April 15th 2008 was the day we found out that our baby had a very complicated Congenital Heart Defect. I was 24 weeks pregnant and was at a Targeted Ultrasound without my husband Mike. I remember praying and crying a lot. Dr. Snyder did a Fetal Echo that same day and told us the hard truth about Hypoplastic Right Heart Babies. He explained the three surgeries and advised us to do an Amniocentesis to check for chromosomal disorders. Two days later we flew to Ireland to visit my family. Upon our return all our care was transferred to Columbia Presbyterian, NY following a negative amniocentesis.
In naming our baby, we wanted to make sure that we gave him a strong name so we named him Matthew Joseph, Matthew means “gift from God” and Joseph was close to Mary, mother to Jesus who we prayed to a lot through the rosary for Matthew! He was born on August 6th, 2008 via scheduled C-Section. His PICC line became infected during the first week in NICU and he ultimately ended up with his first open-heart surgery on August 21st, 2008. Six days later he had a Ladds Procedure, an abdominal surgery. He finally came home on September 2nd to two very happy older brothers Michael and Ryan not to mention two ecstatic parents. Weight gain was an issue and we added Polycose, Human milk fortifier and Rice Cereal to Breast milk to help with this. He gained weight slowly. Matthew is asplenic and has heterotaxy. He had a Grade IV Reflux in his right kidney which resolved untreated! His liver is midline rather than right lower quadrant. His Glenn Procedure was done on February 25th, 2009. He returned home six days later. He ended up with a right sided Chylothorax and was on low fat diet and formula, Portagen for four months.
On June 16th 2010 we learned that Matthew’s Ventricular Diastolic Pressure were high, meaning his heart beats OK but does not rest adequately. After a Case Conference his Fontan was postponed and he was placed on a medication regimen including Sildenafil, Aldactone, and Digoxin. After seeking second and third opinions from Boston Children’s and CHoP, Coreg was added to the med regimen thanks to Dr. Rychik at CHoP.
In May, 2011, a cardiac cath revealed decreased Ventricular Diastolic Pressures and Matthew was eligible for the third surgery, The Fontan.
Matthew had his Fontan surgery on August 17th, 2011. All went well in the Operating Room, the surgery was done off the lung heart machine and he was extubated before coming up to ICU post operatively. He had many ups and downs in the post-op period, including pain control, large right pleural effusion, fast heart rate, constipation and low Potassium levels. He came home on August 26th and did OK for about two days. He was readmitted on September 1st with Bilateral Pleural Effusions and finally came home on September 6th. He started Preschool on September 27th, just shy of six weeks post operatively
A Cardiac Cath in the summer of 2014 revealed a serious problem, the blood return from the lower part of Matthew’s body was mostly returning to the heart via a collateral vein due a blockage at the anastomosis (joining) of the Inferior Vena Cava and the Pulmonary Artery. After much discussion and a second opinion from Children’s Hospital of Philadelphia, it was decided that Dr. Bacha would need to re do Matthew’s third surgery The Fontan and replace the blocked conduit. This was done on November 10th 2014 and Matthew had an uneventful recovery and was home with his brothers in one week. He did start on Coumadin which requires weekly INR checks which I do at home with a machine and a simple finger prick.
He continued to do well until March, 2015 when he was admitted to Cardiac ICU in Respiratory Distress, he was initially supported on BIPAP, weaned to CPAP and then nasal cannula. He was treated with antibiotics since it was assumed he had Pneumonia. He was readmitted six days later in severe Respiratory Distress. An emergency Cardiac Cath and Bronchoscopy was scheduled for Friday, April 10th, coincidentally the ten year anniversary of Matthew’s Uncle Chucky’s passing. We found some comfort in knowing who was watching over him that day. They found that his left lung was completely blocked and full of what we now know were casts. Casts are formed when lymph leaks into the lungs and combines with proteins and form a thick substance that looks like chewing gum. Matthew now had another diagnosis to add to his already long list called Plastic Bronchitis. A Cardiac Cath a few days later revealed good pressures in his heart with a closed fenestration but a collateral vein was acting as a pop off so no stent was needed. He was initially treated like a cystic fibrosis child with Pulmozyme nebulizer and a vest for 20 minutes twice a day.
He did well until July 2015 when he was readmitted to the hospital after coughing up another cast and desatting. He had another bronchoscopy and responded well to treatments. At this point we reached out to Children’s Hospital of Philadelphia who has a whole department that works with patients with lymphatic issues including Plastic Bronchitis. They recommended increasing Matthew’s Aldactone and Sildenafil and also advised us to add Q-Var, an inhaled steroid as well as discontinuing the Pulmozyme and adding Levalbuterol which is the cardiac version of Albuterol. Matthew coughed up one more cast on September 26th , he responded well to Prednisone and has been cast free since then.
He continues to receive 20 minute vest treatments twice a day with Q-Var and Levalbuterol. He also continues on Aldactone twice a day as well as Sildenafil three times a day. Coumadin, Amoxicillin and Lasix are also part of his medication regimen.
Matthew is currently in First Grade and doing well with Spelling Tests and learning to read. He is playing flag football and soccer and having fun with both! He continues to inspire us all to be happy and enjoy life!
Thank you from the bottom of our hearts and Matthew’s half a heart for all your prayers and support and for joining on this journey through the complex world of Congenital Heart Defects. We are making a difference for sure!
Raising Hope, One and a Half Hearts at a Time.
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