Long Echo and Cardiac Visit Post Stent Placement

Kalvin had his first echo and cardiac appointment since having his stent placed in his coarc in January!  Stent  The morning started off a little rough.  Lots of traffic.  And a echocardiography room without a TV.  Meaning Kalvin would have to lay still for an hour without anything to  distract him.  Children's Department of Cardiology is under construction so the rooms are scarce and the new TV's are not connected yet.  They are there in the rooms,  but not hooked up.  A big tease for a seven year old to see the TV,  but not be able to watch it.  Kalvin was a trooper.  This is one situation when Kalvin was younger that would have made for a really long trying day.   As my mind drifted back in time to previous echos,  I was so thankful that Kal was older and that this was a bit easier now that he can be reasoned with.  Sometimes.  My heart went out to those younger patients who would be in that room later in the day.  With no distraction.  When everyone is on edge,  a bump in the road as simple as a non working TV,  can really feel like a mountain to climb.  A tall mountain.  Mt. Everest.

While we were waiting to begin the echocardiogram, the nurse came in and requested that she weigh Kalvin again.  Ahhh, the weight!  Yes, he has lost a lot of weight since our last visit in January,  I acknowledged. Weight Loss  I have to say,  I am quite impressed that everyone is all over his weight loss.  He has been doing great with eating again.  Well, he still wont eat cake which is just unfathomable to me.  He has gained six pounds and is at a perfect weight for his height now.  But he is still five or more pounds lighter than he was in January.  It is comforting that the doctors everywhere are on top of this and not letting it slip by.

Kalvin during his echo-here they are taking images of his coarc.  You can tell because they are way up by his throat.

The sonographer was wonderful.  She squeezed the gel onto Kal's chest and asked him a few questions.  He told her he liked having the gel on his chest because it tickled him.  The sonographer said she had never heard that before!  She diverted his attention by having him watch a different kind of "movie."  The movie of  "his heart."   He ate this up and so did I.  As the sonographer explained what each image on the computer screen was,   I knew this was going to be my opportunity to finally ask all the questions I have been afraid to ask in the past. 

Kalvin having his EKG.  The EKG was a challenge when he was younger.  Trying to keep him still.  Now it is easy peasy.
As the hum  (more like a roar) of the fan from the echocardiography played on in the background,  the sonographer began to explain to Kal that we would be in there for over an hour and that we had a lot of images to capture.  Panic set in.  For me.  Why so long?  Why so many pictures?  What are they looking for?  Is there a problem?

I see the familiar blue and red waves moving back and forth on the screen.  Immediately I think they look out of place.  The waves indicate blood flow.  The red and blue indicate the different direction the blood is flowing.  Why am I so panicked?  There is just so much time to sit.  And think.  In complete darkness.  In silence.  With the roar of the fan as the background music.
Figure 4. Color-flow mapping.
As the sonographer promised, she made the images into a movie for Kalvin and began explaining what we were looking at.  "The left ventricle squeezes and releases as it pumps blood to the body," she began. 
We met with Dr. Brown (Kal's cardiologist) and received great news.  The arrhythmia he was experiencing in his abdomen before the stent was placed in his coarc was now normal.  Normal?!   His heart function looked great.   I think the word "perfect" was even used,  but I may be imagining that.  Kalvin had a great conversation with Dr. Brown and we discovered that Dr. Brown also plays the piano,  like Kalvin.  What doesn't this doctor do?  He is amazing.  We are all set for another year (knock on wood).  What a great morning it had  become. 

 One appointment down and one to go.  We were off to get a CAT scan for Kalvin's leg surgery.  Leg Surgery  Dr. Kim wants to measure the damaged portion of his femoral artery and take images of his abdomen.  A CAT scan will show the artery in more detail than the catheterization or any other imaging machine.
In between the echo and the CAT scan we had some time to wait.  We always try to stop by and visit Kalvin's surgeon,  Dr. Pigula,  when we have extra time.  We still have not seen him in person since Kalvin was in the hospital the first month of his life.  First Surgery   We correspond via holiday cards and emails,  but I would love to see him in person and give him a big big hug... again.  He is responsible for so much of Kalvin's success,  yet we never need to see him anymore (knock on wood...again).  It is an odd feeling.  To have someone make such a difference in your life.   To be so thankful to that person for all they have done.  And then to never see them again. 

Kalvin in Dr. Pigula's office.  Leaning on his desk.  We missed the good surgeon.  He was away at a conference, but his assistant took this picture and emailed it to Dr. Pigula.  We will drop by again another day and hope to meet up with him.

 We mosied on down the musical staircase.  A favorite of Kalvin's at Children's.  We were headed off to have a CAT scan.  Kalvin's first.  Ever.  Anxiety began to rear its ugly head again.  The worry, "Would there be a needle involved?"

Kalvin checking out the mechanics behind the musical staircase in Children's Lobby.


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