15 November 2012

32 Weeks - Update

Tomorrow we travel yet again to the Cleveland Clinic for another fetal echocardiogram, an appointment with our perinatologist (and a 3D ultrasound!!) and also a meeting with the baby's heart surgeon. 

During our last fetal echocardiogram, the doctor noticed that the baby had a small leak associated with one of his heart valves.  She also reminded us that his heart has a mild unbalance, with one side (possibly the right) being larger than the left.  In addition to the holes associated with the CAVC, I'm anxious to learn if either of ant of these issues has gotten worse (or possibly better ?).

My only real questions for the perinatologist center around the baby's perceived low weight (last we knew, he was in the 17th percentile) and what I can do to help him gain?  Also, my regular OB doctor suggested that we'll likely be beginning weekly surveillance to monitor his heart and blood flow.  Lastly, I'm interested to know if my c-section has officially been scheduled?

For the doctor set to complete baby's heart surgery, I've found the following questions on the internet to cover during our consultation tomorrow:

Questions about the surgery itself:
  1. What symptoms make this surgery advisable?
  2. What will likely happen if the operation is not done?
  3. How will the operation improve health or quality of life?
  4. Are there any common complications after the operation?
  5. Who will be the patient's cardiologist at (name of hospital) ?
  6. How long does the surgery usually take?
  7. What's the average length of hospital stay?
  8. What kind of follow-up is expected after the procedure?
  9. What type of long-term follow-up does one need in the years after surgery (i.e. doctor visits, echos, EKGs, etc.)?
  10. Are there any restrictions in lifestyle post-surgery? Weight lifting, high impact sports, or sports of any kind?
  11. How do we go about setting up a consultation appointment with the Surgeon?
  12. Will the patient need to accompany us to the consultation?
  13. Is this a teaching hospital?
  14. Who will be doing the surgery? How many surgeons will be in the room?
*** -Note- *** At most teaching hospitals, the senior residents can do all, or a significant part, of the surgery. If you want to be sure that a particular surgeon does the operation, make sure you have it placed in writing in your chart that Dr. (name of surgeon) is to be your primary surgeon.
  Questions about the surgeon & rate of success:
  1. How many (name of surgery) have you done? On adults? On children? On infants under the age of 1? (depending on your particular situation)
  2. What has been your success rate? Do you know about long-term success rates?
  3. What area do you specialize in? Adult, child, or infant cardiothoracic surgery?
  4. How many total heart surgery procedures are done at your hospital each year?
  5. What is the overall mortality rate at your hospital?
  6. What type of certification do you have? Board certified? Approved by the American Board of Specialties? Fellow of the American College of Surgeons (F.A.C.S.)?
Other Questions Regarding Pre-Op and Post-Op Care:
  1. Can parents accompany child to the operating room until they are asleep and can they be in the recovery room when the child awakes?
  2. What is 'Plan B' if the surgery cannot be performed for some reason?
  3. What would have to happen for you to revert to 'Plan B'?
  4. What do you do for blood transfusions - do you take donor blood before surgery? Can family members donate?
  5. What type of materials are you going to use (Gore-Tex, human, porcine (for valves), mechanical (for valves) or other)?
  6. What will you do for nausea - will you give medication to treat it? How liberally?
  7. What will you give for pain meds? How liberally?
  8. What kinds of post-op medication will you have the patient on (e.g. aspirin, blood thinner, blood pressure med, etc.)? For life, or approximately how long?

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