The Good, the Bad and the Ugly

Wednesday evening was quite a bit scarier than we were anticipating. An afternoon echo showed that the pressure in the right side of the heart was not getting better, even after the docs reintroduced the prostoglandin medication. We met with the cardiology team, who told us that they believed the next step in the process was to perform an angiogram, otherwise known as a heart cath.
A heart cath is a procedure where a catheter is inserted into the femeral artery (in the thigh) and moved up into the heart, where dye is then injected to map the entire area. This seemed to be the best way to ascertain the exact problem causing the pressure in the right side, but it is considered a surgical procedure and does involve some risks and possible damaging outcomes. The docs were confident that it was the right move, so we consented. Let's just say there were several extremely emotional hours spent in the waiting room, lots of prayer, and a few tears.
Emmett handled the procedure with flying colors, and the docs came away with a diagnosis of Persistent Pulmonary Hypertension of the Newborn, or PPHN. This is a condition where the blood flow is not correctly going through the lungs, adding oxygen, and instead it is passing through the Ductus Arteriosis, which fails to close. It is a separate condition from any of his heart issues, fairly rare in newborns and the treatment was simply to keep him on the nitric oxide that he was already on and attempt to lower the pressure. One great piece of news that came from the angiogram was that the doctor plugged the ductus while he was doing the cath, just the see what the heart would do, and told us that he was even more confident that surgery would not be necessary to fix the heart.
It is now Sunday night and the pulmonary pressure is still unchanged. After a brief and brutal conference with the neonatologist, we are more tense than we have been all week. The docs are not happy with the lack of change in the pressure and they have added a new medication, prostocyclene, into the mix. We have learned a little bit more about how dangerous PPHN is to a newborn, and it is frustrating that we are unable to get any kind of prognosis, timeline or even an opinion on how severe his case is. The doctors and nurses all keep repeating that it "unpredictable" and that only time will tell. After a week in the NICU, we have lost all sense of time.
There are definitely some improvements going on. Emmett finally got to have his first meal (colostrum..the liquid gold) on Friday afternoon. I felt a huge weight lift from my shoulders after his meals started. He still gets his milk from a feeding tube, but the doctor bumped him up to every three hours, which is fantastic. We are also thrilled that the ductus is almost completely closed and the left side of the heart seems to be functioning quite adequately. We move farther away from heart surgery every day.
Once again, we called on the power of our Heavenly Father today by administering to Emmett a priesthood blessing.  It was the high point of the day, feeling like there was finally something that we could do to help him heal, instead of just sitting next to his bedside, watching and waiting. Sometimes the nurses do little procedures, like fixing a picc line or changing the caps on his lines, and they let me help. We are blessed to have such kind nurses administering to our son. Sometimes when we have to back up to let them do some kind of medical fix, I notice that they apologize or say "excuse me" every time they walk between us and the baby. We are treated with reverence and sincere sympathy.
The Lord is our companion in all of this. Tomorrow morning I have every expectation that Emmett's pressure will be better and that if it is not, his doctors will be blessed with all the right answers.