Tuesday, September 1, 2009

The Good, The Bad, And the AVA.

Ava had her third cath of the year, second time trying to place a stent, and....IT WAS A SUCCESS! :) So as the sign her Daddy made her so clearly states, AVA ROCKS!!! The good.

Dr. Van Awesome(Gundy) found that little Miss Ava's Left Pulmonary Artery was only 2.5, normal is 7, in size. The general rule of thumb is to only double it's size at one time, so we got it to 5, Part 1 of the bad. Ava will need the stent to be expanded in 6-9 months to get that LPA to a better size, Part 2. Dr. V found a huge increase of leaking from Missy's shunt, part 3. Now, it's been leaky for awhile, that's just how it goes. But part of the possible reasons for the sudden surge may be the wonky pressures due to her LPA being SO stenotic. SO, the stent MAY help, it may not. Ava will have an ECHO in 3 weeks, and then every 3 months after to check that darn leaky shunt.

A run down of the day...We all woke up around 4am, were out the door by 5:10, made a quick stop at Starbucks(necessity) and was at UCD admissions just after 5:40. Not bad. They changed around how they admit Cardiac Cath's now, so Ava went straight to the recovery area instead of up to 7, then back down to 1 where the Cath Lab is located. Makes sense, and this way we don't have a "neighbor" we are worried about Miss Crazy waking up. A little before 8 the anesthesiology crew started appearing and we made our way to the lab. Ava was given a med cocktail(versed and benedryl) that made my little chica QUITE giggly and loopy. She was laughing at the lights, found it hilarious that she had a nose, and was singing up a storm. So instead of her usually scowling at everyone right outside the cath lab doors while they are prepping for her inside, she was waving and saying hi to everyone and serenading them in between random giggle fits. :) Plus, she got VERY sleepy. So we took her back once they were ready, they let me stay until Ava was asleep, Greg watched through the partitioned window, and we made our way back to the waiting room. I am thinking we got back in the waiting room just after 9am. We sure didn't have to wait very long, Dr. Van Gundy came out around 11:30(though I overheard the front desk lady on the phone with recovery telling them that, "Little Miss Bolima is about 30Min's out", so I allowed myself to imagine all had gone well since there were no other orders with that call, and it had been such a short time. Luckily, I was right! Dr. told us the news, which I went into earlier on here, and we waiting about another half hour, 45Min's before they collected us and we walked Ava back to recovery. Now, there was two super nice nurses taking care of missy in recovery, one of which said she TOTALLY remembered Ava from before(3 years ago) when missy was up in the PICU. She was super happy to see Ava and how well she looked. It's always really nice to see people, Dr's nurses, etc, that ONLY knew Ava from that time, for them to see her now, the reaction is always the same. You could literally pick their jaws up off the ground, and the smiles are infectious. I love the gentle reminders of how far she has come. So they get Ava all settled into recovery, and tell me that she will probably remain asleep for a couple of hours, a minimum of an hour, though. And once she is awake they will remove the oxygen mask and we will make our way up to 7. Not 15minutes later guess who's eyes go FLYING open?! And what's the first thing she does, YANK that oxygen mask off before anyone can react and then she goes straight for her IV, boarded up hand. Luckily, we could stop her before she yanked that thing, but barely! This girl has some serious superpower strength when she feels the need to. Of course, she was really, really angry and screaming like she's never screamed before, thrashing around, you know, all the things you should NOT do just an hour after a cath/stent placement. So they gave her a little bit of morphine and Ava calmed down instantly. We got up to special care on 7, and see yet another familiar faced nurse. She recognized Ava by name and said again how healthy and big and beautiful, etc she has gotten now. :) We had quite a few more faces pop in to see Ava that day. Even Velma, the super sweet social worker. LOVED her. Ava was kinda quiet and you could tell she was upset with us all, but did not fuss or complain. As long as we let her eat what she wanted to, and watch what she wanted to, and kept nurses out of her face(lol), she was a happy camper and finally came around and stopped saying she was mad at her Mommy and Daddy(again, who can blame her, though). So we watched Dora the Explorer and 101 Dalmatians about 100 times each, Ava ate lots of yogurt and Doritos, drank apple juice and we waited. There was a bleeding issue while we were still down in recovery, her cath site started bleeding heavily and that caused some concern with Dr. V. Of course. And then again, though not nearly as severe and it subsided on it's own once we were in Special Care on the 7th floor. So basically we had to wait the 5 hours, PLUS, to make sure it didn't happen again. We checked her at 7:30, no bleeding, GREAT! Dr. said to check again in an hour, if there is still none, we could go home...Ava's night nurse checked again, all was OKAY, so she got the discharge papers together, the IV out and away we went! Ava sang at the stars the first half of the car ride home then fell asleep, and stayed asleep until about 4:30, 5am this morning. She wanted hugs and kisses and said lots of I love yous. Sweet girl! Her daddy got her back to sleep, though. :)

All in all, we are so happy and so relieved that our diva has that stent finally in a PERFECT spot. It is a huge relief. And while we MAY be looking at another surgery much sooner than originally anticipated(to replace the shunt), we may not be, either. We will cross that bridge when we get there. This is our life. We left that second amazing huge double ventricle repair knowing that although she didn't need that third repair OHS, she would still need a couple more OHS, to "replace parts". We are still very lucky, very blessed, and I hope we never lose sight of this. We have a darling, loving, bright, sunny, brave, happy, independent, adventurous little girl that makes friends with everyone she meets. Ava does day to day things that we thought we might never see her do, I wake up every day and am SO thankful. I seriously wonder how we got so lucky.

A few photos from the day...

-The very nice lady in the waiting room let Ava pick out some stickers. Ava of course, picked the hearts, and proceeded to stick them all over not only her face, but her baby doll's face as well. :)

-Ava drew this super funny picture and when I asked her who it was, she pointed at her nurse, hee hee! Pre-cath.

- In recovery, just a little oxygen mask until the diva full woke up on her own.

-Ava wanted Daddy's hat. Not very happy with anyone, who can blame her, though!

-But all smiles and snuggles by the end, that's our missy! :)


Carey said...

So glad to hear all the good news and that you got to go home last night! What an amazing girl you have! She'll be able to handle what comes with the bad news.

Carlla said...

Ava looks so cute! The picture below with her little tiara is adorable! Hopefully the next surgery will be later rather than sooner! Glad to see that she is doing well!

Gina and the Gang said...

Sorry my visit to the blog was a little late, but I am SOOOO glad you had such an "easy" cath this time around, and the outcome was exactly what you hoped for!