New Doctor, Mixed Feelings

**Warning** Most of this is to help me keep things straight. Sorry if it's "too much information" for you! :)

Well, Logan had a cardiologist appointment yesterday. We received some information that we’re not sure we’re comfortable with just yet. I have put in a call to his previous cardiologist in Sacramento and after talking things over with him, we’ll decide what’s best. (After typing that out…it sounds so simple. I wish it were that…but it’s anything BUT simple in my mind.)

Clinically, Logan looks great. We all know that! The little guy has always ‘looked’ great, even in heart failure! So that’s a positive and we know that he handles his health condition remarkably. His pulmonary valve and conduit (the one they replaced in Sacto almost 2 years ago now) looks wonderful. It’s handling its position well and Logan’s immune system has decided it likes this one much better than the last, so that’s good!

The part we’re not sure of is that his new cardiologist, Dr. Ghazali, feels that he needs to be put back on Enalapril. This is an ace inhibitor medication used to control his blood pressures. After reviewing the echo from yesterday and comparing it to the previous echoes from Sacto, he feels that Logan is having a gradual enough increase in the pressures in his aortic valve to constitute medication. He reassured us that we are nowhere near ready to talk about replacement; however, it’s more about preserving this valve as long as possible. The better they control the blood pressure leaking through that valve, the better they protect it and preserve it. With this reasoning, we agree.

What we are unsure of is that this has never been an issue brought to our attention until now. I have no frame of reference or scale, to determine the numbers given to us over the course of the last 3 visits. So we’re unable to make an educated decision on whether it’s time to medicate him versus waiting another 6 months, which he also gave us as an option. This is one question that I’ll be asking Dr. Fallah when I speak with him today. Replacing his aortic valve was something we knew would be happening eventually, however it was perceived to be something to deal with in his adulthood. I plan on consulting with his previous surgeon, Dr. Mainwaring regarding this topic. Mostly to gain perspective and additional education on the possibilities and options concerning this area of his heart. I read through the previous echo reports and all that was noted was that the “mild leakage” was something to watch closely. He never mentioned it out loud to us. At least not in a way that was cause for concern. So basically, I’m just looking for reassurance that this is the correct step to take now. It would make us feel more comfortable hearing it from someone who has followed Logan most of his life rather someone we just met. I’m not excited about putting him back on that stuff. I saw such a different baby when he was taken off of it. But if it’s what he needs, then that’s we’ll have to do. Please pray with us for peace and clarity in this next decision we need to make.