This couldn’t really be put together with the awesomeness that was the other post for today. This one is the medical update. Brendan had some issues last night with not having adequate urine output. The IV tower had to come back in because they put him back on the Milrinone to help him with his pressures and then he was able to urinate properly.

The cardiologist had mentioned earlier that another procedure might be necessary, and it looks like it will be now. Brendan will get another echocardiogram in the morning and then the team will make the decision as to whether or not to proceed with it.
Part of Brendan’s heart defect is an Atrial Septal Defect, a hole in the septum (wall) between the left and right atrium of his heart. In a normal heart, this hole would create quite a problem and would be surgically repaired. In Brendan’s heart, this hole is necessary for the proper flow of blood and balance of pressure. In Brendan’s case, this hole is not as big as they would like it to be so the atrium that receives blood back from the lungs has a higher pressure than the other, and that can cause the blood flow from the lungs to back up while the blue blood from the body flows more easily in to his single ventricle.
The physical result is that Brendan can be nice and stable and his numbers can look very good until he gets agitated. In a state of stress or exertion when his heart works harder, the blood moves more slowly from the lungs and the oxygen saturation in his system drops.

They will do the procedure called an Atrial Septostomy, where using a heart catheter they will inflate a balloon and stretch/tear the opening between the two atriums to allow better flow and equal pressures. The main ICU doctor feels that the benefits from this procedure will far outweigh the risks. Where this is not an open surgery, recovery should be quicker. When Brendan has his Glenn procedure, they will be opening this further anyway. So this is just an early step they can take to improve his chances to grow heavier and stronger in preparation for the real open heart surgery.
He just is not ready for the full operation, so this will help him along while he grows.

I am hoping that we will know tomorrow when and if they will be doing this! In the meantime, Brendan is doing well and we are really looking forward to having more brother-time!

So there was something special about the big boy bed that I did not mention yesterday. All of that extra real estate was necessary so that he could have play dates with his brother! We have to tread carefully here because it puts both boys at risk in a way. Trevor could bring in an illness from outside the hospital and give it to Brendan. Or Trevor could pick up a nasty bug from in the hospital and get ill himself. We have been real stingy about allowing anyone to visit, especially during cold and flu season, and we appreciate everyone’s patience. The boys having a chance to bond with each other is important!
It really is a very special day, the boys have not been near each other since they were in the womb almost 6 full weeks ago.

Brendan had a sense that something was up and he assumes his karate chopping position.

Aha! His old nemesis returns! Chops and kicks!

But think of all the trouble we could cause if we teamed up, says Trevor

The pact is sealed .. bros for life!

I can’t even caption this photo, it makes me laugh too much

All humor aside, it was really special to be able to hold both of my boys.

Brendan was wide awake most of the time, and Trevor was pretty well sound asleep for 99% of the visit. When Trevor woke up, Brendan slept.

Our whole family all together at last!

And Gramma is really glad she did not go home yesterday so she was able to be there with us for the reunion.

One last picture because Trevor just looks too adorable