Tuesday, May 18, 2010

heart check-up

I was really worried when the pediatrician in Washington State first found a little murmur in Arabella's heart at 6 weeks. It was quickly diagnosed by a cardiologist as ASD. We've thought very little about this murmur over the past year. Thankfully, Arabella hasn't experienced any signs of the murmur affecting her growth and development. The only time that ASD becomes a problem in small children is when the body starts focusing energy on compensating for the hole in the heart that otherwise should be used for growth and development in other areas of the body. We've been confidant over the past year that our baby girl has been growing steadily. We hoped that the small hole in her heart would close on it's own.

We saw a pediatric cardiologist at Makati Medical yesterday for the annual check-up. We planned for a short consultation so she could go over the diagnosis letter from Bella's first cardiologist followed by a 2-D echo scan. Arabella was scared when we reached the doctor's office. She's very weary of strange places and clung to me for dear life. Finally she warmed up as we waited for the doctor. She munched on Goldfish crackers and walked around the office. The entire time we waited for the doctor the nurse kept telling me that she hoped Arabella would be quiet and not cry during the echo scan. Then the doctor comes in, takes one look at Arabella babbling and walking around the room and says "Oh, I really hope she will be silent during the scan". I was sort of puzzled by the comments because she's a one year old for cheese and rice sake! Anyhow, we get into the doctor's office and Bella's fussing a little bit since she missed most of her afternoon nap for the appointment. The doctor reads the details of the diagnosis provided by the American cardiologist and then indicates that it's time for Bella to lay down on the table so she can listen to her heart. I knew that she would squirm and cry and protest and roll over and try her hardest to jump in my arms. The doctor said she could still hear a slight murmur which was disappointing. She asked if Bella tired easily, seemed winded, or off color like she wasn't getting enough oxygen while playing. Not my girl. If anything she's an Engergizer Bunny. She then explained that the 2 D echo scan would require Bella to be completely quiet and still. The scan would take about 20 minutes and she could not get the accurate reading she wanted unless the quiet and still requirements were met. I almost choked on my laughter because I knew there was no way I would get my daughter to behave like a stunned rabbit for 20 minutes. She couldn't even sit still on my lap. She wanted down to walk around the entire consultation. The doctor watched Bella roam around and try to get into everything as we talked and we both knew the 2 D scan was just not going to go well. The scan room is scary for little ones; dark, strange, with machines and new people. Bella would scream her head off if I tried to lay her down and hold her there! HA! Ridiculous. I told the doctor as much and asked her how she got her patients (all children since she's a pediatric cardiologist) to remain quiet and still for the duration of the procedure. She said she had two solutions. The first solution she recommends is to ask the parents to prevent the child from sleeping very much the day before so the child was very sleepy would thus fall asleep at the office for the 2 D echo! This to me was even more ridiculous than anything the doctor had said up to this point. This solution might be all fine and good for some babies but not mine. Anyone who knows my daughter even a tiny bit would laugh at the idea that I would restrict her precious sleep schedule. Even more unlikely is that she would fall asleep in my arms in a strange doctors office and then continue to sleep through a medical procedure in which strange people would be rubbing a cold gooey wand on her chest. Absolutely absurd. The doctor looked at me incredulously while I tried to explain that there was no way my overtired daughter would just fall asleep for me on command. She responded that "all babies have periods during the day where they are sleepy." Thanks Doc for that revelation. I explained to her the story about our car ride to and from Hidden Valley Springs. I almost told the doc that she would have to bring her 2 D echo machine to our house at night and scan my daughter's chest in the dark while she slept in her crib with the white noise machine running because that was the only time my daughter would sleep for her and even then it's a crap shoot.The doctor then told me that the second solution she has to get her patients to cooperate is to give them a sedative. Okay then. So it's settled how we would have to to a 2 D echo scan of Arabella. Since there was no sedative available that day. In the end the scan is just for academic purposes to monitor the size of the hole. The doctor explained that the hole would either be smaller or the same size as last year. Not bigger since we are not seeing it affect Arabella's growth and development. The scan would not be used to make a decision for treatment. So we opted out of the scan for that day. We thought about just giving it a try to see how she would do and in the end I knew it would be a waste of time. There was no way she was going to willingly lay down and not scream bloody murder during the heart scan.

So she still has a murmur and it's currently not bothering her. There is still a slight chance that it will close up by the time she turns two. Even if the hold never closes it doesn't necessarily mean she will need surgery. She may have a murmur her entire life that never bothers her. I guess it just adds a little character. She'll be the awesome kid at the slumber parties who scares her little girlfriends by holding a flash light under her chin and saying in a spooky voice "I have a hole in my heart". Right now I'm not too worried about my fiery little girl. She weights 10.75 kilos or 23 lbs! She's clearly doing just fine.


Rachel said...

I don't know any one year old that would sit still for 20minutes unless they were sleeping! I'm glad Bella's murmur isn't affecting her. She's cute as a button!!

The Gunning Family said...

I agree with Rachel. And, these were pediatric cardiologists! Are the kids in Manilla that different than kids in most other places in the world? She looks completely healthy and absolutely beautiful. I think it will add to her character. Love and miss you guys.

Sunny said...

I must be having a lot of Manila moments because this story just pisses me off. What is wrong with people? You expect this kind of crap from Metro or a security guard but a freaking PEDIATRIC CARDIOLOGIST. The thing that annoys me the most is that YOU must be doing something wrong that your child can't sleep in your arms, gag. Shame on you for not letting your children stay up until 10 at night roaming the malls. GRRRR. Sara, my patience is wearing out. Are you going to see a DOC in Washington?