Monday, November 29, 2010

We Will Miss You, Steve

“Because your whole world can change in 24 hours.” – The Paper (1994)

That’s Steve Catoe’s quote from his latest blog post, “24 Hours at Johns Hopkins.” I know that for Steve’s family, the past 24 hours have changed their whole world.

It is with a very heavy heart that I share with you that Steve died sometime between the late-night hours of Nov. 28 and early morning hours of Nov. 29. He was at his computer, doing what he does best, championing survivors and writing about congenital heart defects (CHD). 

I’d like to think he left us in the wee hours of Nov. 29, the 66th anniversary of the Blalock-Taussig Shunt, which Steve has been writing about over the past two weeks.

“We’re thinking positive thoughts,” his cousin Denise Baldwin told me this morning. “That he’s not in any pain and that he has a whole heart now.”

Just 11 days ago, Steve wrote a post called “Run the Race.” It’s an analogy of his life, living with CHD. He writes about the stumbles and falls he had throughout his life with tricuspid atresia. In true form, Steve talks about fighting the good fight, never giving up and crossing the finish line still standing.

If Steve was tapping away at his keyboard when he passed away, I think he got what he hoped for – he crossed the finish line still standing. Doing what he loved best, doing what he did best. Telling a great story and teaching us what it means to live, no matter what our struggles might be. He made a huge impact on the CHD community, speaking at several events and being there online for more than 400 followers each on Twitter and his blog, Adventures of a Funky Heart, and more than 800 friends on Facebook. He did fight the good fight for so many of us.

Steve was one of the very first people I “met” online when I signed up for Twitter in February 2009. I immediately recognized his CHD (tricuspid atresia), as it is the same heart defect as my friend and Broken Hearts of the Big Bend heart kid, Eliza, had. When Eliza endured her own battles, Steve took time to keep his readers updated on her status and ask for prayers for her. Later, he was a champion for another of our heart kids, McKenzie, who lost her fight to neonatal Marfan syndrome earlier this year.

In February 2010, Steve flew to Tallahassee, Fla., to attend and speak at Broken Hearts’ Regional Forum on Congenital Heart Disease. I got to meet Steve, and also his cousin Denise, who is the one who called me this morning to tell me about Steve’s passing.

At the Forum, Steve — a masterful storyteller with an amazing story to share — talked about his life and his parents and their courage and determination to give their son the very best care they could find.

I feel so fortunate and blessed to have known Steve and to call him my friend. We e-mailed each other often, talking about our blogs, the latest goings-ons in the online CHD community, and life in general. It was through conversations with Steve that I realized that Broken Hearts would be more effective and be of more benefit to those families we could touch in person.

I’ll miss Steve’s advice, his points of view on congenital heart issues, his storytelling, and his quirky sense of humor. He was a part of my everyday life. I already miss him and I wish I’d had a chance to say goodbye. Although knowing Steve, he prefers it this way.

When I got Denise’s call this morning, I was — am still — shocked. I knew Steve had been struggling with the ever-delicate hemodynamic balance that many CHD survivors cope with.

In Steve’s case, he was working with his cardiologist to adjust the diuretic he took for his congestive heart failure. One of the possible side effects of the drug is gout; and Steve recently had been fighting gout. They took him off the diuretic and his gout improved, but he knew his congestive heart failure was worsening because his ankles swelled, he had a constant cough and felt, in general, rundown and tired. 

Denise said, at this point, they believe his heart had been working too hard lately, and it gave out. “But, he has his right ventricle now. His heart is complete,” Denise said, continuing to stay positive (which Steve would surely insist we do).

Although Steve may physically have had only half a heart, spiritually his heart has always been whole. I believe for Steve what I believe for my Dad. Just as my Dad is up there hanging out with all of the ancestors he researched and wrote about, I believe Steve is in Heaven with all the CHD survivors he championed and wrote about, and he’s telling all of them how much we love them and miss them here on Earth.

A few weeks ago, Steve and I were talking (e-mailing) about his upcoming Funky Heart posts. He was planning to crank it up a notch or two. And he did. Just last Friday, Steve wrote one of his most powerful entries about working toward a cure for congenital heart defects.

I know he’s up there talking with his fellow CHD angels, telling them how his readers better keep fighting the fight from sea to shining sea. So, for Steve, let’s keep fighting the fight.

Keeping Steve's family in our hearts and prayers. Arrangements are being made in Bethune, S.C., where Steve lived. I will try to post information when it becomes available. 

Wednesday, November 24, 2010

Thankful … and Wanting

Growing up, holidays were magical. My mother made them that way. “I Believe” has always been her motto. Snowmen (even in Florida), Santa Claus, flying reindeer … she made it all seem possible and real.Today, I muster up all the “I Believe” I can and try to make the holidays magical for my kids. I want that for them. I want that for myself.
I am thankful my mother is here to share Thanksgiving. I love having one more Thanksgiving with her. She is 83 now, and I know there are not as many Thanksgivings ahead for us with her, as we have had with her in the past. I wish my father were still here to meet and know his youngest grandchild, my son, William George. They would delight in each other’s company.
I am thankful my sister Becky and brother-in-law Doug have joined us again these past few years for our Thanksgiving meal. I wish so much that their son Jonathan were here with us. He was 16 when he died on Dec. 20, 2004.

Thanksgiving 2002
From left, kids in front: Lauren, Jonathan, Martin.
From left, back row: Lee, Mom, Becky, Me, Joaquin.

Thanksgiving 2004 was the last holiday my sister and brother-in-law had with him. None of us knew there would be far more Thanksgivings ahead without him, than all the ones we had shared with him in the past. 

Loss makes love, thankfulness, family and holidays bittersweet. They make me aware of not only my family’s grief, but the mourning of others, too. As the holidays arrive, I think of not only my sweet sister, but all parents and families who are grieving losses.

May we all find peace and comfort throughout the holidays, and maybe, muster up a little magical “I Believe.”

Thursday, November 18, 2010

Shadowing My Son's Heart Surgeon

That Friday in the fall, for sure, goes down as one of my most amazing days ever.

I shadowed a doctor who is arguably the best pediatric heart surgeon in the southeast United States, and one of the best in the country. Dr. Mark Bleiweis is the director and principal cardiothoracic surgeon for the UF Health Congenital Heart Center in Gainesville.  

When I asked Dr. Bleiweis over the summer if I could follow him around at work some time, I assumed I would observe him making rounds in the intensive care unit at the UF Health Shands Children’s Hospital in Gainesville. I figured I would sit in on conferences and consultations he had with families whose children were having, would be having, or just had open-heart surgery to repair their congenital heart defects. I guessed that I would sit and watch while he handled administrative work. I was right. I did all those things.

I did not think I would step into his operating room. But I did.

I stood in the very operating room my son had been in four years earlier, about to observe the very surgeon who repaired my child’s heart. At first, it was overwhelming.

For at least an hour, I stood there, kind of numb, thinking: I’m here. I’m in the operating room. I am about to observe open-heart surgery on a baby. I am about to see what my son went through when he was 2 years old, after he left my arms that morning on Thursday, June 29, 2006. 

I took deep breaths and stayed focused on being a writer, taking in as much as I could. I focused on being an advocate, learning more about what happens after we heart parents give our children over to the doctors and nurses who promise to take care of them, repair their hearts, and return them to us whole. I focused on not fainting from the sheer awesomeness of it all.

For more than six hours, I sat, stood, paced, stretched, watched, listened and absorbed everything going on around me while Dr. Bleiweis repaired the swollen, failing heart of a baby.

Born with a complex, life-threatening heart defect called complete atrioventricular canal defect, the baby did not have the typical four chambers and four valves that of a normal heart. She had one large chamber and one valve

The baby’s heart defect was so obvious that during the pre-surgery ultrasound of her heart, even my untrained eye could see there were essential chambers and valves missing.

This infant’s heart was working so hard to do its job pumping blood, it was more than twice the size it should have been. Without this surgery, the baby would die.    

I saw Dr. Bleiweis delicately cut away the heart’s protective sac and expose the child’s beating heart. He placed the sac in a solution that makes the flimsy tissue firm and durable; it’s what he would use to make patches to cover the holes in the heart.

The team attached tubes and clamps that led from the baby to the heart-lung bypass machine, which circulates a patient’s blood while the heart is stopped. 

The perfusionist (the person who controls the bypass machine) administered a special mix of drugs called cardioplegic solution to make the baby’s heart slowly stop beating. The perfusionist drained the heart of its blood, and the heart shrank. Throughout the operation, Dr. Bleiweis would ask the perfusionist to fill and drain the heart. It was astounding.

I took turns with medical and nursing students and the anesthesiologist to stand on a stool at the head of the operating table. I gazed over surgical drapes and looked straight down, less than a foot away, into the infant’s open chest as Dr. Bleiweis – using high-magnification lenses – delicately sewed the tiniest stitches into the baby’s imperfect heart.

On this day, Dr. Bleiweis was clearly the leader in the operating room. His requests, directives and commands were clear, direct, exact and instructive. His team might not have always liked what they heard, particularly if he was correcting them, but his criticism was constructive and designed to make his team that much better during the very next operation and every operation after that.

During the four-plus-hour operation, Dr. Bleiweis meticulously patched the holes between the baby’s upper chambers (the atria) and the lower chambers (the ventricles), forming a wall between left-side and right-side chambers. He created two functioning valves – a tricuspid valve and a mitral valve.

His work was so exacting, so intricate and so complete that as I watched the post-surgery ultrasound of the heart, I could clearly see the wall in the center of the heart and the two valves that Dr. Bleiweis created for the baby. The baby’s heart would never be normal, but now it would work as efficiently as it ever could. It was extraordinary.

The science and precision weren’t the only remarkable, memorable aspects of watching this elite team of surgeon, nurses, anesthesiologists and perfusionists.

Dr. Bleiweis, who can operate on the grape-size heart of a newborn baby who’s no bigger than a water bottle, could easily be arrogant or condescending. And yet, he is consistently professional and gracious – to his team, his staff and, especially, to his heart families. I’m still absorbing everything I saw that day, but here are thoughts that have stuck with me:
  • I am amazed and struck that a pediatric heart surgeon must map out – sometimes in a matter of days and other times in a matter of minutes – the best surgical option for a child whose heart is complicatedly misconstructed.
  • There is no room for mediocrity in pediatric heart care – not in preoperative procedures, during an operation, or in postoperative care. Pediatric heart teams persistently reach for excellence. Every single day.  
  • In the operating room, everyone must work cohesively. They must anticipate what the person next to them will need next, do next, ask for next. They must foresee what their patient will do next, will need next. And they must be there, ready. If there are personality conflicts, hard feelings, or bad attitudes, they’re not perceptible. Everyone in the room works harmoniously, willingly, gladly and always with one goal in mind – the care and comfort of the patient.  
  • Dr. Bleiweis and his team sweat not just the small stuff, but the minutiae, every hour of every day. And I – along with hundreds of other heart families each year – am very grateful that they do.  
  • I’m inspired that parents can and do entrust their child’s life to the hands of a surgeon – most often, a person they’ve met only briefly – who promises to repair their child’s misassembled heart. I am even more moved that there are people willing to accept that mammoth responsibility as humbly as Dr. Bleiweis and his team do.  
  • I am utterly, wholly and completely awed that this is what this team does: they fix babies’ hearts. They save babies’ lives. Every. day.

          Saturday, November 13, 2010

          William Scores His First, Long-Awaited Soccer Trophy

          Since William was 3, he has begged for his brother to give him one of
          his dozen, prized soccer trophies. We, of course, have told William
          when he plays soccer when he's older, he'll earn his own soccer trophy.
          He just had to be patient. Today was the day he earned his first trophy!
          Dear Coaches Stephen and Brian:

          Thank you so much for being great coaches. It’s been such a positive start to William’s soccer “career.” Not every volunteer coach gets the right mix of skill-building, fun and positive reinforcement, but you both got it right all season.

          So you know just what a wonderful milestone this soccer season has been for our family …

          Letting William run free and wild on the field, and letting him decide when he needs to take a break, has been a huge step for us. William was born with a heart defect. When he was 2 years old, his heart was repaired through open-heart surgery at Shands Children's Hospital.

          William has always had the all-clear to play whatever sports he likes, but as worried parents who weren't sure what a "heart kid" could do, we bite our nails – and have had to learn to bite our tongues – when William plays sports. We have to remind ourselves that he really is just a regular kid.

          Watching William in his first practice and in his first game were sweet, sweet milestones. Because there were times, when William was a baby, that we weren’t sure he would make it at all, never mind be able to run around on a soccer field, passing the ball to his teammates and scoring goals. I've never seen a kid smile so much running up and down a soccer field. William has had a blast, and Joaquin, Martin and I have totally enjoyed watching him play.

          Thank you both for helping make William’s first soccer season such a memorable one. We are very grateful.

          Karen, Joaquin and Martin