Saturday, April 26, 2008

Happy to be Home

We made the long trip home yesterday.  Aubrey did great on the plane rides (Houston to Minneapolis to Anchorage.)  We are so glad to be home.  We were surprised when we landed in a late spring blizzard!  We got about 18 inches of snow yesterday.  So, unfortunately, the heart run was postponed until further notice.  We really had a great time in Texas with Brian's parents.  It was really relaxing and we got lots of quality time as a family.  The more we reflect on all that has gone on over the past two weeks, the more we realize how many things God really orchestrated together for us.  We feel closer to Him and closer to our friends and family and closer to each other than ever before.  We know we most likely have some tough hurdles to cross in the future, but our faith is even greater that God really will carry us through them.  We still have a lot of questions and concerns for our little Aubrey.  We need wisdom about which doctor appointments we need to travel to Texas for, how to tell Aubrey about her heart when the time comes, and more specifically what we should avoid to keep her safe and healthy.  Most of the blood tests are to hopefully rule out some of the metabolic diseases that would be worst scenarios than what we have talked about already.  We will keep praying for her health to remain stable and not to get worse.  

Tuesday, April 22, 2008

The Longest Day

We woke early to get to Texas Childrens Hospital for our 10am appointment. We got there early and after
paperwork was complete and waiting a while Aubrey began her echo cardiogram (ultrasound of the heart.) The technician decided that Aubrey was too squirmy and would have to be sedated. Unfortunately, they didn't
have an appointment available for that until 2:00. So after lunch and a walk, we went back to the cardiology unit.
While we waited for the echo, Aubrey had her chest x-rayed. She did not like that at all, but recovered quickly.
When it was finally our turn, Brian and I took her back to "Tranquility Bay" (where they sedate all the little
babies.) They gave her a liquid medicine to help her go to sleep and she gagged it down. Luckily, she fell asleep
quickly once I started nursing her. From there it was back to an echo room where her heart was looked at and data
collected for over an hour. There were doctors in another room watching the echo as it was going. When the
technician thought she was done, she checked with the doctors, and then came back for several more minutes.
Aubrey stayed asleep for the entire test and only began to stir at the end. They did an EKG (a quick test,) and
took us back to Tranquility Bay for Aubrey to wake and nurse. We were taken to another room to wait for the
doctor and the results.
After about an hour we were told we needed to do it again. The doctor met us in the hall to explain that this time
it wouldn't take as long since they needed to check only one specific thing. They had a doctor do the echo this
time and after three trys, they had what they needed and we headed back to the room to wait for the doctor.
The doctor spent a lot of time and care explaining Aubrey's condition and answering all of our questions. I'll give
some of the facts we learned and then try to explain some of the implications for Aubrey. -First of all, this hospital and this doctor in particular has seen a lot of patients with Hypertropic
Cardiomyopathy (HCM), and even in babies as young as Aubrey. This is nothing new to them. -There are four different typs of therapy to treat this condition and of those there are 2 that are used in children.
They are medical (drug) therapy and myectomy ( surgery.) Texas Children's is biased (based on a lot of data)
towards the least invasive treatment, medical.-Most HCM is caused by a genetic mutation, either passed on from parents or a spontaneous mutation in the
child.-Aubrey is asymptomatic at this point, which for this doctor rules out surgery for the time being.-Aubrey's HCM obstructs bloodflow to the Aorta. Aubrey's obstruction is considered moderate (not
severe.) Her Mitral valve also has a moderate leak/regurgitation, probably caused by the HCM. The
assessment in Alaska did not differentiate the Mitral leakage from the outflow to the Aorta and led the
cardiologist to conclude a more severe obstruction. This is the aspect that took so much time here in Texas as
well.-Beta Blockers are used to lower blood pressure and decrease stress on the heart. Texas Children's
recommends increasing the dose of the medicine as long as it is well tolerated.-The scariest outcome of HCM, one that is talked about most but happens rarely, is sudden death. Based on
case histories from Texas Children's, the chances of this happening are very low, especially while she is young
(before puberty) and while on medication. -Aubrey needs to have a few more tests (blood and urine) to begin to find the cause of this disease. We will also
have our hearts looked at.
So with all of that information, what does this look like for the Bucks? Well, first of all, we will be finishing out the
week in Houston and then hopefully be back for the Heart Run in Anchorage on Saturday. Aubrey will have
the rest of her tests tomorrow, but we won't find out results for quite a while. She will remain on the medicine she
is on for the next month when we will have another appointment when dosage will likely increase. We will most likely
come back to Texas Children's for this appointment. By then they may have more of an idea what is causing her
HCM. Assuming the best case scenerio, she will continue to have heart check-ups monthly, then quarterly, then
less frequently if all is stable or better. Her progress will be closely monitored and medication regulated. As a
little kid, her life should be fairly normal--though we will probably be a little extra-portective. As she gets older her
activity level will have to be limited. Competitive sports will have to be limited to golf or pool or something along
those lines. There may be more complications as the months and years go by, but we will have to just take them as they come.
There is always the possibility that she may have to have a surgery in the future, but for now, we will be managing
this with medicine. The doctor said "We treat the patient, not the echo." They will work with us to give her the
best care and the best quality of life. When this day started we had in mind that a heart transplant was our best case scenerio. Due to all the risks that
involves, we feel like we recieved really great news today. Even though Aubrey has a very serious condition, and
will have some limitations in life, we feel SO blessed. After a week where our minds went down the road of losing
our little girl, we feel hope restored. And can you believe, we do not feel disappointed about anything we heard
today? There are still many unknowns and many wait-and-sees, and we have no guarentees for her future, but we
will continue to trust that God will take care of us. We are so thankful for all of your prayers and support. We have amazing friends and family walking through this
with us. God has been carrying us this week. We have experienced the peace that surpasses understanding. We
have experienced God ordering events to get us the help we need. We have had to put our daughter fully in His
hands and not fear. Thank you for your notes, calls, comments, Bible verses, connections, cleaning, things, and
especially for your love for our family.

Scary Part is Over

I will write more later and be much more specific, but for now I just want everyone to know we are feeling really relieved. It was a really long day. We are so thankful that we came here and for the words we heard. We feel like we have a plan now. After a few more tests this week, we should be home for the Heart Run on Saturday!