Dr Baird (Marshall’s surgeon) isn’t entirely comfortable addressing the total anomalous pulmonary venous return issue at this point.  Drs Friedman &  Baird went to Dr Locke (Harvard’s chief cardiologist) to map out the best plan for Marshall.

Which isn’t easy due to the complexities of his anatomy, condition, and surgical outcomes.

As of now, they repeat a cath tomorrow afternoon.  Again he is n.p.o. at 8 a.m. Then the cath team will address the collateral arteries (by coiling them off), get more information regarding a coronary artery issue which may have contributed to the heart failure and stroke, investigate the anomalous vein issue further, and then try to place a 3mm plastic stent where the B.T. shunt has been since his first surgery.

Which, per a hunch and long talk with the cath lab doctor post June cath, is going to be nearly impossible.

Marshall’s veins and arteries are just too small. Dr P (the cath doctor) wanted to place the stent in June but held back because of the risks.

Hopefully he will remember this tomorrow afternoon.  My goodness I hope.

If not, Marshall will need more intervention.  Likely that Glenn Dr. Baird is quite hesitant to do. 

If they place the stent, that is great.

But.

If they don’t, this means a triple high risk Glenn. It will likely happen Friday, Monday,  or Tuesday.   If, and only if, Marshall can hold his own post cath.

(At least the o.r. is free on Friday…)

If they place stent successfully, and Marshall recovers well, they will try a milrinone wean.  Then maybe we can get home with close monitoring to fatten him up for a Glenn in a few months. 

If he doesn’t tolerate the milrinone wean, he will be relisted for transplant. 

This. Is. So. Much. I. Can. Barely. Breath. At. Times.

Especially today.

Luckily Marshall and I were not alone while Michael made an overnight visit to N.Y.  Marshall thankfully got to play with Grandma Martha, Herb, and Aunt Donna today.  And super thankfully I had extra help as I juggled calls to Michael, chats with my big boys, updates to family, massive stress, meetings, rounds, and whatever I am failing to mention. ..

So thankful.  So worried.  So much…