The subject tells the story for the most part. Caden will be admitted into the hospital tomorrow morning 6/14/06 in order to receive a pacemaker on Thursday. We received a call from Caden’s cardiologist last week and got stunned by his recommendation for Caden to get an internal artificial pacemaker implanted due to heart blocks detected on the last halter monitor. You may remember that Caden experienced third degree (total) heart block back in March which even required a few chest compressions to keep blood flowing. The sequence of events following that episode landed him in the PCICU for a few days. Caden was discharged after those heart blocks because the cardiologists thought the heart blocks were going away due to the steroids they had administered during the ICU visit. A halter monitor (mobile telemetry device) that was sent to us in the mail the week after Caden’s March ICU discharge confirmed that the heart block were still there but less severe. Caden then went in for a cardiology clinic visit at the beginning of May. Sherry and Caden left that visit with another halter monitor just to make sure the heart blocks were gone for good as expected. The new halter monitor in May was still detecting some second-degree heart blocks. This prompted the cardiologists to recommend that Caden get a pacemaker. We had a problem with understanding the recommendation from the initial phone call last week so we made an appointment to speak with the cardiologist in person. We knew that Caden had been discharged over 12 weeks ago after having a third-degree heart blocks in the hospital. What could possibly warrant a recommendation for him to get a pacemaker if he was having any heart block of a lesser degree? We decided that we need to sit down with the cardiologist to get a better understanding before we sign away for another invasive and potentially life changing procedure. They expected the heart blocks to have completed disappeared within a couple of weeks after the March discharge from the hospital. The fact that they were still around six weeks later was reason enough for them to recommend the pacemaker. The fact that they were the more serious form of second-degree heart block was even more concerning to them.
The conversation with the cardiologist last Thursday still did not convince us to jump right on board with their recommendation. We struggled with the decision to put Caden through another surgery that would be done strictly for precautionary reasons. This pacing device may never have to function if Caden never has another heat block. We struggled with the comments by the cardiologist that seemed filled with fear. The cardiologist’s only real reason for the pacemaker is to have it there just in case Caden were to ever have a heart block that he did not recover from on his own. The cardiologist’s term for what might happen to a patient with heart blocks that they don’t recover from is called sudden cardiac death.
We have been so strong in our faith for healing of Caden. We realize that we can still pray and believe for healing and have faith for it. While we wait for it to manifest, we are going to use the treatments and medicines available to get us through the symptoms.
Going into this we also wanted to make sure that the cardiologists were stepping back and looking at the big picture concerning Caden’s heart. Caden’s VERY unique anatomy around his heart has raised questions related to swallowing. Caden is 19 months old and still gets 100% of his food through a g-tube (feeding tube). He went in for a swallow study just over a week ago and showed no major improvement in swallowing functionality compared to the last swallow study. We have been told that his left subclavical artery is protruding in on the esophagus based on previous findings from the heart surgeon and the ENT doctor who EGD scoped Caden a few months back. It seems that there is some research on the effects that the protruding artery may or may not be having on Caden’s swallowing functionality. We may not know for sure until they try. The other heart issue is the outstanding diagnosis of a bicuspid aortic valve however the cardiologist does not feel like the valve should be repaired at this time. Our stance in these talks over the pacemaker were that we did not want Caden to be operated on more times than necessary. Could some of these other things be repaired at the same time if he was going to be under anesthesia and in the room with all the same doctors who would have to be there for any of the other heart repairs? We are still not absolutely sure if the pacemaker will be the only thing done on Thursday. The cardiologists wanted Caden on the schedule for this pacemaker as soon as possible and are currently discussing the artery/swallowing issues to determine if they will want to do any other repairs at the same time. One very convincing reason we are going forward with the pacemaker right away is because multiple cardiologists are in agreement that it needs to be done sooner than later. They were concerned enough to postpone at least on other procedure to get Caden a surgery slot this week.
Sherry and I agreed on moving forward with the pacemaker after much prayer. We spent an hour and a half of phone calls between us and MUSC’s pediatric cardiology, cardio-thoracic surgery, and ENT. We feel comfortable with the decision and are certain that this is in Caden’s best interest. We are at peace with it after a week of praying and consulting with Godly counsel.
Please keep Caden in your prayers over the next couple of days. Please pray for Sherry and I to have the discernment during our interactions with doctors and other medical professionals caring for Caden this week. Please pray for big brother Riley to understand and feel at easy with his baby brother being in the hospital yet again. The bond between these boys is such a blessing to observe as a parent.
Thank you for your prayer and support. May God bless you and your family.