Wednesday, November 7, 2007

Watching and Waiting

Ava has done okay today. She is only on .5 liters of oxygen on a regular flow cannula (through her nose). They started feeding her again today through her NG tube. She had a fever at one point and they took cultures once again to see about infection. You all know the drill - 72 hours to watch the culture to rule out infection. However, the fever came down on it's own and her SATS and blood gases have looked good. She has been pretty agitated (awake a lot but not seeming real comfortable) and they think that all of this may be related to the sedative they took her off yesterday. It was Adavan which patients can have withdrawals from when they stop taking it. Just praying that's it and not that she has another infection. They will be watching her carefully tonight and plan to start another antibiotic if her temp spikes again. She is already on two antibiotics for her infection where her incision is from surgery. The vocal chord scope was again put on hold because of the fever she developed today.

The cardiologist told me today that she'll be here (in ICU) awhile. They don't intend to let her go until they've got all these complications figured out. I'm glad they intend to take it slow especially since the episode we had in Moderate Care over the weekend which set her so far back. At the same time, I'm wondering if we'll ever get there.

Wishing Cheryl (Ava's wonderful nurse) a Happy Birthday tomorrow. Thank you so much, Cheryl, for all you've done for Ava and our entire family. We feel blessed to have you caring for her.

Keep praying everyone!!!

6 comments:

Anonymous said...

Jamie,
Keep your good mommy spirit up for Ava! Ava knows that you're there cheering her on! Your family is on a long journey...hang on to the positive! We're keeping you in our thoughts and prayers.
Love,
Lori Brawley and the boys!

Anonymous said...

Jamie,
Tell Ava if she missed Cheryl that bad, next time you will bring Cheryl to her.

Of course we all wish you were closer so we could give you support and a hug. The weekend will be here soon and then your family will be joining you. Hang in there.

Love and Prayers,
Janelle

Anonymous said...

Ava and jamie and Bray and boy Jamie, you have all of our prayers and love. Every single dsy. I can't be there tomorrow, for I have a cold or something. It breaks my heart to not be able to come and see you as planned. Both of you girls need to rest and take it slow. Everything has just got to be ok!!!! God bless you and good night.
love you
granny and poppy

Anonymous said...

I would be cranky too if I had to go through all that Ava has had to endure! Who wouldn't?! Hang in there, Jamie. I hope you get some answers soon.

Love,
Emilee

Michelle Asmus said...

Jamie,
Was thinking of you tonight at the Young Americans concert. So many of your former (and current)students performed. You would have been so proud.

Ava is so fortunate to have a mommy who is by her side all the time. Stay strong, Jamie.

Love, M

karen said...

Jamie,
I'm sure you and Ava are looking forward to your boys returning soon! Going off the ativan is good. It's also good news that she is a bit restless, any girl of yours has to be anxious to be out there exploring her world. Lots of love,
Karen Kellogg

Ava with Mommy & Daddy

Ava with Mommy & Daddy
Isn't she beautiful!

It's A Girl!

Hello everyone and welcome to Ava Christine's Blog.
First a little info about the new edition to our family.
This beautiful little girl comes to our family after many years of trying on her parents part as well as her being the first girl in 19 years. Yes 19 years! So to say that she is going to be a little spoiled is putting it very lightly.
Ava Christine was welcomed into this world on September 29 2007 by her mommy Jamie, Daddy Jamie, big brother Brayden, grandparents, aunts, uncles, cousins, and numerous friends. Shortly after Ava's arrival the wonderful medical staff at Memorial hospital of South Bend found what they called a murmur in Ava's heart. After some testing little Ava was transported to Motts' Children Hospital at the University of Michigan in Ann Arbor. Jamie and Jamie were informed that little Ava has a heart defect that could be life threatening and that she needed to undergo open heart surgery to fix the defects. So, on Tuesday October 2 2007 Ava was operated on by the wonderful medical staff at the U of M. What this team of doctors did to Ava is incredible. First of all Jamie explained to me over the phone today just what problems Ava's heart has endured. Ava's heart has a couple of different problems. The first is known as Interrupted Aortic Arch. The following info about interrupted aortic arch is best explained by the U of M Cardiac website, "Interrupted aortic arch is a very rare heart defect that occurs when the aorta does not develop normally while the baby is in the mother’s womb. It comprises about 1% of all congenital heart defects. It usually occurs along with other heart problems such as truncus arteriosus, ventricular septal defect, transposition of the great arteries, and aortic stenosis.The aorta is the large blood vessel that arises from the left side of the normal heart and takes red blood out to the body. The first part of the aorta, called the ascending aorta (1) arises upwards. It then curves leftward forming the aortic arch (2). The aorta then curves downward towards the lower body, and this part is called the descending aorta (3). Three blood vessels exit from the aortic arch and supply the head and arms with red blood. These vessels are called the innominate artery (4), the left carotid artery (5), and the left subclavian artery (6).In babies with interrupted aortic arch, there is a complete blockage between the ascending and the descending aorta (1). This means that there is no direct way for red blood leaving the heart to reach the body parts that are "downstream" from the blockage. The site of the defect varies (2) and may or may not involve the take-off of the head and neck vessels. In most babies with interrupted aortic arch (70-90%) there is also a large ventricular septal defect (3).In newborns with interrupted aortic arch, the only way for blood to bypass the blockage is via the patent ductus arteriosus (4). Prior to birth, this small blood vessel permits blood to by-pass the baby’s fluid-filled lungs. One or two days after birth, this vessel usually closes on its own. In a baby with interrupted aortic arch, if the duct closes, blood can no longer reach the lower body. This can cause the baby to suddenly become very ill. Therefore, after the diagnosis is made, a medicine called prostaglandin is used to keep the ductus arteriosus open until surgery". (http://www.med.umich.edu/cvc/mchc/parint.htm)
So how did the doctors fix this? "Interrupted aortic arch is a serious heart defect that requires surgery soon after birth. The goal of surgery is to create remove the blockage. This used to be done in a two-stage operation but is now done most of the time in one stage. The two ends of the aorta are sewn together (1) and the patent ductus arterious (2) is tied off. Sometimes a patch is needed to reinforce the repair. If present, a patch is sewn over the VSD (3)". (http://www.med.umich.edu/cvc/mchc/parint.htm)
In #1 of the picture below is the part of Ava' heart that was repaired.

Before surgery

Before surgery

The Next Step

The next step in repairing Ava's heart was to fix what is known as Truncus Arteriosus. Truncus arteriosus is "characterized by a large ventricular septal defect over which a large, single great vessel (truncus) arises. This single great vessel carries blood both to the body and to the lungs". (http://www.americanheart.org/presenter.jhtml?identifier=11073) Below is a picture of what Ava's heart was like before surgery.

Before Surgery

Before Surgery

After Surgery

After Surgery
The above picture shows what the surgeon did to repair Ava's heart. "Surgery is required to close the ventricular septal defect and separate blood flow to the body from blood flow to the lungs. This is generally done early in infancy to prevent high blood pressure from damaging the lungs' arteries. A patch is used to close the ventricular defect. The pulmonary arteries are then disconnected from the single great vessel and a tube (a conduit or tunnel) is placed from the right ventricle to these pulmonary arteries. This is sometimes called a Rastelli repair". (http://www.americanheart.org/presenter.jhtml?identifier=11073)