Friday 3 June 2005

Subways and Tunnels, and Valves, Oh My.

It's so interesting how the phrasing a doctor uses to be reassuring can be so disturbing sounding.

Case in point: "Your baby will in all probability go on to lead a perfectly normal healthy life."

That's one of the things the pediatrician cardiologist told us today during our breathless cross city adventure, crammed into busses, experimenting with slings, and generally trying to shield the baby from any knowledge of what was going around her as best we could (which sounds a lot like our parenting plans in general).

It started when the midwife came for a checkup today. It was Katrina, our sencondary, and Jenny, her student. Things were going fairly well, except that the baby simply refused to bleed for Jenny. On the upside, the baby besides a short initial cry was hardly upset at all at having her heel pricked. Katrina took over to show how bleeding a baby is done by the experienced. She got the blood flowing. The blood dribbled onto a card to be sent in for testing.

Katrina then listened to the heart, and says: "Oh, we have a bit of a murmer there."

That's where the craziness started. She wanted us to get it checked out right away.

Complications: it was 3:30 pm on a friday afternoon, and even if they could find some placce for us to take her, we have no car seat. As timing would have it, our car seat is in Orillia, and was to be brought to us later tonight.

We were sort of hanging around waiting to see if they could get us an appointment somewhere. I decided to go down and check the mail. Selena has been expecting a sling she ordered off the internet. I went down the stairs, and found the Canada Post slip saying the postman had not been able to deliver a package (which is weird, because we had actually recieved another delivery from Canada Post today---something else Selena had ordered off the internet). Anyhow, i went back up the stairs.

Arriving back at the appartment, winded and sweaty (i'm out of practice on those steps), Selena informs me that we have an appointment with a pediatrician cardiologist at St Clair and Yonge, and we have to leave immediately.

How are we getting there? The only way we can. TTC...

We hastily packed our diaper bag for the first time ever. The trip there actually wasn't too bad at all.

Selena bundled Istra in a blanket, and we headed for the Glencairn subway stop. The postal outlet is on the way to the Glencairn station, so we stopped in hoping that the package was that sling... we could really use it now! And it was indeed the "Wise Woman Sling". We decided not to attempt to figure out how it worked until we got on the subway.

We took the subway, which was virtually empty, down to St. Clair. By the time we got there, Istra was nicely tucked into the sling hanging from one of my shoulders (the diaper bag hanging from the other). Up until now Selena has only taken fairly short walks, and found them surprisingly exhausting, so we didn't want to burden her on this longer journey. We took a street car across St Clair to Yonge. From there we walked one block east and one block north. We made good time and had ten minutes to spare.

The doctor didn't seem to be there. No one was there. We went in into the house (converted into a Doctor's office) and there was no one in any of the rooms we passed. No one at reception. We sat down. After not too long the Doctor came in the front door, and asked us to wait as she had to give instructions to some guys who had come to do some gardening for her.

We took this opportunity to change the baby who had done something quite loud a few moments before. Change her diapers, that is. Not change the actual baby in any way. Just the diapers.

Katrina has told us that it's not all that uncommon for babys to have heart murmers, due to the way the heart starts to work after they are born. It's a complicated explanation that has to with developing muscle and the relative pressure between the heart chambers, and how valves open to the lungs after birth. She said that it was probably nothing to worry about, but that they strongly recommend getting it checked by an expert as soon as possible... just in case...

The doctor finally came in from her gardeners: two largish black fellows, which I may add that by the time we left looked like they had done a pretty nice job back there, despite their, frankly, somewhat rough looking appearance... lots of hostas in a nice circular pattern and some purple flowers I didn't look at closely enough to identify. They were still working when we left. The doctor informed us that she'd just gotten back from vacation and had been planning on taking another week off. The reason she was seeing us now, at 5pm on a friday night, in the middle of her vacation, was that she had to come in to the office anyhow to oversee the gardeners, so when the midwife called her asking if she could look at a baby right away, she figured she might as well since she'd be there anyhow.

She started by asking a lot of questions about the birth, and our family health histories, and all that doctory stuff. I have to admit it felt pretty uncomfortable there having to divulge Selena's dad's heart attacks, and sadly young death, and my dad's high blood pressure (even if that is quite likely more from lifestyle than genetics) and strokes. My mom's dad also died in his 50's from a heart attack, though i'm not aware of any other heart problems in the family. Here we are with this little baby, only 6 days old, which we have rushed across town, urgently resorting to the TTC for transportion, trying to get her checked for heart trouble. Scary.

But even now, I think, despite the nervous feeling, we maintained a pretty stupid confidence that this was all nothing serious. Istra had scored a 10 (a perfect score) on her after birth APGAR tests, which isn't all that common (at least our midwife says she "never" gives out 10s... but she gave our baby a 10). She has seemed very healthy, feeding, and sleeping. Not crying too much. And so on.

The doctor after the interrogation hooked Istra up to some sort of ultrasound cardiac computer. I must say it was a really nifty piece of equipment, even despite looking obviously quite dated. The doctor had hooked 3 electrodes to the baby's chest. She showed us the heart beating. She got the computer to listen to it in all sorts of ways. The ultrasound overlayed itself with a colour coded image which showed blood flows. Cross hairs narrowed in on certain areas. She pointed out these two little orange/red parts that kept appearing and disappearing alternately. She informed us they were little holes in the central heart chamber walls; the bright colour indicated blood rushing through them.

Katrina had already told us that this was probably what the sound she heard was, and that in most cases it was nothing to be worried about. Katrina had spoken in the singular when talking about a small hole in the baby's heart walls. We were being shown two of them. The doctor seemed very clinical while pointing them out. I was trying to figure out whether she was showing any signs of alarm as she described the parts of the heart we were seeing. She didn't seem to be. But then, she's a doctor... but we just listened to her and waited for her conclusions and marvelled at the graphic displays.

She then started sticking bits of tape all over the baby's chest, arms, and legs... Istra was quite upset by all of this. Selena was trying to keep her calm by having her suck on her finger and stroking her head. It worked to some degree. But by the time these stickers started going on, Istra had had enough. And apparently this was just when the doctor needed her to be most restrained. So Selena, while still trying to get her to suck on her finger, had to try to keep Istra's arms from flailing. I was given the job of holding the legs. Poor baby, she was not happy. And this went on for probably 15 minutes. The doctor hooked wires up to the tabs on all of the stickers. I believe this was going to an ECG machine, but i'm not sure what it was. This process was pretty awkward. The stickers kept coming off. At one point when it all seemed set the doctor's stethoscope got caught in the wires and pulled a bunch of them off. It was a mess. But finally, she seemed to get what she wanted... and the stickers came off, and we were told we could dress the baby again.

Back in the office the doctor drew a diagram of the heart, with two little gaps in the central wall. She used red and blue pen, with arrows. And scribbled some notes at the bottom with numbers she matched up to a few of the arrows. She then went into a long and somewhat technical description of how everything worked and what we were seeing. It was pretty interesting, but i can't remember half of it now. She quoted various statistics, none of which I remember. And she said several times that "probably the baby would be able to live a perfectly normal life". I must say, this phrase, in this context was a little chilling!

The long and the short of it is that Istra does have an "organic heart defect" (i remember that specific term that she used, at least), but it does not appear to be serious, and... "the baby will likely lead a perfectly normal life", as she repeatedly said. The little holes generally heal themselves by the time the child is 8 years old, if not much sooner. If they do not heal by the time she is 8 they likely will never heal, but even then they are small and not likely to cause serious problems. I mentioned that our midwife has told us about a possible small hole, but we had seen the baby had two, so was that more serious? The doctor said that while the more holes there are that much more blood escapes between chambers, it wasn't really necessarily more dangerous.

We are to make an appointment to see her again in 3 months, so she can check and see how things are going.

The trip home on the subway and bus was horrific. Selena was completely exhausted already. She walked very slowly, and looked very worn out. The subway was packed. The bus was even more packed. Thank God Selena did manage to get a seat on the bus... the very last one before someone else grabbed it. I had to stand all the way. As did many others... crammed together.

But we made it home. All three of us alive. Hopefully none of us caught any horrible diseases in our emergency trek across town which resulted in a low risk sounding diagnosis, as the midwife predicted, but said that we should do just in case there was a more serious problem.

Istra handled the trip very well. She only cried a slight little bit just as we were nearing our appartment on the bus. The sling which we'd picked up at the post office on the way worked wonderfully. Selena wore the baby on the way home despite her exhaustion, because the baby was hungry... she breastfed her most of the way home... even packed like a sardine on the bus. The sling coming down from her shoulder covered her breast, so that it was really impossible to tell that the baby within the folds was latched onto a naked nipple.

Selena has just now gotten out of the bath. I think she's feeling achy from the exertion. The baby is sleeping beside me on the couch here, half rolled up against my leg. She is wearing a little shirt that makes her hands look like flowers. She has no idea what went on today: oblivious to her first subway, streetcar, and bus rides. Or how many times we've washed our hands...

I heard Elizabeth, our primary midwife, on the phone with the Doctor just before we left. When we got home Elizabeth has asked us to phone her as well. Are we not blessed to have Elizabeth's care? Elizabeth talked to Selena, and pretty much distilled what the doctor had said, but in much easier to understand language. She agrees that it is likely nothing serious, but something to keep an eye on.


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