The echocardiogram

Yesterday was Little Sister's fetal echocardiogram. I'll admit that this whole time, I've been more worried about getting lost on the way than I was about finding anything wrong. After all, from everything I'd heard, it was all going to be just fine. There was no sense in worrying about something I couldn't change, anyway. Getting lost was much more likely.

However, getting lost (which happened, as anticipated) does not preclude heart problems, and as it turns out, you can not only have to pull over and consult a map on the way to a fetal echocardiogram, but you might also hear bad news once you're there.

I'll tell the rest of the story, but in the interest of not driving all of you crazy, I'll start with the end: the baby's heart has a small hole in it that will cause a heart murmur when she's born. It'll very likely heal on its own within a few months. It's a relatively common problem, and if you're going to have a heart defect, this is probably the one you'd want to have. Should really be no big deal and, on the plus side, it didn't look like anything else was wrong, and it's unrelated to the arrhythmia we heard last time, which had disappeared. So it's kind of good news and bad news, right?

And please don't freak out on me. If you freak out, I will too, and that's the last thing any of us need right now. I want you all to remain level-headed. We wouldn't have even known about this for another month and a half if it hadn't been for the completely unrelated arrhythmia, so no one's allowed to worry, openly, around me, anyway at least until 2-3 days after the baby's birth, which is when it would've showed up. And it's not a tragedy, just a little thing we have to face. In the meantime, you are allowed (and encouraged) to pray--that's the best thing for all of us right now, anyway.

Onto the story.

I got lost on the way to the appointment, and I blame it on the fact that the area I was driving to was cut off on the map and continued on a completely different page, as are most of the unknown places I drive to. I had looked up directions in advance, but that made no difference. I can get lost in a tent.

Fortunately, I had allowed plenty of time and made it to the gorgeous lobby of the Duke Children's Health Center with minutes to spare. I opened the book I'd brought, and kind of hoped the wait would be longer rather than shorter.

It wasn't: within 15 minutes or so they'd come to get me. The ultrasonographer was a far cry from the brisk, businesslike professional I'd convinced myself to expect. We chatted like old friends as she began the ultrasound.

"Wow, your little girl takes great pictures!" she enthusiastically commented.
"My girl at home does, too!" I enthusiastically responded.

This became a common theme through the ultrasound--apparently, Little Sister was cooperating so well that the images we got were pretty much textbook quality.

"I could look at these all day," the ultrasonographer often said. I had my answer for why this was taking so long (not that I minded).

I, myself, enjoyed watching the baby's heart pump away--it was very rhythmic and calming. We could see the blood flowing around, and hear how each section of the heart had its own unique sound. Amazing. I think in another life I would become an ultrasonographer.

She also noticed at one time that Little Sister seemed to be exercising her lungs. The baby of course doesn't have any air in there yet, but she was kind of moving her abdomen where they are. Keep up the good work, Sweetie! You'll need those! Cute.

And then it was time for the doctor to come in, to take another look and answer all my questions. I tried to doze as I waited, relieved that the ultrasonographer was still upbeat and happy. Nothing could be too wrong, right?

I again expected a brisk, businesslike doctor and was instead met with a nice, friendly guy who had a great rapport with the ultrasonographer. We discussed our Norwegian spouses (the name is always a dead giveaway) and nuances of the Norwegian culture. I was impressed by his ability to make interesting smalltalk while potentially diagnosing heart issues in my unborn child.

And diagnose he did. After the scanning was over, he sat down for a chat with me:
"The arrhythmia has entirely disappeared," he said, just as I expected. But he wasn't smiling as he continued, "However, there is something we need to talk about."

Sometimes sentences take entirely too long to say. And the pause between sentences can be even longer, and then the sentences that follow, until you get to the part that states, "but the hole in the baby's heart will most likely heal on its own and cause no problems," can be excruciating.

But fortunately we did, eventually, get to this final sentence fragment (or something like it--I wasn't thinking clearly at the time), and then the doctor used as many words as it took to reassure me that everything really, truly, for real should be just fine.

Little Sister has a birth defect called Ventricular Septum Defect. It's a small hole between the two ventricular chambers that is allowing blood to flow back and forth between them (more or less). The septum is a muscle, with lots of muscle fibers, and what happened is that some didn't seal up completely as the heart was being formed. As the heart grows, the hole should naturally seal. The only thing that's a tiny bit worrisome is that the hole is close to the very bottom of the heart, where there's less muscle that can join together. Still, the doctor wasn't worried.

This shouldn't become a problem, but if it does, it'll manifest itself in difficulty feeding and gaining weight. However, the baby will be monitored with extra appointments and such, so we'll make sure she's okay. And even then, there are "things we can do." I didn't ask what those were.

He added that the only way he could even determine there's a hole was because the pictures were so clear that he could see the blood flow rushing back into the ventricle it'd come from. This is what produces the murmur, which should be audible by 2-3 days after birth. He said that it's nice we'd caught it before birth (even though normally we wouldn't have), because once anyone hears it on a stethoscope, they'll start freaking out--but we'll already know it's just a small hole, and we'll already be planning follow-up care.

The follow-up care will include an echocardiogram before Little Sister leaves the hospital, as well as a visit with him probably 2-4 weeks after birth, and another probably 3 months after birth. It's nice to live so close to a respected health system, and to already be under the care of an expert.

And even though I didn't ask, the doctor also made sure that I understood (and practically had me repeat it back) that there's nothing I did to cause this--not even a genetic factor. It happens. It's fairly common--one of the top 2 conditions they see. It's really no big deal.

He also stressed that we're not allowed to Google this--VSD can be associated with lots of scary things that he's confirmed Little Sister does not have. I will take his advice and I'd strongly encourage you to do the same.

Finally, the doctor said that this won't affect the rest of my pregnancy or my delivery. I think I have his leave to continue to celebrate a mostly healthy baby, or one that should be completely fine by the time she's solidly into 6-month onesies. That's my plan, anyway.

And the arrythmia? It's completely gone, and was probably caused either by my stress at the time or the fact that I'd overdosed on M&Ms in the week or so before my last doctor appointment. But the M&Ms have been out of the picture for a while now, and I've been working to keep my stress levels low (is that an oxymoron?), so we likely won't have to worry about that again.

It was a strange evening last night as the news sunk in for all of us, but there was a toddler to care for and supper to make and my sister's dog to walk as happy distraction. For some reason, we decided we'd all feel better if we had hot fudge sundaes at McDonald's, even at the expense of Kalina's timely bedtime. It worked, at least in the short term, and now the only things left to do are wait and pray that this doesn't turn into a bigger deal than the doctor promised it would.