We heart Xmas

By some misfortunate fluke of scheduling, Hope's annual heart examinations always seem to fall near Christmas. And nothing pauses the Holly Jolly quite like anxiety over aortas.

True to form, Hope's annual checkup was Thursday. We switched doctors this year, transferring from the lovely cardiologist in the suburbs to a doctor at Children's Hospital of Detroit, which performs surgeries should they ever be necessary.

It was a long checkup, 2-hours plus, all told, and Hope performed like a champ, giggling at the EKG leads and fiddling with the echocardiogram as the docs checked out her ticker.

The good news, and it's great, is that Hope's issues are status quo. She has a bicuspid aortic valve, which means the valve that regulates blood flow from the heart into the aorta has two leaflets rather than three. She also has a slight jog in the curve of her aorta, which could be suggestive of a very mild coarctation or narrowing. That could present an issue down the road with blood getting to where it should, and worse case, one day lead to a stint to open it and keep things moving.

Or maybe not. So far, neither present a problem. Her blood pressure's great, the blood is flowing like a trucker on 5-hour energy drinks. As it was last year, these are just things we have to wait and watch as they develop. We see them again in a year.

Until then, it's back to the holly jolly stuff.

Cardiac Christmas

Hope saw the two most important people yesterday: Santa and her cardiologist. She was ho-ho-hum about Santa, but kicked, giggled and waved her arms for the cardiologist. The girl's got some suspect priorities.

But maybe she was on to something. The cardiology appointment is a biggie. We've worried about it for weeks, in our familiar way. First, we deny and refuse to discuss. Then, as it approaches, we feel sick to our stomachs and paralyzed by dread until we're in the waiting room thinking, "Oh God, we're going to spend Christmas in the hospital."

It's not the ideal strategy, but so far, so good.

And it sort of works: Hope's appointment went well. Her heart is still a bit abnormal. She has a narrowing of her aorta, which could be suggestive of a mild coarctation. Some blood appears to be flowing a wee bit faster than it should, which could lead to other problems down the road. But not now. Her numbers are great. Her heart is working as it should. There's no change from seven months ago.

In short, good news. We don't have to see the cardiologist again for nine months.

Merry Christmas indeed. Phew.

We wait

Hope has a big heart. It sounds like swell news and something she comes about honestly -- Mo is nothing if not magnanimous -- but it's probably not.

We returned today to the cardiologist for a follow-up appointment. Of the issues that send Hope once a week to various specialists, her heart defects are the ones that terrify us. We fill notebooks cataloguing her daily feeds and weight, debate the quality of her poop and sleep for hours and absolutely delight discussing her latest smiles, farts and grimaces. But we barely talk about her heart issues because they're that scary.

Or maybe they aren't.

As we learned six weeks ago, Hope has an abnormally thick left ventricle. That's the main pumping chamber of the four that comprise her heart. It's on the mild side of big -- we're talking perhaps 5 millimeters compared to 3 -- but it's definitely measuring larger since her birth. Presumably, that's from overuse. Like a muscle, the heart grows bigger when it's asked to do more. It shouldn't have to do all that much for a little girl who turned 3 months old today.

Oddly enough, Hope's heart appears to be working well. Her blood pressures indicate it's doing a bang-up job distributing blood through her body. The flow through her heart seems fine as well. And the cardiologist today ruled out aortic coarctation, a pinching of a valve like a garden hose that causes blood to flow with increased velocity -- and worried us the most just two months ago.

So, like a lot in life and medicine, we're left with an unknown that's only resolved with time.

If her heart is growing thicker, it appears to be doing it on its own. There's no blockage making it work harder. The tissue itself could be abnormal, a very serious condition known as cardiomyopathy. We don't know now. This could go away, be a lifetime condition managed -- but not fixed -- by medicine, or it could eventually prove fatal.

So we wait.

The unknown is frightening. We're not good at it. But there are worse outcomes. The thickening isn't severe enough to rush us back to the cardiologist soon. We have a follow-up appointment in three months. We left feeling OK. The morning was stressful -- Hope melted down during an echocardiogram, EKG and blood-pressure screenings -- but our big, unspoken fears weren't realized. The tests didn't find more problems to require immediate surgery.

Driving home, we talked about the last few months and years. I launched into an empassioned diatribe of gobbledygook about how this is the defining moment of our lives. It sounded awesome for about 40 seconds. Then, as is my wont, it quickly made no sense.

Mo cut me off: "If anything, this just teaches me once again that we need to savor every day like the gift it is." She's right, of course. I'd be tempted to say she has a big heart if I didn't just learn that isn't always a good thing.