calling peds cardiology and derm spouses!

[DCJenn]

OK- quick consult needed:

Cardio:
Nikolai has that valve thing that never closed after birth- Rick says because he's a preemie. So, my plan is to get a peds appointment before we go to Russia to get him so that we can maybe we can get a referral for immediately after we return. My question- is there anything that we need to keep an eye on before we get home- like on the airplane?

Derm:

He also has a pretty large hemangioma on his thumb- is there anything we need to do- especially as our latest email says that he's now crawling...

Thanks in advance-

Jenn

I'll PM you later tonight.
One step closer!

Hi there! I'm a pediatric cardiology fellow whose wife reads this foum and told me about your post. If the valve thing is a patent foramen ovale (a connection between the two upper chambers or atria of the heart), know that this is a very benign problem and is unlikely to cause problems on the flight. To put this in perspective, one in four adults still has a patent foramen ovale (also called a PFO) and generally will probably never know it's there unless someone finds it by accident. Some children (and premies are more susceptible) have a patent ductus arteriosus (aka a PDA), which is a type of bypass tract between the pulmonary arteries and the aorta. They usually close within 48 hours of birth. If they don't close babies can have two general problems--they can have too much blood flow to the lungs or they can develop an infection of the PDA. The amount of blood flow to the lungs depends on how big the residual ductus is and a small one may not cause any symptoms at all. Signs of too much blood flow would include breathing fast, working hard to breathe, having difficult eating, poor growth, and a puffy face. Signs of infection would be the usual, such as fever and acting sick. The bottom line is that if someone in Russia raised a question of congenital heart disease it is probably a good idea to have him evaluated here to get a clear idea of what the diagnosis is. How soon you need to get him in really depends on how sick he is. If he is just supposed to have a PFO and looks well to you there's no hurry to bring him to a cardiologist. If he is said to have a PDA and looks sick, I would bring him in sooner. If he seems very ill when you get there to the degree that you would worry about his health on a plane ride, I would probably try to have him evaluated before you leave Russia because there may be some simple intervention (such as giving him a dose of Lasix or increasing his daily Lasix dose) that would make him much more stable on the flight. This may have been more than you bargained for, but I hope it helps.

[DCJenn]

Thanks for your help everyone!

We got a few more pictures today which helped- he looks pale, and grumpy. He had just been woken up from his nap and boy he doesn't look very happy about it. Of course, Rick's main concern was that he was wearing a pink flowered onesie.

Keep those good thoughts coming-

Jenn