Jan 16th: Second Echocardiogram

So Wednesday last week was our second echocardiogram.  The last few weeks prior have been a whirlwind of activity from switching hospital systems, OB appointments, more ultrasounds, and hospital tours with this next echo always in the forefront of our mind.

We went in with a few questions prepared but our main concern was that atrial septum.  Would she be able to see that hole and if not could she tell if his system was already under pressure?  As Dr. Farrell started the echo it became evident to us that the atrial septum was her main goal as well.  She focused heavily on that wall looking each and every direction trying to see some relief in the left upper chamber.  Here are some of her observations as she scanned:

• No hole in the septum or flow between the two upper chambers were obviously detected so Dr Farrell began looking for other signs.
• The atrial septum was bowed outward toward the right atrium chamber kind of like a balloon blowing up.  This creates a lot of suspicion that the septum is indeed intact and the restricted blood flow from the lungs into the left atrium is causing pressure and this bowing.
• The septum wall was thick looking where it is typically very thin.  Another suspicion that the wall is counterattacking back pressure by thickening.
• There were two possible "squirts", as Dr. Farrell described, of blood flow in between the two chambers that may be some relief of pressure.  This was inconclusive.

At the conclusion of the echo Dr. Farrell went on to discuss that all signs point to us being in the high risk category of the already high risk we had with just HLHS.  She explained the likely outcomes and negative outlooks that go along with an intact or highly restrictive atrial septum along with HLHS.  It was all information that Beth and I did not want to have to hear as it meant this fight just became that much more difficult.

The drive home was not pleasant as everything started sinking in.  January 16th was a bad day and hope was waning.  Later that day Beth received a phoned from Dr. Farrell explaining that she was conferring with her colleagues about our echo.   Riley does not have much experience with this sort of HLHS complication since it is so rare.  It came up that a children's hospital in Boston is performing procedures in utero to combat this complication in attempt to decompress the system and allow the baby a better shot at life.  We went back the following day to have another echo and send the images to Dr. Wayne Tworetzky (profile here) at Boston Children's Hospital who has been specializing in this condition.  He would determine from the extra set of scans if our little Shawn would be a candidate and see some benefit from this kind of procedure.  After this echo it was just another waiting game for Boston to take a look and email us back.