I thought it might be helpful to give some insight in to Finley's heart condition and what she is having surgically repaired on Tuesday.  Finley was born with a congenital heart defect called Tetralogy of Fallot.  It is actually one of the most common congenital heart defects and the prognosis after repair is usually quite good.

Well what is it?
Tetralogy of Fallot, a condition present at birth, is a combination of four ("tetra") heart defects.  I still remember the doctors sitting us down on the evening of August 9th after doing what seemed like an all day echocardiogram and telling us what the name of this condition was and that it was characterized by FOUR defects.  FOUR?  Isn't one enough?  Anyway, I digress.  The four defects cause several problems and usually cause the skin to turn blue due to poorly oxygenated blood.  This is actually why they called the transport team to pick up Finley and bring her to Childrens - she had a bluish-gray tone to her.  I will also never forget, when Mike and I walked into the NICU that day, I asked the cardiology fellow that was doing the echo what she was looking for - and she told me - very matter of factly - she was looking for a "blue baby disease" or in other words a defect that causes cyanosis - the condition of having that bluish pallor.

The four defects associated with Tetralogy of Fallot include:

1) A hole in the heart wall between the lower heart chambers (ventricles - called a ventricular septal defect or a VSD) that causes oxygen -rich blood and oxygen-poor blood to mix.  Finley has a large VSD that will need to be closed.  And, as a bonus, she also has an atrial septal defect - ASD - which is a hole between the upper chambers (atriums) of the heart).

2) A narrowed or blocked passageway between the lower-right heart chamber (right ventricle) and the main blood vessel leading to the lungs (pulmonary artery- infundibular stenosis) that causes reduced blood flow to the lungs and requires the heart to work harder.

3) A shift of the main blood vessel carrying blood to the body (aorta) to the right that causes oxygen-poor blood to mix with the oxygen-rich blood (overarching aorta)

4) Abnormal thickening of the muscle of the wall of the lower right heart chamber (right ventricular hypertrophy)

So how will they correct this?
The surgery is an 6-8 hour procedure that involves the closure of the ASD and the VSD with a patch (which is actually Gortex) so that the blood can flow normall from the left ventricle to the aorta.  The narrowing of the pulmonary valce and right ventricular outflow is then enlarged by a combination of cutting away obstructive tissue in the right ventricle and enlarging the outflow path with a patch.  The hope is that her pulmonary valve will be salvagable - meaning not too tight so it can be widened enough to allow proper blood flow but won't leak.  If the valve is too tight, they will attempt to cut the valve open and put a patch in to make it wider (as previously explained).  The third option would be to put in an artificial valve if its too tight to salvage.  Either of the last two options will mean that Finley will eventually need to have that valve replaced - fortunately this can be done through a catheterization process vs. another open heart surgery.

The interesting thing about the repair and Finley's condition is that they only actually repair two of the four defects.  The act of closing the VSD will correct the overarching aorta and the procedures in total will allow the parts of the heart to do their jobs equally and will, over time, correct the hypertrophy of the one side of her heart.

During the procedure, Finley will be put on the heart/lung bypass machine, her heart will be stopped and the machine will do the work of the heart.  The process of getting her up on the bypass machine and then back off is actually what takes a considerable amount of the time she is in surgery.

Finley's surgeons Dr. Backer and Dr. Russell are the same doctors who performed Finley's first open heart surgery and are two of the best doctors in the country.  We feel very fortunate to have access to such wonderful physicians and know that she will be in the best hands possible.  Finley should be the first case on Tuesday morning so I hope to have some updates by the afternoon or early evening. 

Please keep Finley in your prayers.

Wow.  It was 9 months ago today that Princess Finley came in to our lives.  Its been the longest, yet the shortest 9 months of our lives.  Its amazing to play back those tapes in my head and think about all that she has been through and how far she's come.  And now, as we celebrate her 9 months and prepare for her surgery on Tuesday - it amazing to think she made it THIS far before she needed her heart repair surgery.  When she received her shunt, the doctors told us she would need her repair at 6-8 months.  And here it is 9 months - and we're not doing the surgery now because she's outgrown her shunt - we are doing it because now is a good time.  She is big and she is healthy and she is ready!!!

Here is the princess's 9 month birthday picture:

Its been nice to have Mike home - Nate is of course thrilled.  The night before he got home, he gave Finley a kiss in her crib and told her to "dream about daddy".  And then every airplane that flew over our house Thursday night, Nate would say, "do you hear that?  Daddy is on that plane!".  Needless to say there was a lot of excitement - Nate was so happy he picked these for mommy, daddy, Finley and all of "daddy's friends":

And here is a picture of the little man with his daddy - reunited and it feels SO good!  LOL! (note the Iron Man in the background)

And so we are having a relaxing, family weekend at home - one of the last ones we will have for a couple of weeks.  And daddy got to do one of his favorite weekend activities - napping with the kiddos...

How crazy is that hair right?  I keep (half) joking that they are going to need to put one of those paper shower caps on Finley when she goes in for her surgery!

I hope that everyone had a wonderful Mother's Day tomorrow!  The last 9 months have given new meaning to me to what it is to be a mom and so this Mother's Day is extra special and I feel so lucky to have my two little beautiful children in my life!

Mike gets home in the morning.  Man his flight can't land soon enough.  I am tired.  I look like hell.  I had three hours of sleep last night.  Did I mention I look like hell? I've had exactly two showers since Mike has been gone.  He left on Saturday!  I know, I shouldn't be admitting that.

Mike is on the way home as we speak and we (collectively) couldn't be happier.  I am pretty sure Nate is sick of me - if I have to hear DDDDDAAAAAAADDDDDDDEEEEEEEEEEEEEEEEEEEEEEEEEEEE one more time, my ears are going to explode.  And Nate, he's been in that "That that doesn't kill you will only make you stronger" category for me this week.  I love the kid to bits but Dear God he's been trying my patience.  He's had tantrums that have put every other tantrum to shame.  At times I have been pretty sure his eyes were going to bug out of his head and his head was going to spin.  Seriously, its been that bad.  I can't wait to get out of this house for some alone time tomorrow - I have a hair appt and eyebrow wax tomorrow afternoon - I need to take action on that third sentence in the opening paragraph!

And Finley?  She's been happy as a clam. I said this in my last post, but it bears repeating - she has been such a peach.  I don't think I've seen her so happy and so healthy in a long time - maybe ever.  I have really enjoyed the week with her at home with Gigi here - the two of them in the den and me working in the dining room - I can just hear her chatting away - making all sorts of crazy sounds and noises - giant smile on her face.  I wish I could bottle her up right now and open it up next week after her surgery when I am dying to see that smile.

With Mike in Argentina this week, Nate has been missing his daddy a lot.  And needless to say, he's been a bit of a terror.  If I had a dollar for how many times Nate has told me since Saturday that I "wasn't his best friend", I'd be able to go on a nice little shopping trip.  As awesome an age as three has been, its been equally frustrating and Mike and I often find ourselves really hoping that its just the age and that he doesn't really have issues.  We continue to be hypersensitive toward Finley's hospitalizations and the impact they could possibly have on Nate.  Although we try to keep things as normal as possible for him during those times, he's definitely started to be more emotional around those times.  I tried to begin the conversation with him last night about how Finley would be going back to the hospital last week and he started to cry - so I thought we'd save that for another time.

Anyway, Nate and I started off with a bang yesterday morning.  He was adamantly refusing to get ready to go to school, was running when I tried to get him dressed (and laughing at me) and subsequent time outs didn't work - he just doesn't care about being punished (and he laughed at me some more).  So I took his DVD player away.  And he took notice.  After he finally got dressed, I agreed to give him a second chance with his "DDD" player (as he calls it) but after school was more of the same - so not got "grounded" from his DDD player and the TV.  All night long, he kept asking me, "Do you want to let me watch my DDD player?  I can tell you sorry." or "Let's watch Madagascar mom".  And then I kept telling him - he made that decision he said, "I can have it in the morning time?".  Needless to say, Nate and I had a nice dinner together and a nice quiet, TV less evening.  And since he had nothing else to do, he wanted to cuddle with his mommy a lot - and we both fell asleep at 8:30 pm!  I think I can get used to being the bad guy (LOL!).

Finley is doing awesome.  Her smiles abound and she seems to be feeling the best she has been in a long time.  Prior to her hospitalization she had this pesky cough and runny nose for weeks and now its completely clear.  When she sleeps, she is so quiet, I have to put my face down really close to her to make sure she is breathing! She has been so actively chatting, kicking her feet and doing her Miss America wave (she does this thing where she holds her paci in one hand and twirls her wrist and when she does it, the other hand simultaneously moves and does the same thing!).  Her progress though as made us think - that certainly the antibiotics and steroids have helped to get her better so maybe that wasn't just a cold she had?  Its something I plan to talk with the ENT about next week.  Perhaps the hardest thing for us right now is wrapping our heads around the fact that in less than a week she will be back in the hospital and while planned, it will likely be the most serious surgical procedure of her life (hopefully).  And to anticipate that we will be missing those smiles, the chatting, those waves, for a couple of weeks while Finley recovers is heartbreaking to say the least.  So for now, we'll just soak them up...

And this about sums up Nate's mood for the past few days...

And an after picture (don't mind the garbage and recycling bin!):