Yesterday we had a heart clinic appointment at Lucille Packard (LPCH). The appointment went pretty well considering Bean has now begun to realize that hospitals are not amusement parks and she is probably going to get poked and prodded. We had to start off with a blood draw, which we usually try to have done here in Chico because the woman who does it here has the magic touch with Bean's somewhat belligerent vein...she can always get blood on the first poke without having to dig around. At LPCH, amazingly, considering how large the Children's Hospital is there, we have to go to the adult side of the hospital and they always have problems. The last time we went there, the woman dug around in one arm for about three minutes, never getting any vein and then proceeded to the second arm, dug around there for about the same amount of time before hitting any vein. It was horrible. This time was considerably better. Thanks to the woman at Chico, I no know that one arm is much easier to find vein than the other, so I offered that one up and she did have to dig around a bit, but probably only for 60 seconds or so before hitting vein. Whew...Bean was still screaming bloody murder the entire time, but it was much shorter than the last time.
The biggest problem with starting the day with a blood draw is that Bean becomes convinced that everyone she comes into contact with during the day is going to stick a needle in her. So, she screamed while we weighed her. I had to wrestle her down to get measured. Thankfully, the echo rooms have TVs in them and we hit during Mickey Mouse Clubhouse, so she would get distracted by that, then every once in a while she would realize where she was and start writhing and screaming... The echos probably take 30-45 minutes, but it seems like hours that you are stuck in there. I have to hold her down because she tries to roll over to avoid the little tool they use or she takes her hand and pushes them away as hard as she can. And she is getting stronger. But, we survived. I always feel bad because I know people can here her screaming up and down the hallway and out into the waiting room - and the echos are not at all invasive. But, she HATES being held down or restrained in any way, so she hates the echos.
Finally, we got everything taken care of and I was excited to see Dr. McDreamy was back and would be her main doctor this visit. Sure its ridiculous to call him that, but he is very cute and heck, I have to find something good about these visits! We also got to say goodbye to one of my favorite fellows while Bean was in the hospital. She was the one who wrote these orders in Bean's chart:
|"decrease vent rate to 26bpm and give Mackenzie a kiss to make her feel better."|
So, back to Dr. McDreamy...he examined Bean, looked at all her records, asked all the regular questions and then Dr. Chin, the head post-transplant cardiologist who oversees everyone who works with Bean came in and they had a little chat about her rejection status. When it was done, Dr. Chin left and my hubby asked about the repeated 1A status. He was super honest and said that they really don't know...because pediatric transplants are so new and the medicine regimens have been changing as medicines get better, etc. they really can't say what a repeated 1A rejection means. He did explain, for the first time that I can remember, what a 1A status means though. It means that white blood cells are found in higher numbers than "normal", meaning that her body thinks the heart is an infection or foreign object. But, it means that the tissue sample shows no signs of harm from those white blood cells. So, her immune system is working, but not so well as to cause any actual damage to the heart at this point. He said that some places would treat 1A as normal, while others would act aggressively to get to zero. LPCH is somewhere in the middle. And he said his thoughts are that increased medication risks damage to the kidney later on and that a large number of pediatric heart transplant recipients end up needing a kidney transplant in their late teens/early twenties due to medication. So, he thinks if it isn't showing damage, increasing the meds is just asking for something else to go wrong later...and he said that he probably isn't much more able to guess correctly than we are about what this means long term. I told him that I hoped he was at least a LITTLE more able to guess correctly than we were...all that med school and all...My very favorite quote of the appointment though came at the end of that discussion, when he said, "basically, we're looking at the best possible transplant patient that I've ever seen." Which is a pretty awesome endorsement of Bean's current health at least. :)
So, we are in the same old place we've been. Biopsy is scheduled for six weeks from now. This one will be her annual, which means they do all her pressures, test her arterial flexibility, plus all the normal stuff they do at biopsies. So, it will be a longer day than normal because she has to under for longer and then recovery is slightly longer. Hopefully all goes well though and we get that just-out-of-reach zero we've been looking for!
In addition to the appointment, we also visited my parents, who live about two thirds of the way to the hospital from our house. They so enjoy the Bean! Overall, it was a great visit with them and a positive appointment at the heart clinic!
As I said, I will be trying to play a bit of catch up on here over the next week or so as we've done some really fun things and Bean is quite the character. I wouldn't want any of her fans to miss out on her escapades!
Thanks for reading! To finish off, our friend Karina just got back from a trip to China and she brought back an awesome hat for the Bean. Here are some pics of her in the hat and towards the end a cute little dress my sister made for her!
|Hat from China, Bean from Chico|
|Papa, Bean and Grandma on the couch.|
|Trying to get her to show the matching bloomers...|
|Daddy and Bean - she's saying "cheeese"|
|Grandma and Bean on a walk|