It Seems I Spoke too Soon :o(.

Miss K had a breakthrough SVT episode this morning :o(.  Her first one in 3 months :o(.  Since January she's been quite good at having an episode once every 3 months, I should have been prepared for it instead of surprised this time.

Since last Thursday (9-13-12) we have been dealing with allergies, poor Miss K is miserable and can hardly breath through the congestion :o(.  She was VERY congested last year starting a few days after coming home from PCMC, around this same time.  We hoped, along with her Pediatrician, that it was not fall allergies but instead a reaction to being out in the open with all the dust and pollen that she was not used to due to being hospitalized for so long in a VERY sterile environment.  No such luck.  Our first adventure into an open area packed full of pollen and fall changes and Miss K woke up the next morning unable to breath and sneezing every 5 minutes.

So today the SVT could have been caused by any number of things.  I seriously doubt it is due to the Amiodarone being fully out of her system though and I doubt she will ever be put back on it again for any reason.  I also don't think she'll need her Propanolol dose adjusted, she hasn't gained hardly a few ounces since the last adjustment, but we'll see what she does in the next month before she goes back to see the EP Cardiologist.  When she had her episode she a) was having a moment of extreme congestion and was being forced to breath from her mouth constantly, b) had just tripped over a toy and hurt herself causing one of those "fun" crying so hard she forgets to breath moments, and c) had just gained the hiccups from the crying, and not normal hiccups but the painful kind that sound like the poor kid is belching a huge bubble between hiccuping.

I could feel her heart with my hand, it felt fine that way though maybe a tiny bit fast.  So I checked with the stethoscope to find that she was indeed in SVT, though I'm not sure if it was True SVT (True SVT is a heart rate over 210 BPM) or if she was just beating a little too fast for her normal heart rate as I didn't take the time to count it out but it surely didn't sound fast enough to be at 210+ BPM.  I cradled her and blew in her face, the little stinker smiled and giggled through the Physical Maneuver lol and I was sure it wasn't going to work but she surprised me, when I listened with the stethoscope again she was beating at her normal heart rate.  It took a mere 5 seconds from finding her in SVT to getting her out of it.  I wish I was brave enough to wait it out and see if she could come out of it on her own, but I'm just not.  I still fear she is still more likely to get stuck in it the longer she's allowed to keep that rate and that I'll end up taking her to the ER for help getting her out of it so I jump on the Physical Maneuvers as soon as I know she's in SVT and don't give her little heart a chance to try converting on it's own :o(.

I am disappointed, even though I shouldn't be surprised and should never have gotten my hopes up.  I was looking forward to trying to take her off of the Propanolol, or at least bringing her down to 2 doses a day instead of 3, within the next 4-6 months but reality has hit today and I'm realizing this is most likely not a possibility for at least another 12 months if not longer :o(.  Giving her the Propanolol really isn't the real issue...the real issue is that the longer she has to have the Propanolol and is actually having breakthrough SVT, no matter how often, the more likely it is that she will be getting a Catheter Ablation in the near future and that actually scares me to death.  I know some will say I shouldn't worry and that their child or other children they know have had one and did great but I also know what I have been told by the EP Cardiologist and what I have read about Ablations, they are not invasive therefore not as dangerous as say Open Heart Surgery is but they are still dangerous in that the surgeon could cauterize the wrong area or could miss and hit a vital part of the heart causing serious damage.  It terrifies me.

1 more month until Miss K's EP Cardiology appointment and hopefully you won't be hearing from us again until then, at least not bad news anyway ;o).  Here's to hoping!

And Yet Another SVT Episode :o(

Miss K had a bad afternoon yesterday.  It started at about 1pm after her morning nap, she woke up smiling but it didn't last long.  She was fussy and hard to make happy until her afternoon nap, I thought she was just tired and would sleep her usual 3 hours to wake up happy for the evening but I was SO wrong :o(.  Miss K only slept 30 minutes and woke up screaming, I rocked her and bounced her and tried everything I could think of to get her back to sleep, she got her self really worked up, I checked her heart rate constantly throughout this spurt of crankiness and was happy to hear it beating at a good steady, slow pace of about 120 BPM like normal the whole time.  After almost an hour of rocking and bouncing she finally calmed down and fell into a very light sleep.  I spent the next hour keeping her big brother VERY quiet so as not to wake the screaming, cranky girl again.  When her Daddy got home she woke up immediately and wasn't happy about it, no matter how quiet my husband is the kids just know he's home and asleep or not they want to be with him.  Miss K spent the rest of the evening being crabby and fussy.  At bedtime I was trying to make her happy so she wouldn't keep her brother up, I noticed her heart seemed to be beating out of her chest under my hand so I grabbed the stethoscope for about the hundredth time yesterday and sure enough it was racing.  I am happy to say that it wasn't beating so fast we couldn't count it and I was able to keep count for a whole minute, I came up with about 192 BPM.  It was hard to know exactly what to do for her, we've never been through an episode like this before.  Miss K was fine, just fussy and acting like she didn't feel well and her heart wasn't in "true SVT" as her Cardiologist would say.  True SVT is a heart rate over 210 BPM.  So her Daddy and I just decided to ride it out and see what happened, we listened to her heart about every 2-3 minutes to make sure it didn't beat any faster.  At 10pm we were able to give her her Propanolol and then I could feed her for the night, while eating Miss K finally relaxed completely and soon after that her heart rate slowed to it's normal 120's and she fell asleep.  It was a stressful moment for us, we knew she was fine but the whole not knowing if she would stay below 200 BPM or if she was inevitably going to race above 200 BPM and pass out like her first episode of this year was nerve racking.  I'll be logging this episode in her little log book and hope and pray she doesn't have any more or worse episodes.  Any "true SVT" episodes that end up being scary will inevitably mean a medication adjustment, most likely upping her Amiodarone, which is something we DO NOT wish to do if we can avoid it.