First Annual Cath

I want to put together a coherent post, but my brain is so fuzzy and tired right now.  It's only been a week since I last posted, but EVERYTHING has happened.  Brooklyn's missionary homecoming (yay!), her homecoming talk in church, Jason's work party with ASSIST, multiple concerts, friend and family celebrations, Eli's robotics competition, Annika's heartiversary, and now today Annika's heart cath and biopsy.

Being back here at Primary Children's in December feels both familiar and strange. Yesterday marks a year since Annika's transplant. As we've been moving through pre-op, recovery and post-op, the nurses keep reporting that Annika is here for her "yearly cath."  Being a tween, I think most assume that she has had multiple. While it's true that we've had our fair share of cath procedures over the past year, this annual check-up is still a first for us and feels like a big deal. In truth, listening to other heart transplant families, no matter how many years it has been, every cath feels weighty. This is where you get an in-depth look at the health of the transplanted heart. How are the coronary arteries functioning? Any signs of rejection? What do labs reveal about the health of the other organs?

Overall, the news seems positive. Annika's coronary arteries look great. Rejection can cause narrowing or hardening of these arteries, but hers look beautiful. It's pretty fascinating to do a side-by-side visual comparison see how they perfuse compared with six months ago. Her left coronary arteries are dominant--far more extensive and robust than the arteries on the right side, but both sides seem to be doing a great job providing circulation to the heart itself. The wedge pressures in her pulmonary arteries are on the high side (16/17) but they haven't changed significantly since her last cath, so the team doesn't seem particularly concerned.

Looking at her labs her white blood cell count is low (this is expected given the immuno-suppressants), but not more than usual. Magnesium is also still low, despite the fact that we've been doing oral supplements. I was surprised to see that her hematocrit/hemoglobin/red blood cell counts are significantly lower than last time. Her blood glucose is also high and her protein low. It will be interesting to see if her team has anything to say about any of these tests. Given the number of medications that she is on, it's common for labs to flag as "abnormal" but still be within an acceptable range for transplant. Either way, I'm hoping to focus on quality nutrition at home with more healthy whole foods and less refined sugar. Oh, and DEFINITELY better hydration. Annika is not great about drinking water. She's especially hesitant since starting Lasix a few months ago, and it's reflected in her kidney labs. Her BUN popped slightly above range at 20 with this lab draw, which worries me. I'd really like to keep those kidneys happy.

Okay, enough nerdy medical stuff. I'll keep you updated if we learn anything significant.

In the meantime, how about the funny stuff? Despite having to report to Primary's at 5:45 am, Annika woke up extremely happy and chipper. She arrived with a smile and her two dragons, Toothless and Chloe. She also came equipped with printed lyrics to Your Idol from K-Pop Demon Hunters to pass out to the cath lab team. She was quite insistent that her anesthesiologist sing to her as she drift off to sleep and told everyone her plan. Fortunately Dr. Christensen and Dr. Mary-Hunt Martin were great sports. She trotted off into the cath lab with a huge smile, and when Jason peeked in on her, she was literally standing on the table as she adjusted positions. What a hoot! This kid is a riot. The stories everyone must tell...

Waking up from anesthesia is less fun, but thanks to Sprite and slushies, she now feels up to eating her shrimp linguini. I'm so grateful that Primary Children's is a space where she feels safe and cared for. Her cardiology team just stopped by and gave us the two thumbs up to go home!  We will continue to have follow-up appointments every three months, but with a little luck we won't be back in cath lab until December 2027. We are so grateful to her donor and everyone who helps care keep this special heart beating.