Yesterday, I did CardioPosted: June 30, 2011
No, not the fitness kind. If you think that, you must be a stranger reading my blog, which makes me very happy.
“Wait,” you say, “Das Baby has heart problems? I knew he saw a pulmonologist for breathing problems, and a feeding specialist, nutritionist and gastroenterologist for the hideous GERD that makes him hate eating, and that he has a physical therapist and an occupational therapist to help with development, but what’s this about a cardiologist!?”
Well, Das Baby has a very mild (even debatable) case of pulmonary hypertension (PH), or high blood pressure in the lungs. It causes the heart to have to work too hard, and can be as scary as it sounds, but it’s fairly common in babies who, like Das Baby, have chronic lung disease (CLD). Das Baby was especially vulnerable to PH because his lungs were underdeveloped even for his gestational age due to my water breaking. Amniotic fluid is essential for lung development. It sort of seems like a design flaw that Das Baby was born with a full head of thick hair, but hadn’t really finished making his lungs yet. I’ve mentioned to him that things might have been easier if he’d spent a little more time on lungs and a little less on hair, but if he’s vain, he comes by it honestly. In all seriousness, we hope that as he outgrows the CLD, the pulmonary hypertension, if he even has it, should continue to improve.
Back in the NICU, the neonatologists were always trying to keep the pulmonary hypertension team away from Das Baby. It was like a turf war, except both gangs wore white. The pulmonary hypertension team’s one great act with Das Baby was prescribing, no joke, Viagra (see, the turf war even involved drugs), until the next day when one of the neonatologists decided it was way more than Das Baby needed (and no, we did not notice any changes in the way Das Baby filled out his diaper. Get your mind out of the gutter. We’re talking about a neonate here! He was still technically a fetus at this point!).
The pulmonary hypertension team had a way of popping up whenever I was alone by Das Baby’s
“isolette” or crib. They were captained by a woman with tetracycline teeth who moved like a snake. She was friendly enough, but I knew she just wanted to get her fangs in him and put him on more drugs (what would it be this time, I wondered, Latisse? Methadone? (which they actually do give in the NICU for babies who’ve been on morphine)).
At rounds the day before Das Baby’s discharge, the team decided he didn’t need a final echocardiogram; he’d been fine, they reasoned, and he could get one in Boston. It was agreed that no one would mention this plan to the PH team.
Later that afternoon, the pod was empty save for me, Das Baby, and his tiny neighbors. I felt the air shift, and there she was. “I like his o2 sats,” she said, leaning over him and looking deep into my eyes. “So he’s doing well on the cannula?”
“Yes,” I managed to sputter, “really well…” The silence was excruciating as she bored into my mind. I cracked. “He’s going home tomorrow.”
“Tomorrow? Well then he needs a discharge echo! I’ll see to it right away!” And she was gone.
It was the same in Boston; Das Baby’s pulmonologist had planned to follow his PH, but then Das Baby needed hernia surgery, and he had to be cleared by cardiology. And that’s when the PH doctor at Children’s got involved, “I’ll keep following him, if it’s all right with you,” he said. I was too powerless to say no. But actually, he’s lovely, and not at all snakelike. And so far he hasn’t offered Das Baby any street drugs.
The great news is that the PH Doc feels that Das Baby’s PH is likely better; he didn’t even think it was worth doing an echo to find out. Das Baby was his adorable, smiley, wiggly self the whole time we were there, and Doc was impressed with how alert and curious he was, remarking “He doesn’t even look like a preemie; I mean, look at his head shape.” Das Baby showed off his new trick of rolling from side to side, and crumpled up the exam table paper and shoved it in his mouth for good measure (the part that touched the table did not go in his mouth, which obviously would have freaked me out germ wise.)
Speaking of germs, the Doc also said that whatever we’ve been doing to keep Das Baby germ and virus free is clearly working–KNOCK ON WOOD (all of you, right now, KNOCK ON WOOD) and should continue to avoid worsening the PH.
“The paranoia’s paying off?” I said.
“The paranoia’s paying off,” he agreed.
So that means I’m going to continue to demand you wash your hands if you come within a hundred feet of us, and it means we’re going back into full-on sequestration once summer is over. Sad, but worth it. And, it’s a perfect excuse not to do cardio (the fitness kind), because I’ll be stuck in das Haus.