Thursday, May 22, 2014

Dealing with VSD: Part 2 - What is VSD?

This post, I copied from a few sources that I have quoted. Just for your knowledge on what VSD is.

~Ventricular septal defect describes one or more holes in the wall that separates the right and left ventricles of the heart. Ventricular septal defect is one of the most common congenital (present from birth) heart defects. It may occur by itself or with other congenital diseases.~ National Institute of Health, USA


Causes:

Before a baby is born, the right and left ventricles of its heart are not separate. As the fetus grows, a wall forms to separate these two ventricles. If the wall does not completely form, a hole remains. This hole is known as a ventricular septal defect, or a VSD.
Ventricular septal defect is one of the most common congenital heart defects. The baby may have no symptoms, and the hole can eventually close as the wall continues to grow after birth. If the hole is large, too much blood will be pumped to the lungs, leading to heart failure.
The cause of VSD is not yet known. This defect often occurs along with other congenital heart defects.
In adults, ventricular septal defects are a rare but serious complication of heart attacks. These holes do not result from a birth defect.

What Can be Done about VSD?
If the opening is small, it won't make the heart and lungs work harder. Surgery and other treatments may not be needed. Small VSDs often close on their own. There isn't any medicine or other treatment that will make the VSD get smaller or close any faster than it might do naturally.

If the opening is large, open-heart surgery may be needed to close it and prevent serious problems. Babies with VSD may develop severe symptoms and early repair, within the first few months, is often necessary. The repair may be delayed in other babies. Medicines may be used temporarily to help with symptoms, but they don't cure the VSD or prevent permanent damage to the lung arteries.
Closing a large VSD by open-heart surgery usually is done in infancy or childhood even in patients with few symptoms, to prevent complications later. Usually a patch of fabric or pericardium (the normal lining around the outside of the heart) is sewn over the VSD to close it completely. Later this patch is covered by the normal heart lining tissue and becomes a permanent part of the heart. Some defects can be sewn closed without a patch. It may be possible to close some VSDs in the cath lab.
-American Heart Association-

Now, what I shared hear is pretty much VSD on a child. VSD however could also affect an adult. You can google VSD for more information on the disease.

Tuesday, May 6, 2014

Dealing with it. VSD & PDA in a child and handling it as a family: Part 1

As you have read on my previous post, we had a beautiful baby boy, about 4 months 3 weeks ago. My journey, my husbands journey towards parenthood was wonderful, giving birth to Arif was such a beauty (I went thru a c-section, and I loved every moment of it, up till I heard Arif's cry as soon as he came out of my tummy.)

But, everything almost completely came down crashing on us, about three days after his birth. Arif's pediatrician was making his last check up on Arif before we were allowed to go home. Me n my mom was in my hospital room, and Yus was back in Penang to settle some job. About an hour later, Arif's Paeds came in and told us that Arif had jaundice and he heard a murmur in Arif's hearbeat. He had called upon a child cardiologist to check on Arif later in the evening. In the mean time, Arif would have to stay in the hospital until his jaundice clears off. Arif would have to be put under an ultraviolet light in the Special Nursing Care Unit, at the end of the hospital ward.

When Arif's paeds told me that he had jaundice, I wasn't nervous. I knew it could happen because of the readings I did and how common newborns could get it. But when the doctor told us that he found a murmur, my heart skipped a little. Nervously waiting until the cardiologist arrived in the evening. (It was little before noon when the Paeds told us)

At about 6pm, the nursing room called me to come to the nursing room, as the cardiologist had already arrived. So i rushed to the room, where Arif was in his special bed, Eyes covered with a cloth and net. The doctor was doing an ultrasound on him and was really, really quiet. Concentrating I guess.

I watched from far the Ultrasound machine screen. I knew there was a whole. Why? Because when I was younger, I had a hole in the heart, but it closed by itself. The routine check ups still linger in my mind sometime, and I can still remember how an ultrasound of a baby with a hole in the heart looked like. And Arif's looked exactly like that. My heart was pumping hard. Mom wasn't allowed to go in. So I was there alone with Arif, the nurses and the very serious doctor.

Then the doctor asked me to sit down by the table in the nursing room. He then let out a sigh and put a string of ultrasound prints on the table. And then he explained.

Arif had what they call a PDA (Patent Ductus Arteriosus), a whole between the left and right ventrical of the heart, in which old blood and new blood mixed. He also indicated another hole which he thought was not a concern. I remember clearly the doctor saying "Don't be to optimistic that the hole would close on its own, because it is quite a large hole. But I will check it from time to time". I was holding back tears by then. I stayed back for awhile to nurse Arif and watch the nurses change his diapers. My mom and aunties were waiting anxiously outside for me to come out with the results.

I didn't reach the exit door of the special care nursery before I broke down in tears. Mom must have figured something and opened the door in between the exit area and the nursing area and saw me crying. Mom asked me what was wrong, but I didn't want to talk just then. I walked quietly while crying back to my room in the maternity ward, while mom and a string of my relatives followed suit behind me. Macam drama pun ada kat tengah2 maternity ward tu.

As soon as I came into the room, mom asked again what the doctor said about Arif's health. Then I choke up my tears and explain it to everyone that was in the room. One by one, my mom and my aunties and cousins started crying. I asked mom how would I tell Yus. She told me, to wait until I calm down. Mom told daddy, who was waiting for his flight to Oman for a business trip and couldn't join us at the hospital on that day.

As if Yus sensed something, about less than an hour later, he called. I went into the bathroom to talk to him, because everyone else was outside. I told him to be calm and that I had some news about Arif for him. He kept silent. Then I told him... and more silence came thru. Then I assured him that everything would be alright, though at that moment, I had no idea myself whether everything WOULD be alright.

An appointment with the cardiologist was set in two weeks for another detailed check up. I told mom to call her cardiologist so that we could get a second opinion from Institut Jantung Negara (National Heart Institute), where most cardio cases was sent too. So the next day my mom called her cardiologist and he set up an appointment with a child cardiologist, just a few days after Arif's check up with the cardiologist in Damansara Specialist Hospital (DSH).

Two weeks later, in DSH, the doc went for another ultrasound as well as an ECG check. He reconfirm his findings and mentioned that he would have to monitor Arif's condition from time to time. While us as parents and grandparents would have to watch out for symptoms of heart failure in Arif, if any. These signs included:

 1- Bluish Tinge on lips or fingers
 2- Weight loss
 3- Loss in appetite in baby
 4- Difficulty in breathing
 5- Sweating while drinking

Arif had No. 3 and 5.

A few days later, New Year's Eve to be exact, my parents sent Arif for his appointment with the cardiologist in IJN, Dr. Mazeni Alwi. I couldn't follow because I was still in my confinement, and Yus went back to settle his job again.

When my parents came home with Arif, they told us that Dr. Mazeni explained it much clearer than the cardiologist in DSH. He even explained that the other hole was called VSD (Ventrical Septal Defect) about 8mm in width. Quite large for a baby at Arif's age. He said, worse case scenario, an open heart surgery would have to be done, but he'll try to postpone to operation until Arif is bigger and as long as Arif's symptoms have not worsen.

We then decided to stay with IJN and Dr. Mazeni as our Pediatric Cardiologist Consultant and do Arif's monthly check up with him.

I'll continue about this post later. Haven't typed so much for so long (except on a phone), my fingers are cramped up.