Part 10 - Questions and Answers

The day after meeting with the GC, I received a phone call from Dr. J (the OB). He wanted me to know that Dr. K had called him to tell him the test results. He just was calling to find out how I was handling everything. When I told him the shock was starting to wear off and we were coming to terms with everything he remained quiet for a moment. Knowing that he was trying to come up with a tactful way of saying something, and figuring I knew what that was, I let him off the hook. "I know what my options are." I heard him let out a breath on the other end of the line. "Have you decided?" he asked. I told him a little more about what Arty and I had discussed, about not deciding anything until we knew if she had a healthy heart. At the end, I said, "I think you know me well enough to know that I won't give her up unless it's the absolute right thing to do FOR HER." He replied, "I pretty much thought that was what you were going to say." We finished the conversation with him saying to call him on his cell phone if I had any questions, or if I needed him for anything at all. I have to say, I couldn't have chosen a better doctor, or a more supportive friend than he.

I went back to work on the days I was well enough. It was very difficult to answer the questions of my boss and my coworkers. I cried many times during my explanations, but the more I talked about it, the easier it became. Working for a doctor, there were many representatives of different companies who frequented our facility, and most of them became my friends. I had many discussions with them. I'll never forget talking to one friend on the phone at work one day, and she asked how the pregnancy was going. When I told her the baby had Down Syndrome, she said, "Well, that's okay. She'll still be a baby, and she'll be yours." Yes, she will be. Once I really got that through my head, (and got my heart to understand) things started turning around for us.

The appointment with Dr. K and his UT went better than we'd known it could. The baby's heart wasn't perfect - it did have two holes. (These are commonly referred to as "murmurs".) One hole is an atrial septal defect.

** Normally the heart has four chambers: two upper chambers known as atria that are separated from each other by a fibrous partition known as the atrial septum and two lower chambers known as ventricles that are separated from each other by the ventricular septum. Valves connect the atria (left and right) to their respective ventricles. A small opening between the two atria (foramen ovale) is present at birth. Shortly after birth, the atrial septum gradually grows and seals this opening. In infants with atrial septal defects, the atrial septum may not close properly or may be malformed during fetal development. In these disorders, the opening (called patent foramen ovale) between the atria persists long after it should be closed, resulting in an increase in the workload on the right side of the heart and excessive blood flow to the lungs.

The second hole is a Ventricular Septal Defect

** A ventricular septal defect can allow newly oxygenated blood to flow from the left ventricle, where the pressures are higher, to the right ventricle, where the pressures are lower, and mix with unoxygenated blood. The mixed blood in the right ventricle flows back or recirculates into the lungs. This means that the right and left ventricles are working harder, pumping a greater volume of blood than they normally would.

** Eventually, the left ventricle can work so hard that it starts to fail. It can no longer pump blood as well as it did. Blood returning to the heart from the blood vessels backs up into the lungs, causing pulmonary congestion, and further backup into the body, causing weight gain and fluid retention. Overall, this is called congestive heart failure.

While any heart condition can be potentially serious and fatal, these two holes in the heart are about as minor as they could be, especially in the case of our baby, because both holes were relatively small. At this early stage of gestation, the VSD could still close on its own before our baby is born. If they don't close before she is born, they can still close after birth. They would evaluate her and decide if she would need surgery to close the holes, or if she was doing well, they would wait and see if the holes would close on their own.

We received more (relatively) good news as well. The fluid in the ventricles of her brain had decreased slightly so that the level of fluid was considered in the "high normal" range. This was good news since if she continued to have too much fluid, it could result in her needing surgery to place a stent into her brain to drain excess fluid - something she would most likely have for the rest of her life.

Even though we never wanted our daughter to have congenital heart defects, if she HAD to have them, these were easily the most treatable. Arty and I left the office that day smiling - for the first time in a long time, and I felt like I could actually breathe without telling myself to do so.

Things were looking up...would they stay that way?


(** This information is a WebMD Medical Reference from eMedicineHealth.)