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It’s been a while since I last update on Anaqi’s cardiac condition. Back in May 2009 – weeks into his presence into this world – news of him having two holes in his heart daunted upon me. When cardiologists mentioned of the probability of a heart surgery, I was distraught. In fact, the whole family was. I prayed hard that it’ll never happen and that the holes will eventually get smaller and close on their own.
In case you haven’t heard, this was the entry I posted last year on my blog: http://aprima.org/2009/05/28/echocardiogram
Back then, his echocardiogram report was as follow:
Early in this year, on 6th Jan, I had brought Anaqi for a follow up check-up at KKH. His cardiologists said they could still hear slight murmurs in his heart when they listened via their stethoscopes. To confirm, they did another echocardiogram to scan his heart.
He slept soundly during the whole diagnosis, which took about an hour or so to complete. It seemed as though it had gone on for hours.
Last year when Anaqi did his first scan, I wasn’t focusing on the screens and was oblivious to the beeps and readings (that was before the doctors broke the news about the holes in his heart). The images on the screen looked similar to what I’ve seen during my FA scan when Anaqi was inside me. This time I paid attention to every single detail. His sleeping helped me focus better.
The result made me beamed a hundred dollar smile. Alhamdulillah, I was informed that one of his holes (the ventricular septal defect – VSD) has spontaneously closed! Which was surprising because the VSD was much bigger than his ASD (atrial septal defect). His ASD is still there however it has reduced in size to about 2.9mm. This is indeed great news! He no longer need to consume his medication – diuretics - for flushing out fluid from his lungs due to the mix of oxygenated and non-oxygenated blood flowing into them. His next follow up check-up will be in December this year. I hope then it will bear even better news for us, insyallah.
His scan results on 6th Jan.
It’s been almost a month since the birth of Anaqi, and Misha has been showing nothing but warm affection towards her little brother thus far. Many a times she would ‘help out’ while I change his diaper, or give him his bath, or wake up to feed him in the middle of the night. She will always be by his side, either stroking his head, or shower him with small little kisses.
She is one who would noticeably look for wet tissues whenever excess milk spews out of the baby’s mouth. She would call out to me claiming "the baby is calling you" whenever she hear him cry. She would try to quieten him down by hushing and patting him when I’m busy doing other things and not attending to the little one on time. She would bring to him her favourite books and toys, probably thinking that anything she might want is something her brother might also want.
In all, I’m pretty pleased with her reaction towards Anaqi. Her caring behaviour – the same way as she had cared for her other brother when he was just a baby – to me, is very awe-inspiring indeed.
I wish the same can be said of Mika, but so far he had been quite ignorant to his little brother’s existence. He probably needs a little bit more time for the idea to settle in. We’ll see.
An appointment was set up on 25th May for Anaqi to undergo an echocardiogram at the Cardiac Centre at KKH. After a detailed analysis, it turns out that his PD’s suspicion indeed holds true. Anaqi is diagnosed to have "moderate to large perimembranous ventricular septal defect with inlet extension (VSD), moderate atrial septal defect (ASD), high pulmonary pressure". In short, he has two holes in his heart – one in the upper chambers (atrium) and one (slighter bigger) in the lower chambers (ventricle).
Here’s a detailed graphical representation of ASD, VSD versus the normal heart.
According to KKH website library, the left atrium and ventricle is normally at a highler pressure than the right, so the defects allow blood to flow from the left to the right. Blood is shunted across and re-circulated back to the lungs. The effects of having "extra" blood flowing across into the right atrium/ventricle are:
- ASD – The right-sided upper heart chamber (right atrium) and right-sided lower heart chamber (right ventricle) become dilated to accommodate this extra blood volume.
- VSD – The left-sided upper heart chamber (left atrium) and left-sided lower heart chamber (left ventricle) can become dilated to accommodate the extra blood volume returning from the lungs.
- The lungs becomes more "wet" or even become "flooded" with this extra re-circulated blood.
- The blood pressure in the lungs increases.
The degree at which these effects occur would depend on the size of the ASD/VSD and the amount of blood that is re-circulated back to the lungs. This can range from insignificant to severe.
Here’s a graphical representation of blood flow of a heart with ASD/VSD (courtesy of KKH):
According to the cardiologist who did his scan, this is treatable – so this is good news! Anaqi will need to undergo periodic review to see if, over time, the holes will eventually get smaller, or if otherwise, he may need some medication to "buy time" before he’s ready to undergo surgery.
Let’s all hope for the best for the little one.
Firstly, I would like to thank everyone for the congrats and well wishes – it’s nice to hear!
After my two-day stay at East Shore, I was glad to be out of the hospital. I was even more glad that Anaqi was not held up for his mild jaundice as compared to his elder brother almost two years ago.
The first few nights has been pretty tiring, as the bub kept waking up for feed every one to two hours. I was having bad headaches that won’t quit, probably due to the lack of sleep (and engorgement feeding issues). After a while, I began to adapt to my new routine. Feeding became much easier, and late-night cries became a lot less.
Within the first week, Anaqi had two doctors’ appointments – one with Dr Heng (Gynae) on 20th May to check on his jaundice, and another with Dr Low (Pediatric) on 21st May for his overall assessment. It was during the PD check-up that I was told Anaqi had a heart murmur, and was suspected to have a hole in his heart. He wrote a referral letter for an appointment with a heart specialist at KK Hospital on 25th May. The details of that will ensue in my next entry.
As for his jaundice, it remains mild. I continue to sun him every morning and evening (at times even in the afternoon where the light shines directly into our balcony). Now he is one tanned baby! (Thankfully, not fried…) However his eyes still show a tinge of yellow. Hopefully his jaundice will go away soon.
On Day 7, P and I shaved off his hair close to botak (bald). Due to the nature of his hair texture and volume, it’s difficult to get him completely clean-shaven. P calls him little Leonidas (because of Gerard Butler’s hairdo in 300, heh.) Spot the difference?
So far, I noticed the little one has been smiling a lot with gazing eyes, as if responding back to when his name is called. Too cute!
Until more updates…
Shortly after 0600hrs on 14th May 2009, Mirza Anaqi became the newest member of our family. He weighed at 3.225kg and measured at 49cm in length. Even though this was my third labour ordeal, the whole experience did not fall short of being dramatic. So much for the "I-should-be-used-to-it-by-now" mentality.
Me and my newborn, Mirza Anaqi.
I was already having slight contractions throughout Wednesday night. As the frequency was irregular, I simply just ignored them. It was in the wee hours of Thursday morning, around 0115hrs, I was still online checking my emails (even forwarded a Pumpkin Patch Mid Season sale promotion to Liz and Yati), when I felt the contractions were about 10 minutes apart. I thought I’d just shut down my computer, head to bed and try to sleep off the pain, and probably wait till the next morning to go over to the hospital after both Ipul and Misha had headed for school.
Well, I thought wrong! Trying to sleep sucked as I was feeling really uncomfortable. I took a hot shower and felt that I needed to go to the hospital right away. After bath, I woke P up (who apparently had just dozed off while I was showering) and requested him to send me to East Shore. I think it was around 0300hrs at that time (I wasn’t exactly keeping track). The contractions felt even closer now (and a bit unbearable), and we really had no choice but to leave the sleeping kids behind, at home alone, while we zoomed off to the hospital.
As soon as we reached there, I was a little lost because the place is just newly-renovated, and the entrance has been detoured. Ultimately the security guard saw me, and helped to wheel me in on a wheelchair. I was sent straight to the labour ward, as opposed to the previous two experiences where I had to register myself first before being sent to the ward. P made a return trip home in an attempt to send the kids over to my parents’.
In the ward, I had to change to the operating gown while lying down on the delivery bed. The midwife checked me and I was told I was already 8cm dilated, and can deliver about anytime soon. I texted P to ask him to return back to the hospital immediately, after I called and spoke to my dad to help fetch the kids instead. At that time, it was about 0400hrs in the morning.
The midwife did all the prep work – strapped me to check my BP, contraction level, baby’s heart rate, etc. This time, there was no inducing required. I was informed that the baby’s heart rate was pretty low on and off, and warned me against using any form of anesthesia – the gas and/or pethidine drug – as it may put the baby at risk. I was asked only to inhale oxygen to help regulate the baby’s heart rate better. Imagine the pain I had to endure throughout the whole thing!
Baby’s heart rate was low on and off.
Time passed by pretty fast when you’re in pain. After reaching 10cm dilation, Dr Heng (my gynae) eventually arrived, and with the midwife’s "assistance" (I’m not going into much details on that), at 0605hrs, the baby’s finally outside, instead of inside, before you know it! It was all 100% natural! I was of course sore and a bit tired, but recovering well, and very happy to be done with pregnancy.
The baby is indeed adorable and cuddly, and P and I are having a wonderful time getting to know our new son! I will upload more pictures on Flickr, Facebook and Multiply soon.
