart surgery (The Glenn) to follow about mid-March or so. However, with the narrowing of the shunt early, it pushes our time table forward.  Based on observation today (with has sats ranging from 60 to high 80's ) as long as they don't tank, we would be looking at the catheter on Tuesday, with surgery possible on Thursday.  From what we have gleaned from doctor discussion and observation, his weight is technically large enough for the Glenn- they just like them to be 4 to 6 months, versus Declan's 3 months.  I'm not sure how to feel about this change of timetable. On one hand I am glad the surgery will be over with sooner, but I'm also a bit nervous, as mentally I was not ready for this point and a bit apprehensive because his is only 3 months old.

So today was spent watching Declan's oxygen saturation rates and cleaning up his frequent vomiting. Usually when he's sleeping it's around 80 but when he's awake, it is much lower. So the doctors and nurses kept adjusting his nasal cannula (oxygen tube) moving the oxygen rate up and down, trying to get him steady in the 80's. It's a bit nerve-racking, with the machine's alarm ringing once his "sat rate" drops, following by doctors and nurses coming into his room to adjust things, and watching the screen, waiting or the number to rise and the alarm to stop ringing So far, it's been good enough to hold off the catheter until Tuesday, but they are keeping a close watch on his numbers. The other unfortunate part of this change of schedule is that we were hoping to address his frequent vomiting by having a "g-tube" surgically put into his stomach. We had met with the doctor who performs the procedure yesterday, with the hopes to have the tube placed prior to his second surgery, the Glenn. Now, with the second surgery so close - possibly within the week-  they can't do it until some time after the Glen is done. Thus, we are in for the long haul in changing his clothes after all his vomiting. In fact, I think we single handedly used up all the infant hospital shirts on this floor of the hospital today. From mid afternoon or so, and forward the nurses were unable to locate any more of the baby gown shirts. He's going to make his mark on this world any way he can!