Tuesday, April 24, 2007

A visit to Duke Children's Clinic

Today, we took Jacob for his 5th follow up visit since his discharge from Duke on August 16. We see Dr. Delaney, who is Jacob's pediatric cardiologist. Dr. Delaney is also an interventional catheterization specialist - he was there the morning Jacob arrived at Duke and performed Jacob's balloon septostomy along with Dr. Rhodes. Dr. Delaney also sat down with Jeff and I before Jacob's surgery and detailed Jacob's condition and surgery and let us ask questions. He is a good doctor and has a good "bedside manner." Anyway, on to the visit...

After our traditional breakfast at Elmo's, we arrived at Duke at 8:45 a.m. We were taken back for a height & weight check. Jacob's length was 28 inches and his weight was 18 lbs, 7 oz. Then, it was over to the main hospital for the echocardiogram. This was Jacob's third outpatient echo, so Jeff and I thought we had the routine down. We arrived on the 7th floor to find a sign that said something to the effect of wait by the elevators for x, y, z and peds echo. That was odd. The paper we were given at the Children's Hospital said to go to the waiting room at 7416, which is where we usually went. We walked towards the waiting room anyway, and found doors covered in plastic. Something was definitely different. We went back to the elevator area. A nice woman we'd seen on the elevator figured out we were there for a peds echo and offered to tell them we were waiting. A little later, they came out and walked us back to the echo room. The nurse explained that they had a pipe burst in the waiting room and it was being repaired. It's funny because the Children's Hospital receptionists had no idea about this.... Anyway, so we get back to the echo room, and we wait.... and we wait... and we wait. It was 10:00 a.m. before the doctor overseeing the echo labs came in to examine Jacob. He recognized him from his treatment last August and noted how great Jacob looked. This happens to us pretty frequently at Duke. Nurses & doctors that we don't necessarily remember, remember us and remember Jacob. While heart defects are 1 out of 100 babies born, transposition (a.k.a TGA) is seen about 1 in 1000, so Duke sees maybe about a TGA baby a month (a nurse told me this), so they tend to remember those patients.

Anyway, Jacob finally got the sedation medicine, chloral hydrate, about 10:00 a.m. For the next 15 minutes, he went from crying, to babbling and doing raspberries. He was quite funny. We noted he was a funny "drunk." Finally, we went to sleep about 10:20 a.m. and they began the echo. After taking echo pictures for about 25 minutes, the technician went out to discuss everything with the doctor. The nurse came back in about 5 minutes later and said we were all done. We headed back over to the Children's Clinic and were immediately taken back to the exam room since our appointment was 11:00 a.m. with Dr. Delaney.

A little later, another doctor came in. He introduced himself, but all I caught was "Roddy" was his first name. He talked to us about Jacob's last 3 months, and then went to discuss with Dr. Delaney. A little later, Dr. Delaney came in and said that the echo results were "excellant." Everything is flowing along just great. Of course, they are keeping an eye on the pulmonary artery, as well as the arteries (?) to the lungs for stenosis, but so far, so good. They were very pleased that Jacob doesn't even sound like he has a murmur on exam, which would be typical. The best news is we don't have to go back in 3 months! They told us to return in 6 months and Jacob will have another echo at that point. For probably the next 2-3 years, they will want to echo him every 6 months, but in January, he mentioned they would want to see him every 3 months in between echos, so this was good news! Dr. Delaney did mention that Jacob's weight had fallen down a notch on the growth curve, but this is likely due to Jacob crawling and becoming more active. We have Jacob's 9 month check up with his peditrician in a couple of weeks, so I'm sure we can address that then. From what I understand, that isn't all that out of the ordinary.

So, the bottom line is Jacob gets an A+ on his echo and no return for 6 months!!

He slept until 12:30 p.m., had a bottle, a little lunch around 2:00 p.m. and passed out again at 2:30. He's still asleep at 4:45 p.m.! I need to go wake him!

1 comment:

Anonymous said...

Wow! What a day :) Glad things went so well, what a relief. I was surprised to see how often you guys have to go in to the PC for checkups. We had the routine, two weeks after, and then 6 months after, and then we didn't have to go in for another 6 months after that - the one year. Then, get this, we got to stay away for an entire year, until this last March. We actually don't have to see his PC until 2009 now - two more years! :) It's kinda nice.

I do have to see our ped. though tomorrow because one of Jacob's stitches from this last little mini surgery is poking out of his chest, kinda weird actually.