Gavin's Speedy Heart

This post is actually at the culmination of quite a saga, though one that transpired rather quickly.  While coaching Gavin at soccer this past fall, I had been noticing that Gavin would occasionally start holding his chest while running around on the field.  He is always a bit difficult to get information out of, but did volunteer that his heart seemed to be beating fast sometimes.  I tried to get a better understand of what "sometimes" means, but then he quickly inferred that it barely ever happened.  I started to watch him a bit more carefully and it was readily apparent that he was actually having this problem almost daily.  Even with my medical background, I couldn't exactly tell what the issue was but I knew that this was not normal.  

We quickly set up some appointments with a pediatric cardiologist and they checked him about and determined that to make any specific diagnosis that they would need to capture some of the episodes on an actual heart monitor.  This led to a comfortable 14 day stint with a heart monitor stuck to Gavin's chest.  The funny part about this monitor was that it had this little button on the front that we had no idea about.  A soccer ball hit the button one time and then Gavin may have experimented with randomly pushing the button a few times, or so he said.  However, about half way through the week we realized the button was there to push when he was having an episode so that the analyst could be queued in to where they should look over the 14 day recording.  Oops.

We did finally capture an episode, so we thought, and ended up writing down the time/date for it because Gavin had already pushed the button probably a few dozen times before then.  The monitor was eventually sent in and we went back in to the cardiologist for a follow up.  She explained that they were able to see what was going on and his heart had these occasional events where his heart started to beat at approximately 200 bpm.  This was most likely caused by a second set of cells that receive the primary signal from his SA node and send out a repeat or secondary signal that the AV node sends out.  The result is that he had dual sets of electrical signals being sent to the lower half of his heart to contract.  In his case, it would reset itself after a few minutes of rest and then he would be fine again.

She reassured us this wasn't a life threatening issue, but could have some long term consequences depending on how we proceed.  She gave us three options: 1) Do nothing, in which he could live with the condition and it may get worse (more frequent incidents) over time, 2) Put him on medicine for the rest of his life that he would take daily, or 3) Have an ablation procedure to deal with the extra repeater cells.  After some tough discussion, we decided to have the procedure so that he wouldn't have to deal with this the rest of his life.  This quickly progressed because we had met our insurance deductible and there was only one opportunity before the end of the year to sneak the procedure in.

Only about three days later, we were in Children's Hospital walking in the front door for this procedure.  We walk through the front entrance, all a bit scared of what we were walking in to, and we were pleasantly greeted to a children's orchestra playing Christmas songs in the commons area.  I think this put us at ease.  We were supposed to be the third case of the day, so we slowly made our way up to the office.  However, when we arrived, they were already ready to rumble because the first two patients had been finished ahead of schedule.  The "procedure" itself was supposed to take almost three and a half hours where he would be under general anesthesia.  They quickly prepped Gavin and we were visited by two pediatric cardiologists, an anesthesiologist, a nurse, and a child patient advocate that explained everything to Gavin in language he could understand.  The advocate also gave him this squishy thing for him to hold and play with and that really helped him.  I couldn't have been more impressed.  We were briefed and signed all the paperwork and they soon wheeled him away.  

As a parent, it is always scary to see your child wheeled away in the hospital...even for something that is supposed to be fairly routine.  The plan was to put him under a general anesthesia and then insert a probe into his heart from his femoral artery and locate the repeater cells.  They would text us about every hour as to his progress with the procedure and Tara and I went over across the street to Panera Bread company so I could work a bit and we could wait together.  It was pretty nerve wracking, but I also felt some sense of peace and trust in the doctors there.

Finally, we got the call to come back over and that he would be recovering soon.  The doctor showed us the below picture that showed an electrical map of his heart and where they had mapped with the probe.  In his case, the issue was on the right side of the heart (meaning they would not have to pierce the septum between the two chambers in a more risky maneuver), but the extra set of cells were fairly close to the real cells (AV node) that you want to keep working.  They elected to go with freezing the bad cells vs. burning them because of the proximity but this comes with a 10% recurrence chance.  We were certainly supportive of the more conservative approach.

After talking to the doctor, we had to wait another 20 minutes until Gavin was able to see us.  We were so excited to see him awake and through the other side of this.  One of the perks at Children's Hospital is the food menu where the patient gets to order anything he wants.  This includes an apparent off-the-menu milkshake item.  As you can see, he was quite happy to take advantage of the options.

We were under strict instructions for Gavin to stay laying down for three to four hours after the procedure to make sure everything was alright.  This was a bit uncomfortable for him, but they had some movies to watch.  We were released later that night and we came home to our house for a further three days of no-exercise recovery that mostly was him just sitting on the couch per doctor's orders.

He recovered quite quickly, though, and by the following Monday was cleared to play soccer again and continue on with life as he knew it.  All of the sticky leads and stuff sure made a nice red patchwork of irritated skin on his body!  In the end, I couldn't have been happier with our experience at Children's Hospital.  What amazing work they do there everyday to help kids with all sorts of medical needs.  It is so hard to see something medically wrong with your child, but so exciting to see them come through it and continue on with no real significant problems.