Tick tock tick tock ...

OK, they wheeled Gavin down the hall to the OR at 3:50pm. I suppose I should feel more nervous, but I don't. Am I in shock? Denial? I don't know. Mostly, I think I just have the peaceful feeling of "Gavin is going to be fine." So I'm not worried. He is in the hands of some of the best doctors in the world.
*Tim

Still waiting for the waiting to begin...

Apparently the surgeries earlier today went longer than expected and pushed Gavin's back. They just came to let us know they are about ready to come get him. Heather and I have each had some time to hold him. Sure is a wierd feeling, but we're excited to have it all start.

Surgery set for Friday around 1 p.m.!

It seems crazy to be excited about a surgery appointment--but we certainly are so happy that Gavin was bumped to the top of the schedule! They bumped him because while he is stable now--his condition is fragile enough that if his heart gets further stress, it could weaken him enough that he would need more than one surgery--a stent put in before the actual repairing surgery. So they want to operate on him while he is at his strongest.

In these photos we are listening to the murmur of his heart. It is very humbling to hear how hard this muscle works for us. It is just the machine that keeps us going all day and night, and we never give it a thought. His murmur sounds like a whoosing sound. It's very loud--almost louder than the rythmic heartbeat. I was surprised by that. And it seems to have it's own rhythm.

As of tomorrow afternoon, he won't have that murmur!

The surgery will start around 1 p.m. and should take about 3 hours. When he comes out he will be sedated, and have all kinds of tubes coming out of him: his nose, neck, both wrists/hands, chest and probably other places I'm not thinking of. But he should come out of sedation within 24 hours and be home by middle of next week. John mentioned he can't believe we are here in Mia's NICU, about to go to her PICU. It is especially hard to believe since Mia was just barely here! And as it turns out, Gavin's surgery will be even be performed by Mia's surgeon Dr. Kohen (sp?). It is very reassuring to trust our baby with a doctor we already have so much confidence in.

So far I've been able to stay at the hospital this whole time--thanks to much help from my ward family at home! Thanks also to all the offers of help from my fam-family. Tim is keeping you on speed-dial! :) There is a tiny little "sleep room" (think dorm room, but smaller) upstairs where I sleep. I got 4 hours sleep the first night and six the next. I'm hoping for seven tonight! There is a "common area" for families where there are computers for parents to use.

Gavin is still not allowed to eat, so I am kept busy with pumping every 3 hours. I am a little worried about losing my milk, but I received excellent advice from a lactation specialist that really helped. But what helped most was when I realized how tense I was!! As soon as I took my mind off of pumping and thought of something peaceful, I seemed to sense immediate improvement and was able to pump more. I really didn't realize how tense and stressed my body really has been through this.

I was blessed my first day here with very special visitors: my sisters Mimi & Anne, and our kiddos. They all came perfectly staggered throughout the day, and their visits were a huge blessing to me. Mimi with all of her "insider" advice and showing me the ropes of life in NICU (Neonatal Intensive Care Unit). Her advice and support have been--well, I can't even describe how reassuring it has felt. (By the way, CICU is the Cardiac Intensive Care Unit--Gavin would be there already except they were too crowded.) Anne was a life-line of sisterly love and kindred spirit. Both of them had there baby girls with them--who were a JOY to see.

And then my kiddos. When I saw them with their Daddy walking down the hall to me, it just choked me up with love and perhaps a bit of homesickness. They got to spend a few minutes with Gavin, before we whisked them away to the cafeteria for a fun meal together! The kids all seem to be coping alright, but it is hard for me not to know the ins and outs of their day and well, just be so isolated from their worlds! They are pretty much having fun with their friends after school, until bedtime when they really realize my absence.

We have had many calls of support and advice, which I so very much appreciate! I haven't had a chance to call or email everyone back, but please know I am grateful for you. Maybe I'll have more time when Gavin is post-op, but right now I am soaking up the opportunity to hold him. You'd think time would pass slowly here--but as of right now, these two days have just sped past.

Tonight Tim gave Gavin a beautiful priesthood blessing, with the help of a dear neighbor/hometeacher. I am confident that all will go well tomorrow, and look forward to hearing that new heartbeat!

Google-ing Coarctation of the Aorta

OK. Well, I haven't gone down to see Gavin yet, but I wanted to do some Google-ing first. I now have a few more questions to ask the doctor and a few more worries--as Google-ing is wont to create. The ER doctor mentioned stress to Gavin's biscuspid valve, for example, and I need to follow up asking about that. It is good to be informed. Most of what I read, has been exactly what I've been told on this end. But the info helps me process all of this. The two websites I found helpful are: http://www.cincinnatichildrens.org/health/heart-encyclopedia/anomalies/coarctation.htm and http://www.healthatoz.com/healthatoz/Atoz/common/standard/transform.jsp?requestURI=/healthatoz/Atoz/ency/coarctation_of_the_aorta.jsp
There is a picture on the first one.
The purple area indicates the place where Gavin's coartaction is located. It sounds like he's pretty much a textbook case. Very treatable, though recurrence is quite possible, which is also very treatable.

We are Fine :)

Things are going fairly well. They still won't allow me to feed him (they don't want to make his heart do the extra work of digestion), so that means his surgery will go higher up on the priority list. Gavin is not a happy camper, but the medications have caused him to be drowsy and sleep most of the time. It's pretty heart-wrenching. But I have good nurses. So far we are OK.

Tidbits of info:
Earlier today I was told he wouldn't be assigned a surgery date until Monday. Now I think I will know tomorrow when his surgery will be. The medication he's on is Prostoglandin--it is succeeding in opening the ductus artery more, which is probably giving his heart a break and lowering his blood pressure. They don't know what causes a "coarctation"--but one idea is that when the fetal ductus artery closes after birth, it appears possible that it sort of "sucks in" the wall of the aorta on the other side. In Gavin's case, his heart seemed to have "saved" itself, by leaving the artery open. The severity of his aorta blockage is an "8" on a 1-10 scale. Almost the entire aorta is blocked. The only way Gavin's blood got through was through that open artery, which is supposed to automatically close upon birth. All of his nurses have told me with a bit of wonder, "He's very lucky." Thank goodness our pediatrician took action when he heard the murmur. If he hadn't, they tell me he would have either become very sick, as his extremities slowly got less and less oxygen until his kidneys shut down OR he could have suddenly died if the artery had decided to go ahead and close.

For those now worrying about their babies and wondering what symptoms he had, please don't worry, this is so rare. But my sister-in-law Kirsten was wondering, so in a nutshell, this is how his diagnosis went: a heart murmer and retractive breathing (inhaling deeply under the ribcage) were detected. Blood pressure was higher than desired (resulting in a femoral pulse that is hard to detect). He's not an enthusiastic nurser--possibly because it expends too much energy. (The cold he had is unrelated, by the way). With these symptoms, the x-ray was ordered, and then the symptoms of enlarged heart tissue and fluid in the lungs triggered the ECHO (fancy ultrasound) of his heart--and whalaa--he was diagnosed.

Thanks for all your prayers and emails, and offers of help at home. We are blessed!

Gavin is in NICU--He Needs Heart Surgery!

I can not believe I am here, at Children's in Seattle, with Gavin. Yesterday I took him for a well-child 2 month old checkup. The doctor heard a heart murmur and ordered an X-ray at Valley Hospital. By the time I returned home from that x-ray apptmt, and picking up kids from their playdates, Tim met me in the driveway and told me that doctor had called him (my cell phone was dead)--we had to take Gavin to the ER at Children's immediately. Wow. Gavin looked fine. He's had a cold for 3 weeks, and granted, he's had a funny way of breathing, but he's been thriving, is alert, everything. He didn't act he was in critically compromised health. Dr. Chan's words to Tim were: "I've called ahead to the ER at Children's. They are waiting for you. You need to find your wife."

I took the news in stride. Talking with the kids, gathering them for a prayer, as I processed this in my mind. It wasn't until calling people and verbalizing "I'm taking Gavin to the hospital" that I broke down.

The X-ray had shown that his heart was enlarged (a big sign of a problem, of the heart over-working because of a problem) and that there was fluid in his lungs.

The bottom line is, Gavin is going to be OK. They called in specialists and did an ECHO right there in the ER. The cardiologist has diagnosed him with a Coarctation of the Aorta. Basically, there is a kink in the artery that is seriously impeding the flow of blood to his extremities. Luckily, the blood flow to his brain has been fine. What has kept him alive and thriving, is the simple blessing that the PDA (artery that delivers blood from mom to baby in utero) did not fully close. The blood that was blocked in his aorta took a detour through that PDA artery and then back into the aorta and on through the body.

The surgery he needs will involve cutting away the section of the aorta with the kink and bringing the two ends together. The surgery should be done through an incision in his left side--moving some ribs aside, should give them complete access to the aorta. He should fully recover. His heart is enlarged right now, because it is having to pump extra hard to get the blood around the kink. After surgery, his heart won't havt to work so hard, the tissue will shrink back to normal, which will allow the fluid in his lungs to clear up. This is how I understand the facts at this point.

Gavin spent the night in the NICU. I slept for a few hours in a sleep room. They arent' letting him nurse. I can't bear to deny him. It is a terrible thing. But so far he has been exhausted enough not to fight it--he was sleeping when I woke up this morning. So I went to breakfast. They will page me when he wakes up. They don't want him to nurse, because he is on a medication to keep the fetal artery open, and they don't know if because of lack of bloodflow, if his stomach lining has been compromised. It's possible his stomach can't tolerate the medicine and the food. Doctors have also noted, and been concerned that he's only gained 2 lbs since birth (he now weighs 12 lbs 6 oz). He's never been a voracious eater--that could be because of the amount of effort it took him to eat and keep oxygenated. The medicine he's on, should make the blook flow more easily, giving him extra strength and rest before his surger.

I can't believe we are here. Gavin is in the same wing of the hospital that his cousin, Mia was in until just a few weeks ago--with a heart condition of his own. It has been a comfort to have Mimi and John's support and advice. They know the ropes around here better than anybody ever should. (For those that don't know, my niece Mia received a heart transplant here at Children's in November. Their story is at www.mcdonaldfam.blogspot.com.)

We are waiting for the doctor to visit Gavin. They will tell us when his surgery will be. I'm expecting it will be within the next 7 days. I am hoping it will be ASAP, especially if he is not going to be able to eat. Thank you for all your prayers and support for us here, and for the kids at home. Thank you for wonderful family, friends and visiting teachers. We will keep the blog posted with any updates--as it is the fastest way to reach all of you.
Love,
Gavin's Mom and Dad

Meeting baby Gavin! This is one of the best moments of my life--with each baby I've had--introducing the new baby to their biggest fans-his/her brothers and sisters. And this time was no exception. Spencer, Rachel, Levi and Elizabeth are all so enamored with their precious baby brother.

Elizabeth loves her baby bro, but notice her grip on my fingers. This is all kind of scary for her, too. She knows somehow that things are changing, and that she doesn't have the same access to mommy right now. She is trying really hard to be careful for mommy's bandaids on her tummy--I showed them to her--but it is upsetting for her. She sat beside me on the couch all evening, with a glowing smile, but with tears in her eyes. It about broke my heart! She'll be OK, though!

First Family Photo!

Taking their first peek at his little hands.

WELCOME HOME GAVIN!

Tim and I brought our little guy home from the hospital last night, in the middle of a beautiful, thick snowstorm. The snow was gone by morning, but it made the drive home that much more memorable. Isn't the sign Tim made cute?! I was very impressed.

I was very grateful to have the blanket wrap that Rachel made for Gavin. He was toasty warm all the way home.

All ready to load up and say farewell to the nice nurses at Valley Hospital in Renton.

SOME HOSPITAL HIGHLIGHTS:

Gavin had lots of visitors from friends and family. I do not have pictures of everyone available--Grandma and Grandpa McDonald saw Gavin when he was just a few hours old. My sweet friends Kristin and Jana came, and even Uncle John was able to stop by on his way back from visiting his own wife and daughter in the hospital at Children's where they had to stay a few nights for testing. Hopefully Mimi and Mia are back home again by now!

Aunt Bethy came just in time to help us gather up our things, and get our precious cargo ready to leave the hospital and head for home.

I love this photo of Daddy Tim with his little man. It turns out Gavin is the third of three of our sons to inherit their Dad's olive skin and dark hair. "Tall, dark and handsome" is how we make 'em!

My precious baby.

Love this photo! My sister Anne and I hold our little bundles! Eve and Gavin are just 5 weeks apart! It is fun having a baby the same time as my little sister. I remember when I was newly married, Anne worried that all her older sibs would be done having kids before she got started. I'd say with 5 of us having babies within about a year's time has those worries washed away! :) On Tim's side, all 7 of the children in his family will have had a baby within 15 months of each other. Can you say, hurray for cousins!

I put this photo in for a little perspective--can anybody guess how this guy fit into my belly just a few hours before the photo was taken?

GAVIN THOMAS KOVACS - Our belated Christmas gift!!

We love the name we have given our son. GAVIN was a name that I intially thought of in reference to Christmas--as it ties to the spirit of 'giving'. While he decided to be born in January, we still loved his name, and besides, the Christmas spirit should last all year long! His name also means "White Hawk" and has noble connections to the Knights of the Round Table.

THOMAS is meaningful for us in several ways. It is the name of one of our ancestors on my Grandma Hallmeyer's side, who owned a castle in Ireland centuries ago. Thomas is also the name of our religious leader, our prophet, President Thomas S. Monson--a man whom Tim and I admire and hope our son will be inspired by and feel a special connection to, as he matures into his own personality!

The kids came bringing gifts for their baby brother! Rachel shows him the blanket wrap she sewed for him.