So, after a crazy sort of day – bloodwork in the morning and then waiting for a copy of Hana’s latest echocardiagram and it almost seems like everyone at Kaiser knows her. I saw her bloodwork results before we left and my heart dropped. Her BUN is high – 36. Her BNP has tripled – over 1400 (it is a test for heart failure). Her potassium was high. After seeing her bloodwork results I packed as if we were going to be away for more than a few hours. The trunk of our car was full of bags.
We drove to Palo Alto and the nurse practitioner who manages everything saw us as we were being led from having her vitals taken to our room. She said, “She looks angry!” to which I replied, “She is angry!” Hana really hates getting measured – length, weight, temperature, blood pressure, O2, she hates it all and she lets you know! But I think angry is an okay response, because perhaps if it were really bad she wouldn’t necessarily be “angry”.
The nurse practitioner came in the room ten minutes later and said she was relieved to see her. She examined her, as did a medical student, well he just listened to her heart while I quietly sang songs. They heard a gallup. But then Hana wanted to be up and walking around (still holding on to things, not quite on her own all the time yet). They took the copy of the echo and left the room.
When her cardiologist came in and looked at her he said he was relieved too. It is amazing to me, with all the instruments and tests they can do, but really what they rely on most is just seeing her. The want to see how she acts and behaves. She looks normal. He listened to her. They felt her liver. We talked about her cold last week and her constipation from the new pediatric formula (Hana helped out by letting go of some smelly farts) and he said that those two things could cause the belly breathing they saw in the videos. Or, it could still be a very early sign that her heart is worsening.
So, the plan is we are increasing her Lasix to three times a day until Thursday. We are not giving her Aldactone (because of her potassium levels being too high) until Thursday. She will see the Kaiser cardiologist on Thursday and we will repeat her bloodwork. I will continue to monitor her breathing. If it continues to stay rapid periodically (it was normal in clinic) or worsens or if her bloodwork results do not improve, then she may have to come to the hospital and get IV medications for a few days.
We are relieved too!