Echocardiogram

I'm worn out after today's adventures, so this will actually be brief! Jack had is 3rd echo today. After both Dr Owen and a sweet intern named Christina examined him, Dr Owen said his murmur sounds more like an ASD than anything else. The echo says not! The PFO persists, and the VSD most certainly is still open, but small. So, where the heck was the oddball murmur coming from? Interesting story. First let me tell all of my fellow nurse friends that Jack does not have any sort of aneurysm in the sense we think of aneurysms. What he has is benign, but also so infrequently seen as to be an oddity. All of the interns were lined up to watch the replay of Jack's heart, trying to hazard guesses as to what they were looking at. Then Dr Owen would let them off the hook by saying they wouldn't see this often. By the time I had Jack fully dressed, I'd seen it enough times to describe it. For the last two interns, after they'd made their guesses, Dr Owen said "Mom?" So I repeated it: You're looking at an aneurysmal vetricular septal defect flap, and pointed out the muscular flap of tissue protrusion that attempted to close the hole with each beat of Jack's heart. Purely esoteric, but interesting.

So we're basically right back where we started. An open PFO that will likely close very soon, and a small VSD that will also close very soon. Not insignificant, but small all the same. And not something they would even consider surgically repairing! Follow up in three months.

Jack weighs 17 pounds 9.5 ounces
He is 26.8 inches long
Head circumference is 17 inches with very poor attempt at accuracy
BP LUE 91/58

The same surly gal did his weight, measure and blood pressure, but today she wasn't about to be charmed into being pleasant to even Jack! Maybe her hemorrhoids were itchier today.

While we were at the cardiologist's office, Dr Asshat called. He said that our insurance would not authorize the barium swallow study; that he'd set us up with their ST services to be evaluated again; there was currently an 8 month wait, that he'd get an urgent referral; that they would have to be the entity to refer us for the swallow eval; and finally that any swallow eval that took place would have to be done at big county in LA because no one here in town will take a baby. Dang. He also said that if I didn't hear from the referral department for our ST appointment within a week, to call him back personally. He even took the time to ask if we'd gotten our urology consult appointment yet. Hmmmmmm. This is new. Maybe the radiologist passed on the earful he heard from Dr Elaine and I both. We'll see.