Matthew is feeling much better this morning. When I walked in his room, I was greeted with a smile and Matthew’s signature “happy sqirm.” As my dad says, “Matthew smiles with his whole body!” He had a really good night, and they were able to take him off the oxygen completely! He is O2 sats rage from about 92-99% on room air right now. He really likes having all the tubes off his face, too! We’re discharged from the PICU and on the intermediate pediatric floor now.
We were also able to talk with Dr. Anderson (cardiologist) this morning, and learned that we didn’t quite get the correct information from his nurse last night. His echocardiogram yesterday actually showed a moderate amount of right heart failure with increased pressures in the pulmonary arteries and some pulmonary hypertension with pulmonary edema, and enlargement of the liver. His repair looks good, but he does have some tricuspid regurgitation. His left heart is doing just fine.
In non-medical terms, this means that the right side of his heart, which pumps blood to his lungs, is not working as well as it should. This causes lung problems, and causes fluid build-up all over the body. The patches with his heart repair look really good, but he has one leaky valve. It was expected due to the complexity of the valve repair, and it should not cause any major problems.
Dr. Anderson said that it is not uncommon for kids with Down Syndrome to have some pulmonary hypertension, even without heart problems. Right now they will treat it with diuretic medication and digoxin.
When Dr. Anderson looked at Matthew this morning, he said he was much improved from yesterday – he was breathing easier, his liver has already gotten a bit smaller, and his O2 sats were good on room air. He said he would expect that if they did another echocardiogram today, it would already show significant improvement.
His chest X-ray from this morning shows a lot of improvement from yesterday, too. The collapsed portion of his right lung is opening back up, and he has less fluid on his lungs.
They are talking about letting us go home very soon. We just need to make sure Matthew is eating well (he’s getting better), and we’ll be able to go home!
He said the issues of right heart failure and pulmonary hypertension may get better as he recovers, or may be a long-term issue that we have to follow up on. I told him, “It’s Matthew – he’ll just heal his right heart on his own!”
Dr. Anderson agreed, “I wouldn’t be surprised. This kid is incredible.”