A healthy heart and a growing mass

A little muscle-flexing action from our little warrior :)

This week was our first set of appointments since our CCAM diagnosis. We first met with a cardiologist on Monday and had an echo cardiogram done. This was to look at the actual functioning of the heart in greater detail than was done at our other ultrasounds.

At our first ultrasound, our doctor hinted that there might be a ventricular septal defect (or VSD) which basically amounts to a hole in the septum of the lower chambers of the heart. Immediately my brain went "Eeeee!", but he assured us it wasn't certain, nor did it mean anything horrible. Our cardiologist told us she couldn't find it, and didn't think it existed. Huuuuge relief. Furthermore, she told us everything was structurally sound, and the heart was functioning just as it should (aside from being pushed over to the other side of the body). It was still oriented correctly, the arteries leading to and from it were in working order, and she went as far to say that there shouldn't be any complications in terms of the heart after birth. Again... huuuuge relief! This meant that aside from this CCAM, baby looks healthy. Once the mass is removed/shrinks/whatever, we won't have any heart issues to deal with.

Our second ultrasound at Froedtert was today. Again, we were told that there was no evidence of a VSD (yay!). We were also told that the mass had grown since our last appointment two weeks ago. I wish I could remember the exact measurements, but they escape me at the moment.

There was a moment at our first ultrasound that the doctor asked the technician if she could get some ratios for him, and she replied right back that she already computed them. It was pretty funny, and although I remembered what she said, I couldn't catch what it meant. 

Basically, this ratio is used to predict how likely hydrops is to occur.  Hydrops is when fluid collects around various parts of the body due to heart failure. The ratio, or CVR, is computed by taking the size of the mass and dividing it by the circumference of the head. Our ratio at our first appointment was 1.2. Today it was 1.3.  Although it went up, our doctor told us that 1.6 is the red zone. So, we're still ok. Our cardiologist told us that there was an "insignificant" amount of fluid around the heart currently. So, while this sounds pretty scary, we're still good.

We were told, and I read, that growth is likely, so we shouldn't be alarmed or worried when we are told at every appointment that the mass has grown yet again. This is to be expected. I'm kind of at the place where "high alert" is the new norm.

We're still scheduled every two weeks for an ultrasound, and in a month we'll be meeting with a pediatric surgeon to discuss potential outcomes for the baby. If things start looking a little more stable, we might cancel future appointments, but again, there is no way to predict what will happen (definitely the most used phrase in the past month).

We also discussed (briefly) things like steroids to help shrink the mass, the fact that I might be induced or undergo a c-section, and the fact that I might give birth at Froedtert in case baby needs help after birth. While I wouldn't mind delivering at a different hospital, being induced or getting a c-section freaks me out. My body labors so well (contractions for a little while, 4-5 pushes, and BOOM, baby) that I really hope we can go that route again. Obviously, this would mean baby is doing ok, but the selfish part of me wants this to happen per usual just for my own sanity. I know, totally selfish.

But again, no way to know right now.

Maybe it's my typical post-clinic mood, but I think I'm accepting of the fact that this isn't good, but it isn't bad either. The unknown is ok. We have a long way to go, so as long as nothing devastating happens, we can dig in and get through the next couple of months. I feel super confident in the staff, doctors, and our family.

Yup, I think it's probably just my post-clinic mood. Give it a week or so and we'll see ;)

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