We'll be hitting the trifecta, so to speak, on Sunday, though it's not one we are looking forward to winning.
The trio to which I refer is the third different ICU that Zachary soon will be visiting. He was in the Neonatal ICU for his first eight months, then had several stints in the Pediatric ICU over the past year. And now he'll be spending some time in the Cardiac ICU starting Sunday in preparation for surgery the following day to fix his AVM.
We weren't expecting surgery so soon but his condition has worsened over the past week or so. His heart rate is getting higher as his heart compensates for the short-circuited blood flow created by the tangled vessels. He's also been breathing faster and the amount of oxygen in his blood has crept close to dropping below the level his cardiologist and pulmonologist are comfortable with.
The plan is to thread a catheter through his groin to his heart and inject contrast dye so they can see what exactly is going on with the vessels. Then, absent any other problems, use a metal coil to divert the blood flow back where it's supposed to go, a procedure called an arteriogram with embolization.
Then they'll also perform a pulmonary angiograph, which is similar, but to check for vessel malformations in his lungs. The lung doc wants to rule out an underlying genetic condition called Hereditary Hemorrhagic Telangiectasis (HHT) that could be causing abnormal blood vessel formation in his lungs. Not going to worry about that now though.
We're really bummed about the coming hospitalization. Best case is he'll be in for three or four days if all goes well. Could be longer if it doesn't.
It's going to be sad to see him poked and prodded again and not understand why we aren't stopping his pain. And he'll probably be most troubled by being caged up in the hospital cribs, which are really like little jails, bars and all.
We'll see what happens.
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