Joshua had his routine cardiologist visit yesterday.  Overall, things went well according to the doctor, although his extensive exam revealed more damage to Josh’s heart than we’d previously known about (although it’s “mild,” so don’t freak out too much before you read more).  Because Joshua is a squirmy toddler & not too keen on going to the doctor anymore (to say the least!), Dr. Becker, Erick, & I decided to have him sedated for the echocardiogram.  The last 2 times, he wouldn’t stay still long enough for the doctors to get a full look at his heart & they recommended doing it under sedation if he didn’t “cooperate” again.  Last time, Joshua screamed bloody murder during the EKG & pulled the leads off so we hadn’t had that done in almost a year.  The procedure was done at Walter Reed because they have a peds sedation department.  We had to get there at 7am, so parking thankfully wasn’t an issue like usual.  Being me, we were early, so we spent about 20 minutes walking around & looking at the animal paintings on the wall of the peds ward.  Joshua enjoyed this so that helped pass the time.  Once Joshua took the medication (although he spit out about 1/4 of it), he fell completely asleep in about 5 minutes.  The nurse quickly got the EKG done while Dr. Becker was setting up the computer for the echo.  Joshua cooperated wonderfully this time since he was out of it—he even snored for part of the time (that reminded me of my grandpa, who fell asleep & snored during his cataract surgery!).

Dr. Becker took around 45 minutes to perform a very thorough echo to take full advantage of the sedation.  Because he got to look around for so long, he found more than was previously noticed.  For the good news, he found that Joshua’s VSD (the small hole between the right & left ventricles of his heart) has completely closed, which means that Josh might not need to take antibiotics before dental procedures down the line.  He also said that Josh’s other problems (the aortic insufficiency & pulmonary stenosis) haven’t gotten worse & are still graded as “mild.”  As for the new stuff, it turns out that Joshua has what appears to be a PDA (patent ductus arteriosus), which is basically an opening between the aorta & pulmonary artery.  It was hard to tell if it was actually a PDA or if it was a collateral vessel that was just very close to where a PDA would be.  Either way, he said there was nothing that needed to be done about it for now other than monitoring.  It also turns out that Joshua has mild pulmonary artery stenosis, which is a narrowing in the artery that supplies blood to the lungs.  So that’s the news.  It’s nothing scary to the cardiologist, who tried to reassure me that these are common problems for a TGA kid & nothing unexpected.  But to a mom (or dad, grandparent, etc), it’s still scary.  We go back for another check-up (without sedation) around Joshua’s 2nd birthday, & if all goes well, then Josh will only need to go for cardio checks every year.  That’s great news, but I still like the reassurance of getting a look at his heart more frequently.  But that’s because I’m a worrying mom, I suppose.

Joshua slept like a little angel for over 3 hours.  I was smart & brought the fingernail clippers with us so it was the easiest time I’ve had in a long time cutting his little nails!  When we got home, Josh had a lot of lost play time to make up for, but it was exhausting for me because I had to be right with him wherever he went because he was somewhat drunk from the drugs.  He kept toppling over when he would make a quick movement, but it didn’t take too long before he could at least stand up & take a couple of steps.  But leave it to Josh to not be satisfied with that—he wanted to climb all over things like usual, which he wasn’t able to do without Mommy helping.  It was a very long day for me since I woke up around 5am & didn’t get a nice, long nap like Joshua did.  Despite being drunk, he was full of energy from his “nap” at the hospital.  I even tried putting on a Disney cartoon to see if that would keep him still for a little while, but it didn’t work.  He did take a short nap in the afternoon, but not long enough for me to get any rest.  Boy, I slept well last night after that long day..

As for today, Joshua graduated from the synagis clinic!  He had his last set of RSV shots–yeah!!!  I am so glad that he’s completed all 5 for the year because the last 3 appointments were very emotionally difficult for both of us.  Joshua cried for most of the time, although his stuffed tiger Sue helped a little.  The doctor even listened to Sue’s heart with her stethescope before even attempting to listen to Joshua’s.  It was really cute, because Josh was very protective of her & seemed upset at first when the doctor tried to examine her.  Fortunately, we won’t have to do this next year because they think Joshua’s immune system should be strong enough by next winter to fight off RSV should he get it.

Next week, Josh will be a year & a half old!  It’s hard to believe that time has flown by so quickly.  I’ve been looking into nursery schools recently & it’s been weird to think about Joshua starting school already.  I was watching the little 2-year-olds at the school I visited this week & they seemed so grown-up compared to how Joshua is at this age.  We’re in for quite a year because it’ll be him this time next year.  Before I know it, my little toddler will be going off to college (alright, I might be getting ahead of myself a little, but it’s still hard to imagine Joshua starting school).