Nearly every cardiology visit is filled with big and scary words. Tomorrow’s word of the day is echocardiogram. (Am I supposed to put a hyphen or space in there somewhere? As a self-taught medical student – by necessity, you understand – I can never remember.)

Every day brings us closer, whether we like it or not, to Namine’s third (and hopefully final) heart surgery: the Fontan. Before we get there, though, she has tomorrow’s scheduled echo. It will tell us how her heart is doing, as well as what the surrounding vessels looks like. A big concern, and one that will decide on the urgency of surgery, is if Namine has developed collaterals around her heart.

I’ve written about this before, but I’ll recap: angiogenesis is the idea that the body will grow entirely new blood vessels from existing blood vessels. The body does this in response to a blockage, for example; it will grow new vessels and reconnect to the intended organ downstream. These new vessels are called collateral vessels.

Long story short, the echo will tell the cardiac team how much Namine needs heart surgery immediately. If they feel she’s doing well enough, they may say see you in six months and send us on our way.

But there is another consideration: school. We had originally planned on sending Namine to kindergarten this upcoming school year, but it seems likely that if Namine doesn’t need surgery now, then she will in six months. We feel it would be better to delay school for a year rather than start her this year and end up holding her back because she missed half a year.

Even if she doesn’t need the Fontan immediately, as a post-Glen of sufficient size and weight, Namine is a good candidate for the surgery. If she were still a tiny thing, she would have to wait; her own body wouldn’t be able to cope. But she’s a big girl now, and certainly has no “failure to thrive.”

This post is part of the timeline: Heart Repair – an ongoing story on this site. View the timeline for more context on this post.