Tue 15 Jun 2010
heart murmur
Posted by bon under mama-baby stuff, milestone stuff, smitten stuff
[41] Comments
it was the clinic doctor last Christmas when both the kids had ear infections. he looked up from the white-draped table where Posey reclined obligingly. i was wrestling Oscar’s turtleneck back over his head now that it was his sister’s turn. i thought i’d misheard.
what?
it came out more snappish than i’d intended. i am not snappish with doctors. i have occasionally wished in hindsight for more snap, but when it is Christmas Eve and you are the physician kindly humouring my family through the investigation of ear pus and “mommy, it hurts” mere minutes before the pharmacies close for three days, any snap you get from me is just weariness. i promise.
you know she has a heart murmur, right?
my head tilted, as if to accommodate the weight of that tidbit. its meaning registered in stages, internal standup comedy. heart. those are important. but MY children have lung issues, not heart problems. don’t be silly. Finn’s lungs, underdeveloped. Oscar’s asthma. all those visits to pediatric recussitation. i don’t know nothin’ ’bout birthin’ no heart murmurs. Posey is my healthy one, my never-once-admitted-to-the-hospital baby. fuck off, heart murmur. what the hell does that MEAN, anyway?
i remember feeling profoundly stupid in that moment, neglectful in my ignorance, as if i’d failed to read the fine print on the instruction manual that had come with my daughter.
is that a big deal? i asked, hesitant. no, he said. and so i nodded and more or less promptly forgot about it.
when you experience a major medical catastrophe with a child, the kind where doctors start speaking in hushed voices and you feel like you’re probably being superdramatic to ask if it’s bad but they say yes and then the bottom sinks out of your world and everything changes, there are two ways you can go, after. you can live scared for a very long time. you can fret over coughs and lather with Purell and generally treat the world like a bus waiting to hit the precious ones left to you. which, with all due respect, it kinda is.
or you can build a wall behind which you hide, where so long as nobody ever speaks the words “he probably won’t recover” ever again, you’re golden. untroubled. pretty much everything else sounds petty next to that, after all.
so when you rush an eight-month-old to the hospital in the dead of winter gasping for air and they speed you through to the oxygen tents and then say, oh, probably asthma, you exhale with an almost palpable relief. you have to catch yourself, actually, and stand up straight and ask all the right questions and try not to look so bizarrely grateful. and your brain does take a circuitous loop through the swamps of guilt where you wonder how this prognosis will impact the life of the once-again pink and happy baby in your arms…but your brain does not remain there. it is too busy hightailing it back behind its wall, where inhalers look pretty damn pasty and thin compared to the shopvac wail of the NICU ventilator you still hear in your sleep, sometimes.
obviously, i chose the wall. or it chose me.
Oscar was a relatively sickly baby, by most standards. by the time he was fifteen months old, he’d been hospitalized on six different occasions, in two different countries, and had spent almost a month of nights in neonatal and pediatric wards. he had respiratory issues and colic and a variety of possible allergies. and it exhausted me and worried me, in the sense that i worried whether i was doing right by him with every choice we made about milk and reflux meds and steroids, ad nauseum. but never did i actually, seriously, worry about him. compared to his 2.2 pound brother with the tube forced through his chest wall, Oscar was hearty and breathing pretty fine.
and with her brothers as a baseline, Josephine was the Gerber baby. sure, she had jaundice for a few days at birth, and the cursed colic, and from the time she could roll over showed a terrifying predilection for banging headfirst into anything that could possibly get in her way, but this one, she was healthy. roly-poly. fiesty. sweet as pie and tough as nails.
so the heart murmur news caught me off-guard. but when the clinic doctor and Dr. Google both concurred that it was no big deal, i shrugged and booked the ECG and went along my merry way, behind my Wall of I’ve Heard Worse.
i stayed there through the ECG, which was prompt and painless, and straight through the followup appointment with the pediatric clinic a few months later, because i was so damn chill i forgot to actually take the child to her appointment. as did her father. yes, we got coupons with our Parents of the Year awards.
but i think my wall is crumbling.
we had the followup to the followup today. Posey beetled around the doc’s office in a diaper and socks and pigtails, admonishing the toy blocks to stay put and then shouting, look Mama! i RIDIN’! as she scooted across the linoleum floor on an eight-inch-long plastic schoolbus. she sat, watchful but patient in my lap as this new specialist listened to the mysteries inside of her little chest. he took a long family history, listened some more, checked her pulse at various points throughout her body. and he then lifted his head and i asked, what do you hear? and he said, well, i think we should do more tests.
it’s not a big deal, not in any serious sense: just not the innocent murmur i’d hoped. a thickened muscle, possibly, perhaps with a hole or ventricular septal defect. no immediate risk. possible surgery down the road, if it doesn’t close on its own.
we got to go straight down to xray, then for another ECG. there will be an echocardiogram at some point, later. followups. pediatric cardiologists. not a big deal.
but still a bit of a deal. an uncertain deal.
by virtue of lack of exposure, my armour is slipping. i spent all my pregnancies in and out of the doctor’s office and the big regional specialist hospital, constantly subject to poking and prodding and ultrasounds and blood tests. between Finn’s calamitous birth and two months of hospitalization before Oscar was born and then his many admissions, i was hospital-proofed, inured. not only had i heard the worst, but i never got far from the sharp alcohol tang of the hospital handwash. until Posey. since Posey was born, my only trips to the hospital have been for Oscar’s ear tube surgeries.
i was not ready. when i called my boss to say i’d be late for our lunch meeting, juggling Josephine and a sippy cup and a sheaf of requisitions in my hands, i felt it for the first time in years, that metallic taste of fear.
because here we leap, naked and vulnerable, back into the world of medical machines and systems i am glad for, grateful for, but would far prefer to never see again as long as i live.
***
the doctor asked today, is she fragile? timid? does she get overexerted easily? i laughed.
i do not know much about heart murmurs, would appreciate anything you can tell. so i can bolster up my wall with knowledge, and keep exhorting her to bounce higher.

41 Responses to “ heart murmur ”
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Trackback from BonStewart (Bonnie Stewart)
June 15th, 2010 at 11:33 pm
do the words ventricular septal defect mean anything to you? [link to post] -
Trackback from AureliaCotta (Aurelia Cotta)
June 16th, 2010 at 4:03 am
RT @bonstewart: do the words ventricular septal defect mean anything to you? [link to post] //Anyone? Please help?




June 15th, 2010 at 11:37 pm
That girl? THAT girl is the picture of health. And cuteness.
**knocks on wood**
June 15th, 2010 at 11:39 pm
I had a heart murmer when I was a child and when I was around twelve it went away on its own. As I was the child and all the talking about it was done above my head, I know little about it or the severity of it. I do know that I would use it as an excuse during gym class the odd time, but I don’t think it effected me at all. But, like I said, I don’t know the medical degree of it, and because it went away around when I hit puberty, I’m guessing I had a mild case.
I wish you strength, wisdom and laughter through this. I have nothing really to offer except that. I wish I could pass on something more.
June 15th, 2010 at 11:40 pm
The words mean nothing to me but I am wishing for all the minor minor nothingness that health care can find.
June 15th, 2010 at 11:45 pm
Damn the hoops. No more hoops! No more. The only hoops you should have to worry about are the kind with a ‘hula’ in the front. Enough medical ones.
The only thing I know about ventricular septal defects is that you would be well-advised to give the shepherd’s pie in the hospital cafeteria a solid two-mile berth. But you knew that already.
Hoops! Damn hoops. I know it’s hard to be back there. Here’s hoping answers are swift and positive. xo
June 15th, 2010 at 11:46 pm
Oof, Bon, talk about unexpected. You must be reeling. I wish I knew volumes of reassuring things about heart murmurs.
There is this…a good friend had one due to a hole that would have been there from birth but was not even noticed except she was getting heart scans due to other medical treatment she was receiving (for side effects of medication). They decided to fix it up, and she’s only noticed having a wee bit more energy since then.
I’m trusting Posey will be fine. I hope you are, too.
June 15th, 2010 at 11:50 pm
all I know about VCD is it’s the most common heart defect, or one of the most common (I think the other is ACD – very similar). And with most children, it self-corrects. Hang in there, hon. We’re all here with you.
June 16th, 2010 at 12:16 am
I don’t know about it, but I can send prayers to your Posey xo
June 16th, 2010 at 1:05 am
I have one, I have one still. It’s become my litmus test for good doctors – do they listen to my chest and say “do you know you have a heart murmur.”
It was a big deal as a kid, but much less so now.
June 16th, 2010 at 1:14 am
I have a heart murmur and it wasnt discovered until I was pregnant with my first baby. It’s a bicuspid, aortic valve defect and it’s apparently fairly common. Basically the aorta should have 3 valves and i only have two. the severity of this condition varies person to person. Being pregnant is one of the bigger risks, plus heart disease in later life, but my defect is relatively minor so I can do what everyone else can. I can feel my heart skip beats at times (in pregnancy its a lot more noticeable) it can make me breathless when this happens, and dizzy, but truthfully thats the only impact I have had on my life. I talk about it in my blog on July, 2009. I was told its nothing to worry about so I havent. I hope things turn out the same for your little girl. Best of luck.
June 16th, 2010 at 3:01 am
I know that lots of kids have them, including friends of my sons, and they close on their own over time and it’s never an issue.
The only exception is if it’s very large or the echo shows a very poor ejection fraction. (For an adult like me, mine was great at 69%, and normal range is 50-70, kid’s range might be different.)
A poor ejection fraction (low) means the heart has to work harder, and the person is more tired and out of breath, which is why he asked that, and from what you have written and pictured, I’m sure she is fine and not experiencing that! I think that because of your family history, your doctor is just trying to be extra special careful.
The very good news is that even if she did have a problem and ever needed an operation, it’s very very simple to fix these. My college roommate had one and had it fixed at 22, almost 20 years ago. She was in hospital for 2 weeks, and perfectly healthy, right as rain afterwards. But things have progressed so amazingly well technologically in those 20 years, that just a month ago, a good friend of mine, who is 50 and a marathon runner, finally got his fixed while he was in having something else done, just because why not? He was in for only a week! We’re going out to dinner with him and his wife this Saturday.
I know it’s scary, and if you need a valium or two to get through the nervous holy crap part, then TAKE SOME.
But this is fixable. Really.
June 16th, 2010 at 5:41 am
My husband’s murmur was diagnosed age 40. It has had zero effect on his life. All I know about ventricular septal defects are that they are the commonest congenital heart defect and generally in mild cases close on their own. If they aren’t mild there will almost invariably have been symptoms like breathlessness, sweating, poor weight gain etc. From the sound of things it all sounds like on the mildish side although being in the hospital system is always very scary. Hoping answers are quick and reassuring.
June 16th, 2010 at 10:06 am
Oy! Stuff like this, nobody wants to hear, but especially when they’ve been through what you have already. On the bright side, now you know — it sounds like a mild one, but now you can keep an eye on it.
I was diagnosed with a very mild heart murmur when I was in my late 20s. My dr sent me to a cardiologist who ran me through all the usual tests, & told me that on a scale of 0 to 6, I’m a 0.5. When I started having anxiety attacks, post-IF treatments, I worried that it might actually be my heart, so I went back for another round of tests & was told that nothing had really changed over the past 10 years or so. I took amoxicillin prior to dentist appointments for several years, but they don’t even think that’s necessary now.
June 16th, 2010 at 10:24 am
Oh bon, as if you needed this.
My three year old has an ASD* and we are seen annually because and echo or ECG will show if it is having an effect on her heart and needs to be closed. As others have said some holes close on their own, some end up needing surgery. Some kids develop symptoms – shortness of breath, fatigue and need surgery, others do not.
Often the closures can now be done through tiny incisions via an artery in the leg.
Even if you have seen worse, its still stressful. I’ve told them I do not have the nerve for it and they said it could likely wait until she is 6 or 7.
*hole between the atria which are above the ventricles
June 16th, 2010 at 12:26 pm
Who knows what will come of this, but I’m confident in a few things. First, Posey is indeed tough as nails. Second, doctors can do amazing things.
June 16th, 2010 at 12:32 pm
Here is my attempt at cooing reassurance:
My little E. had several heart murmur tests, the final being an echocardiogram when she was three. The pediatric cardiologist eventually named it something else, the name escapes me. I believe it boiled down to some little hearts just making a different noise. It was nothing to worry about. He also said that kids with true heart problems do not have energy, vigor and palor that your Josephine seems to have in spades.
Hoping, wishing and crossing fingers that all is innocent in the end.
June 16th, 2010 at 12:48 pm
I don’t know anything about heart murmurs, but I do know that your Posey is a beautiful picture of health, so I hope and pray that she’s as healthy as she looks. I really hope it truly is not a big deal, and I wish I could give you a great big hug.
June 16th, 2010 at 12:49 pm
Sam had one. An echocardiogram interpreted by a cardiologist found it nothing to worry about. I haven’t even thought about it in years. Guess I win one of those parent of the year awards too.
June 16th, 2010 at 1:37 pm
I have a heart murmur. It hasn’t affected my life, except that whenever I see a new doctor he/she says, “Do you know you have a heart murmur?”
Here’s hoping that’s your daughter’s situation, too.
June 16th, 2010 at 3:28 pm
Hello Bon. I read always, but rarely comment.
I had a heart murmur when I was a child. I had to take tons of antibiotics before I went to the dentist to get my teeth cleaned … I hated it.
Then, it just up and went away. They say I “grew out of it.”
She is a beauty … don’t stress too much.
June 16th, 2010 at 4:11 pm
I know nothing about them, but the comments about are reassuring. But still, you worry, of course you do. Love and luck to you and Posey.
June 16th, 2010 at 4:46 pm
Hugs, Bon!
My husband and I (now I sound like the Queen!) both have heart murmurs. I also have sinus arrhythmia, which I didn’t find out until a cardiologist checked out the murmur when I needed dental surgery. The only inconvenience for me of having a murmur is that whenever I need an anaesthetic I have to wave the letter from the cardiologist around to reassure the anaesthetist that I don’t need preventative IV antibiotics.
I hope all the comments are rebuilding that wall for you. And thanks for sharing that gorgeous photo!
June 16th, 2010 at 7:03 pm
Darling Posey.
I also have a heart murmur. Actually mine has officially been diagnosed as a mitro valve prolapse, which essentially means that the pump gets lazy every 2nd beat or so, but makes up for it every third beat or so. The general consensus for my diagnosis is that it would be riskier to have surgery than to leave it be. I still run. I’ve done a few triathlons. I’ve had 3 kids. I can honestly say it hasn’t affected my life other than on top of getting a papsmere every year, I’m also required to see a cardiologist.
I’m hoping for swift resolution and solid answers for you guys!
June 16th, 2010 at 8:05 pm
Norah’s two holes closed up by her second birthday. Here’s to a clear check up by two for Josie!
June 16th, 2010 at 10:34 pm
I know nothing. I am no help at all.
But I have all fingers and toes crossed and would be praying to something if I believed in anything.
June 17th, 2010 at 10:26 am
I’m no doctor, but if Posey is ‘unhealthy’, then we’re all doomed. Nothing will stop that kid.
Nimue has a slight murmur, as well. The doctors found it on her six week checkup, or thereabouts. They told us, and we looked at each other and shrugged.
Kim has the same one.
The way I look at it, unless the doctor doing the exam calls in another one right away, or presses that giant red panic button that they all seem to have, it’s not as big a deal as it seems. Even when they try, later, to impress upon me the seriousness of the issue, unless they get a worried look, and start talking to other doctors about specific tests and surgeries and “where the hell is that Physician’s Desk Reference anyway?”, I’m not going to panic.
When she was born, Nimue had a bump on the back of her head. A pretty big one, soft to the touch. It was just to the left of center, on the crown of her skull. Nothing to worry about at first; after all, babies have weird heads.
But when the edges started getting hard, we worried. Took her in. The doctor immediately got pale when he saw it, and started talking surgery. We were devastated, for days, until it came back that it was nothing. Cephalhaematoma, perfectly normal, and she is apparently one of the 5% of kids whose blood pockets will calcify and turn to bone.
She still has it, though as she’s grown, it’s faded. I still see it because I know it’s there. I keep wanting to tell her it’s a twin sister, who will spring forth fully formed on their 16th birthday to fight to the death for our love, but Kim won’t let me.
The point is, if the doctor doesn’t freak out right away, there’s no need for you to, either. If it was serious, she would not have been sent home.
June 17th, 2010 at 3:43 pm
Fraser’s got an innocent heart murmur – we’ve been through all the tests, including an ultrasound and he’s got the all clear. I honestly couldn’t even think about it while we waited for our appt, just pushed it to the back of my head, but it feels better now that it’s all sorted.
June 17th, 2010 at 6:12 pm
May it be innocent and forgettable and have absolutely no impact on her beautiful, robust self.
May you jump through hoops and drive to appointments and fill out paperwork for absolutely nothing, only to have it never bother her one minute of one day and resolve on its own. That’s my prayer for you.
June 17th, 2010 at 8:45 pm
thanks to all of you for the love & support & good thoughts.
yep, the kid is a truck. a happy, bouncy truck who falls on her head about six times a day and bounces straight back up. i hope she stays that way, and i appreciate knowing that for many of you, heart murmurs have been absolutely zero impediment.
hers isn’t the “innocent” kind but could still turn out to be pretty insignificant in the grand scheme of her life, which would be nice.
whatever. could be worse. and i say that with the greatest, deepest gratitude a person can feel.
June 17th, 2010 at 11:28 pm
I’m on pins and needles every time I take the kids in to the doctor. I’m a catastrophic thinker at the best of times. I, too, went through the heart murmur diagnosis with our daughter ( I was diagnosed with it too, as a kid). It was detected at birth with our daughter and then for 3 years after, nothing was mentioned. At her 3 year checkup, it was detected again and was referred to a pediatrician. The ped detected it, and recommended an echo; results came back fine. It’s scary, though. I hope all goes well with your little one. It seems as though worry is a constant, when one has kids.
June 18th, 2010 at 1:42 pm
I’m thinking you’re supposed to get a free pass from fear, anxiety and worry for the rest of your lives. That’s my .02.
My anecdotal info on heart murmurs is that they’re generally nothing serious and go away on their own. Precisely what this heart murmur will do. (Lovely pic of that Posey. Just lovely.)
June 18th, 2010 at 8:25 pm
My brother has a murmur, has had one his whole life – and asthma – and it hasn’t slowed him down that I’ve noticed.
Michael had one, and had surgery to correct it at age four. Other than a truly boss scar on his chest, no ill effects to speak of. And he doesn’t remember the surgery, even though he was very nearly school age when he had it.
Vague I know, but at least I can add to the chorus of voices saying “meh, not a huge deal”. Good luck.
June 19th, 2010 at 1:21 am
Hey, haven’t checked in in a while… I know nothing about heart murmurs so I can’t help you there, but it sounds like you’ve gotten a lot of good thoughts from the other commenters. I really commented just to say how flipping CUTE Posey is!
June 20th, 2010 at 9:04 pm
Porgie was born with two heart murmurs. We have seen pediatric cardiologists too. Our doctor was largely unconcerned. She told me that heart murmurs are really common, and often times never go away. As kids grow, their chest walls thicken and doctors can simply no longer hear the murmur.
June 21st, 2010 at 8:21 pm
I’m so sorry that you’ve got this to think of and worry over and cope with now.
I was born with a heart murmur. It was very thoroughly checked in my youth, but none of my doctors was ever worried about it – to the point that I couldn’t tell you what kind of murmur it is. I truly hope Posey’s murmur turns out to be the same sort of non-worry for you and for her.
And that is the most absolutely adorable little jumping bean I’ve ever, ever seen.
June 23rd, 2010 at 10:52 pm
Forgive my long absence and late interjection. Add my voice to those who had a heart murmur diagnosed as a baby. I had to have an electrocardiogram, actually, after having what turned out to be a really bad case of indigestion, and they found it still does exist, but still, doesn’t seem to matter.
June 26th, 2010 at 12:28 am
Any mom who’s been a hospital mom knows about the wall, but I’ve never heard it described so aptly. In the meantime, watch out for that bus.
You can tell from the comments on this post, but it feels important to say it still: you’re not alone. You have touched all of us who read you. Let us know if there’s ever anything we can do.
June 27th, 2010 at 1:39 am
I’ve got nothin’, but am loathe to leave without saying anything. My money is on a cautious doctor and a robust Posey
June 28th, 2010 at 12:53 am
Are they thinking it is a VSD?
I hope that this remains a tiny blip on Posey’s healthy trajectory in life, with any luck, the defect repair will itself in a timely manner and she’ll never suffers any ill effects from it.
Most VSDs that are an incidental finding are innocent and either close on their own, or never cause problems even if they don’t fully close on their own. The serious sort tend to be serious early on and are found because the kiddo is symptomatic. But, still my fingers are crossed for you guys, just to be sure.
July 8th, 2010 at 3:26 pm
my cousin had a heart murmur due to coarctation of the aorta for 28 years, that was noted, but not really a concern, until suddenly it was. she had lose 5 lbs, then had a stent placed. it all went fine, and now her hands and feet no longer go numb when she exercises.
i’ve had many a patient with a VSD, repaired and un. (i’m a pediatric physical therapist) they are usually repaired early-ish, depending on the size. if they didn’t catch it till now, my guess is they’ll close it when she achieves a critical mass, or just let it go. i’ve worked with a mom who had an unrepaired VSD who had two pregnancies, one preemie (32 wks) and one full term, without other event to herself.
but i think it’s basically a case by case basis.