Palpating Pedal Pulses

When we spoke with the doctor about the cath procedure, he wasn't very sure of what the outcome would be. He said he was doubtful that they could balloon him, and doubtful that he could stent him... in fact he was suggesting that the better alternative would probably be to send Caleb to the surgery team and have them implant the stent. He basically said, "I could be an hour, I could be three, I don't know."

Well... when we were past the hour mark I started to relax. I had been telling everyone all morning that the balloon procedure would work, and that's just the way it is. Caleb and I had talked about it. The stenting didn't end up sounding as bad as I was afraid of, but I still didn't want that. I knew Caleb wouldn't want it, either.

After visiting the Parent's Center, I was walking back to visit the gift shop, and one of the doctors passed me. He was one of Caleb's original doctors and had recognized us from our original stay. He visited us that morning in the the pre-op area. In any case, he gave us a quick update. When they used the dye in his blood, the right lung instantly darkened and was full of blood. A small, pencil thin line of dye did eventually show up on the left side. He said that the doctor perfoming the procedure was "very surprised" but they were able to get a wire through. But that's where it was left, and the doctor didn't know what he was going to do from there yet.

I was very encouraged by this news indeed! After a while I got the page and went to listen to the doctor. I got some pretty pictures out of this deal. Before and after. Well, they did end up balooning the artery. There was a signifigant improvement over before (ie blood was flowing!!), however, blood wasn't flowing everywhere it needed to go... yet.

The doctor said that it might just fix on its own, now that the blood vessel was pumping blood where it should go, and might grow and expand like it needs to. He felt that the problem was at the beginning of the artery where he balooned it, not out in the branches. He said this wasn't very likely, but could happen. The second option was that now that there was bloodflow, in six months or so they might go in and give the baby a stent after all when he's bigger.

What we do now: Watch it. Make sure it doesn't close back up. Have an echo with our favorite cardiologist on Wednesday.

We spent the night at Children's for observation. What they ended up observing closely was his right leg. That was the side they went through the groin veins on, and although rare, the vein could colapse and not give blood to the rest of the leg. The signs were "a foot as blue as your jeans." This being said, Caleb's right leg was visibly paler than his left, and you could feel a temperature difference.

It was difficult to "palpate" his "pedal pulses." What this means is that it was difficult to feel his pulse in his right foot with your hand. The doctor who did the cath came back and felt that the bandage was too tight. He loosened it. In another hour he came back and loosened it a little more, and brought his doppler with him. (A doppler is a machine that listens to pulses--the same idea as the one that they use to listen to the baby's heartbeat when he's still inside the mama!) He "wasn't convinced" he was feeling a pulse in Caleb's foot The doppler proved there was a pulse.

All night long and all morning long everyone was concerned about the foot, and confused over the foot. Here the foot has pulses that you can feel no problem, there the foot has no pulses that you can feel, the foot is lighter than the other, the foot is colder than the other... one of the guys said, "If we didn't have the other leg to compare it to, then we would just think it was fine."

In the end, they sent him home and just told us to keep an eye on it.... bah, crazy stuff.