Friday, June 29, 2007

The Great Guessing Game Continues

So the Great Guessing Game continues. I (naively) assumed Clare would reach an age where I wouldn't be faced with these questions anymore, but I have a feeling that will never happen. With the arrival of Simon (who is such a chunk, he is almost Clare's size), I think I field even more questions now.

I had an experience with a woman yesterday. She was a friend of a friend, and we were together for a couple of hours. She was fascinated by Clare. Maybe because her 19-month old could run circles around Clare? Maybe because I carried both Clare and Simon up and down the stairs at the same time? Maybe because Clare is the most gorgeous little curly-haired girl with the infectious grin? (Yeah, that's the one!) This woman must have asked me the same question and repeated the same statement over and over in a variety of ways. "Wow, she is really little." "How old is she?" "Did you say she was two?" "Gee, she is tiny." "When did she turn two?" I patiently answered and responded over and over, "Yes, she is small. Yes, she is two." And left it at that. Part of me was irritated that the woman just could not let it go, and I was not going to satisfy her curiosity about Clare because I was annoyed. The other part of me did not want to get into it - the big, long explanation for why Clare is who she is. I might have nipped it all in the bud if I had just explained about Williams syndrome, but I was not in that kind of mood yesterday. (Nancy - I need some of your cards!)

During our trip to Storyland these last couple days, we answered the question over and over about the age difference of our children. I know it is because Clare looks so much younger than she is and Simon is a big baby that they look much closer in age than they really are (exactly 2 years, 1 month, and 1 day). I have a feeling Simon is now going to be an active player in the Great Guessing Game based on his size. It is nice, though, to have a chubby baby with no health issues to worry about. Even with Jamie, we were dealing with his congenital hypothyroidism from birth (Jamie was born without a thyroid gland). To new parents, those multiple visits to the endocrinologist, countless trips for blood work, and one daily medication was a lot on our plate. Now I know it was really just gearing us up for Clare! My mom made a comment about how more relaxed we seemed with Simon's arrival than with Clare's, for obvious reasons. There is something about being told frequently to watch for signs of congestive heart failure to ruin the joys of your newborn in those first few weeks. I did not appreciate how hard Clare has to work on doing everything until I see how easy it is for Simon (even though he is only two months old). We are already receiving big grins and coos from our sweet little guy and just love him to pieces!

Thursday, June 28, 2007

Where Have They Gone?

We are here, we are here! We have just been super busy. Much too busy to be blogging! Here's a rundown of what we have been up to:

Father's Day picnic, hike in the woods, and fishing trip. We surprised Shawn with a morning massage (not us doing the massage, but we sent him out of the house for one!) while we packed the car for our day trip. No one caught any fish, but we all had a grand time and enjoyed our beautiful day at one of the local state parks.

Simon's Baptism was another hot, gorgeous day. I love taking out the baptismal gown which both Shawn and his older brother wore over 30 years ago and dressing another one of our children in it. I don't know which was more precious - naked Simon being immersed into the Baptismal font at church and letting out indignant shrieks or Simon in white smelling sweetly of the Chrism oil at our post-Baptism barbecue.

Shawn and Jamie went on a father-son camping trip with friends. From fishing to exploring to building and launching rockets to smore making to horseshoe pitching, it sounded like they had a blast.

And, most recently, we returned from our annual trip to Storyland, a children's amusement park. Despite the 100-degree weather, we managed to stay reasonably cool and had a fun-filled two days. This year, Clare enjoyed more of the rides, but she did have a tough time with the intense heat. Lots of water, strawberry smoothies, breaks in the shade or mist tents, and a hand-held squirting water bottle-fan contraption helped to keep Clare (and the rest of us) going in the heat.

It's been a busy month, but as June is closing, we are looking forward to the rest of our summer!

Wednesday, June 13, 2007

Cardiology Follow-Up

Sorry in advance for the long post, but it's been a busy few days.

Bad news out of the way first. Clare had her post-cath follow-up with the cardiologist today. A slight thing that the doctors at Children's Hospital neglected to tell us was that they want Clare back in September for another cath. I was shocked when Clare's cardiologist casually brought it up that we were going back in three months, since we had no idea! (And I distinctly remember being told 6-12 months between caths, so I don't where the lines were crossed.) Anyway, the cardiologist performing Clare's cath had to do so much work on Clare's right pulmonary side (placing the stent and dilating six other vessels), that he was unable to work on the left side. There is only so much dye Clare's body can tolerate (or she would go into renal failure), so that is why Clare has to go back in three months to have her left pulmonary side worked on. I am still slightly in shock that we have to go through all this all over again in the fall. September's a busy month, too, with Jamie starting school, we will be full-force in Clare's preschool transition (since that is the six-month mark), and we have tentative vacation plans that we will now have to reconsider. At least we will enjoy the rest of the summer!

The good news about Clare's echo today was that she was unsedated and did beautifully. She was content to lie still and watch Blues Clues, as long as the echo tech allowed her to hold one of the wands as well (which she did). So the cardiologist has given Clare the thumbs up to remain unsedated for her future echos, as long as she continues to cooperate! Clare will have another echo in August so they can send her latest results down to Boston prior to her cath.

And it was echo one, get another free at the cardiologist's office today. They had a cancellation right after Clare's appointment, so they echoed Simon as well. He was not as content as Clare during his echo. (Lucky Simon was initiated into the joys of a cardiology appointment.) Thankfully Simon does not need to go back to the cardiologist's ever again. His heart is perfectly normal! And the little chub weighed in at 12 lbs, 5 oz. (He is going to pass Clare before long, since her weight is 19 lbs, 9 oz.) I can't believe he has gained five pounds in the short six weeks since he was born. No eating issues here apparently!

We did the Easter Seals Walk last week. Shawn's family from Maine joined us. It threatened to rain, but held off. The kids had a great time and everyone was a trooper for the long walk! Thank you again to all for your generous donations. Both Clare and Jamie had their hand-prints stamped on the Easter Seals banner celebrating the walk.

And the wedding weekend is over. My sister Christina was a beautiful bride, and we are so honored to have been a part of her special day. But I am not surprising anyone by stating how exhausting and difficult it was with three little kids. Late nights, early mornings, long days, and erratic meals. (Clare practically lived on bread and butter and Hershey kisses.) Everyone looked simply gorgeous in their wedding attire (poor Simon was left out of the loop!). Both Jamie and Clare were a big hit at the reception. Jamie with his slick dancing moves. We had to literally drag the child off the dance floor after 10 pm to go home because Clare was virtually comatose on my shoulder. He was a riot to watch - doing spins, slides across the floor, wild moves. I am sure the three champagne glasses of soda on the limo ride with Auntie Erin played a big part in our dancing king! Clare was passed from person to person as we had our extended family from all over the country meeting her for the first time. She is a celebrity on our blog, so they all wanted to hold her and hug her and kiss her. I was a proud mommy to show her off to everyone, but Clare could only handle so much, then she was done. (Sorry for the crying fit, Aunt Joan!!) I know it is not easy to meet so many new people at one time. I was on overload by the end of the night by all the noise - I can only imagine how Clare felt. But she was a trooper, as always.

Whew - it's been a long couple of weeks!

Thursday, June 07, 2007

Random Thoughts

Now that Clare's cath is behind us, I have all these random thoughts floating around in my head that are just begging to get out. So pardon the lack of continuity in this post.

We had an awesome anesthesiologist during this cath. Not that all of Clare's anesthesiologists haven't been great, but this one really stands out. And I cannot even remember his name. It doesn't really matter because he only has two more months of his fellowship at Children's, then he is practicing at York Hospital. He stayed with us after Clare was given her cocktail to drink but before she was mellow enough to be brought back into the cath lab, and we chatted. Mostly about southern Maine (since Shawn is from southern Maine - this doctor did his residency at Maine Med in Portland, and is heading back to Maine soon), but also about WS. It is always refreshing to meet someone who not only has heard of Williams syndrome, but is very familiar with it. Especially when this doctor will be taking care of your daughter. Because of the nature of the blood vessels and heart disease when it comes to Williams syndrome, anesthesia in any form is very risky for these children. Although you do not like to hear it, I do appreciate it when the doctor is straight forward with us, as this one was. He told us bottom line is that Clare has always done well with the anesthesia process, but it is always a huge risk for her and that will never change, especially since blood vessels are being occluded during the cath. It's hard to hear, but at least we know that the doctor is aware of the risks and (hopefully) knows what to do to avoid those risks. I would rather have that attitude than a doctor who says "Oh, she'll be fine. We do this all the time." On a lighter side, the anesthesiologist told us, that in his experience, in a couple years, Clare may even enjoy her hospital stays. His experiences with kids with WS are that they are not afraid of the hospital and the procedures they have to undergo. They are chatty, social kids with a great personality. He has even been asked to the prom by one. I hope someday Clare will have this attitude, too. She was so aware of everything that was going on that, in many ways, this was the hardest procedure yet. We know she has many more hospital stays ahead of her, so it would be great if every one wasn't traumatic.

The cocktail Clare was given to drink was a mix of versed and ketamine. As I said earlier, ketamine is a popular street drug (known as Special K) since it is a hallucinogen. It works quite well on mellowing people out, to say the least. Clare was given it prior to her cath to relax her so she would not freak out when the doctors took her away and started her under general anesthesia. However, ketamine can cause some scary hallucinations (people have reported "seeing" sounds, that kind of thing), and takers can have flashback nightmares weeks after the drug. That is why versed was added to the ketamine. The versed makes Clare forget anything she hallucinated, so she won't have flashbacks. All very weird to be discussing this quite normally about your two-year old. Clare was pretty funny after the cocktail started to work. She stared intently at the red light on her toe from the pulse-oximeter. She would slowly wave the foot back and forth in front of her eyes. She had been watching Sesame Street before she had her drink - I can only imagine what Cookie Monster and Elmo sounded like to her after! Clare was definitely mellow and did not even care that strangers carried her away from Mommy and Daddy. Which is a good thing, I guess.

When we met with Clare's hospital cardiologist after the cath, he told us Clare would need another cath in 6-12 months. In the past this cardiologist is usually more optimistic about the length of time between caths than Clare's home cardiologist. So, on one hand, I am skeptical whether Clare will go another year between caths. On the other hand, I am hopeful that she will since she made it 15 months between cath 4 and cath 5. (We have the full follow-up with Clare's home cardiologist next week - echo, EKG, chest x-ray - so I am curious to hear her prognosis as well.) The Boston doctor also said that Clare is still on the severe end with her heart disease, though, which was another hard thing to hear. We've known since almost the beginning that in the scope of the stenoses found in Williams syndrome, Clare's was severe. But I can never let go of that hope that Clare will outgrow this. I keep reminding myself that she is only 2 years old, so she is still growing. At the same time, early adulthood seems so far away that I dread the idea of cath after cath. I know Clare will get there someday, I just fear there is a long road ahead of her.

Thank you again to all who generously donated (on- and off-line) to the Easter Seals Walk With Me in honor of Clare. We raised over $1,700! We are getting ready to walk tonight with Shawn's family. Clare got her new AFO sneakers yesterday. They are adorable and big clunkers! I don't know how she can walk with all that weight on her legs. She will see Kelly, her PT, next week to start in them. Another thank you to all who donated to the Williams Syndrome Association Valentine Fund in honor of Clare - we appreciate the support of all our family and friends.

And, finally, Clare's little brother had his first photos done, and they are gorgeous. (As all our children's photos are!) So enjoy our Simon photos... we are off to do our walk tonight, then are taking off for my sister's wedding.

Tuesday, June 05, 2007


And speaking of Easter Seals, Clare had her evaluation today. Jessica (her occupational therapist), Kelly (her physical therapist), and Bonnie (an educator) came to evaluate Clare. Clare was delighted to see both Jessica and Kelly at the same time and eagerly played with the toys they pulled out for them. It was so cute to watch Clare listen to the directions and try to follow what the ladies wanted her to do. It hit me how much Clare has grown since her evaluation last year.

Clare fared much better than I expected. Shawn and I were delighted to hear that on many levels, Clare is performing at the appropriate age level. She has so many amazing skills. Her cognitive, emotional, fine motor, and receptive language skills are right where they should be. Her speech is slightly delayed, which we know, but not so delayed that they feel Clare needs speech therapy at this point. We know that Clare is very delayed in her gross motor skills, but it was still hard to hear that she is at the level of a 10-month old when it came to gross motor.

The big kicker at the evaluation was Jessica's announcement that she is leaving Easter Seals. Jess has been Clare's OT since she was four months old. Clare loves Jessica. During the evaluation today, she frequently wanted to sit in Jessica's lap and snuggle (Clare often does this during her OT sessions as well). They have such a great bond, and Clare's fine motor skills have far surpassed what we expected her to be able to do by this age. (In some areas, she has the abilities of a child 4-6 months older than she is.) We are so sad to see Jess go (but we understand why - she has good reasons). Currently, Clare has OT every week and PT every other week. Since Clare's fine motor skills are progressing nicely, Clare is going to start having PT every week and OT every other week until August. Jessica leaves at the end of August, at which time, Clare will stop receiving OT and simply continue with weekly PT.

All in all, we were pleased with Clare's evaluation. We talked briefly about the transition to preschool. All agreed that Clare would benefit most being in a preschool that includes typically-developing children as well. Since Clare enjoys being with other children and mimics peer behavior, it would be a disservice to her to place her in a classroom where the majority of the children are behind her developmentally. Our city has many developmental preschool options, so we are sure to find a great fit for Clare. This evaluation is the first step in Clare's transition process, and I think it was a positive step.

Monday, June 04, 2007

Easter Seals Walk with Me-Part II

S~I am posting this again as a reminder that if anyone would still like to sponsor us, we can still accept donations up until 3:00pm on Thursday. The walk is this Thursday and so far we have raised $1325.00! Thank you so much to all of you who have supported us thus far; your friendship and support are so important to Teresa and I, and we are extremely greatful.

(from the previous post by Teresa, I would not want to be blamed for plagerism) "Easter Seals has truly been a blessing in our lives. I read about families who have trouble finding services or do not get along with their therapists. We have never had an issue like that. Easter Seals is our Early Intervention Program where we live. Clare was connected with the organization when she was three months old, a few weeks after her diagnosis. She began her first occupational therapy session at four months old and has been going strong ever since. We all loved her OT from the start. As Clare got older and walking still seemed in the distant future, Easter Seals (without any headaches) added physical therapy to Clare's services. Again, we hit it off with Clare's PT from the first session. In addition, Clare's therapists have aided us in connecting with the swallow specialist, nutritionist, and most recently, the orthopedic surgeon. They are both ready with research and other resources that we may need. All of this is to NO COST TO US. We do not pay a dime for Clare's services through Easter Seals. Medical bills can be very stressful and quite a damper on a family's financial situation. There have already been many, many bills due to Clare's multiple caths and surgery. Not having to worry about how many therapies we can afford or how many our insurance can pay for has been a big load off our mind. We can concentrate instead on making sure Clare gets everything she needs to thrive. Therefore, it is very important to us that Easter Seals continues to be able to offer this same exceptional service to other children (and adults) like Clare.

Please donate to the walk - there is a link to your right that takes you to our personal Walk page. Thank you for your support!"
Thanks again to everyone and we will be sure to post some pics of the walk!

Sunday, June 03, 2007

What A Crazy Trip

We are home. When Simon and I arrived at the hospital this morning, the doctors were finishing their exam of Clare and said she could go home. Her puffiness had gone down so much the day before that they did not give her the second dose of Lasix last night. Her lungs sounded great, and this morning she ate some breakfast, so she received the green light to be discharged. Our nurse was awesome and had us out of there by 11 am (which is incredible in hospital discharge time, especially on a Sunday). Clare did not get much sleep Friday night because of pain nor on Saturday night because of a beeping IV pump that would stop infusing constantly (more on that in a minute), so she conked out immediately in the car. This evening, she was back to her old grinning self. Her poor little body is bruised and stuck and red all over, but it's wonderful to have our Clare Bear back!

I felt so unprepared for this hospital stay. It was all a big scramble getting there, and I felt like we were novices from the moment we stepped into the hospital lobby. It had been so long! Maybe because I was not the one staying overnight, but I was not even prepared for the long hospital waits - no cards, no crossword puzzles, no snacks! And we had the added dimension of Simon to work around. He is fairly easy-going, being only one month old, but it never failed that the minute Shawn stepped out of the room, both Clare and Simon started crying. They would have both been sound asleep two seconds before, so we would think we were in the clear for Shawn to grab something to eat, but then BAM - diapers, hungry, wanting to be held, they both needed it at the same time!

The morning after Clare had her breathing tube removed, when I got to the ICU, she was on the bed with her eyes closed. I came in the room and said, "Clare, Mommy's here." Immediately, her eyes flew open and she started wailing. Agonizing sobs that made my own eyes fill with tears. Shawn told me that when they had removed her tube the night before, as soon as her mouth was clear, she cried, "Mama, Mama." It breaks my heart that I could not be there with her. I know that Shawn is totally capable of being the bedside parent, but it is so hard for me to not be there. Especially when she is in pain and needs comforting. Obviously, Shawn can comfort her as well, but when your baby is crying for you and you are not there, that hurts. Especially when she starts crying upon seeing you - as if saying, Where were you, Mommy? So the first thing I obviously did was to hold her as soon as I could. She had already been given her first dose of Lasix to flush out the extra fluid that was building up. Lasix is a diuretic that enables the body to urinate the fluid out. As Clare and I are sitting and cuddling, I felt a strange sensation. It took me a moment to realize I was soaking wet and another moment to realize why. The Lasix was working! It was an uncomfortable, bow-legged walk to the staff bathroom to change my pants. Thankfully the nurse didn't make me walk all the way through the ICU, into the hall, and the public restroom looking like I was the one who wet my pants!

Unfortunately, that was not my only mishap this hospital trip. Once Clare was transferred to the cardiac floor and slept a bit, we ordered her some dinner. Although she did not eat anything, she sat in the high chair for a while and played with her macaroni and cheese and saltines. I think she was enjoying being out of the bed for the first time. The cardiology resident came in to exam her while she was still in the high chair. I went to lift Clare from the high chair to put her back in the bed, and one of her multiple wires got stuck in the high chair straps and yanked a bit. (I forgot what a pain in the butt it is to have three cardiac leads, oxygen sensor, blood pressure cuff, and IV lines everywhere.) Clare let out a yelp, so I sat her back down and the doctor helped me disentangle Clare out of the chair and transfer her to the bed. Once she was in the bed, the doctor turned on the overhead light to examine her and that is when we saw that the yank from the chair was not simply a wire that got stuck but was me pulling Clare's IV right out of her foot. There was blood everywhere - from the chair to the bed and making an even bigger mess since it kept bleeding (being on blood thinners never helps in these instances). (We did not notice the bleeding right away because the room was fairly dark since Clare had been sleeping.) Oh, what a bad mommy! Clean-up was great fun. I was supremely grateful that Clare already had another IV line in one of her arms, so the nurse was able to easily transfer Clare's fluids over to that line without any more needle sticks. Unfortunately, that IV site was in the bend of her arm, so the IV would constantly stop infusing because of the position. Thus the constant beeping of the pump and the constant fiddling by the nurse, and Shawn and Clare getting little sleep. Sorry, guys! Maybe it was better that I didn't stay overnight after all. Look how much damage I caused just being there half the time!

But now we are home and happy. Clare is having some trouble settling down and getting to sleep tonight. As much of an adjustment as it is going into the hospital, sometimes it's an even bigger adjustment coming home. The cath is past us now, and Clare is healthier again. We'll follow up with her cardiologist here in a week or two. The doctor will most likely want an echo done to see the results of the cath (she always likes to check these things herself as well). And we'll go from there, as we always do.

Photos - 1) Clare in the ICU on the ventilator. 2) After moving to the cardiac floor, Clare is wiped. 3) Finally awake and up watching Blues Clues. 4) Enjoying watching the balls in the lobby of Children's prior to her cath.

Saturday, June 02, 2007

Yet Another Update

S~ Hey there. I snuck out of the room as Clare was trying to go to sleep. Things are definitely perking up. Clare devoured two packages of saltine crackers and then went after some water, so her appetite is coming back. Teresa and I said we were surprised if she ate at all while we were here. I am hoping Clare and I have a better night. She and, as a result me, did not get more than 3 1/2 hours of sleep last night. Pray for a restful night for both of us. Clare is also looking a lot less puffy, so much so that they may not do the second round of lasix. All in all, we can't wait to go home!

Another Day Here

I am not going to get to post from home after all. They are keeping Clare for at least another night. She is doing great off her breathing tube, but is very puffy. The doctors don't know if she is retaining fluid or if she is puffy from some congestion around her heart. So they want to keep her on Lasix overnight to get rid of some of that fluid. I would write more but Shawn just informed me that they are transferring Clare out of the ICU and Simon is screaming in the stroller!

A Quick Update

I spoke with Shawn briefly last night, and Clare's breathing tube was removed around 10 pm, which is earlier than we expected. She was unhappy and in pain, but they held off on giving her morphine because it suppresses respiration. Instead, the nurse gave her tylenol (which is surprisingly effective for pain relief in small children) and was going to monitor her breathing on her own. As of last night, the plan was to have us discharged today. It is just around dawn (thank you, Simon), so that's all the news for now. I am going to head back over there in a little bit. If all goes well, we will be updating once we get home.

Friday, June 01, 2007

ICU Update

We have finally gotten to see our sweet girl in the ICU. It never gets easier seeing your child with a breathing tube, but Clare actually looks pretty good considering. Her color is beautiful (thanks to the blood transfusion), and she looked fairly peaceful... until they started letting her wake up from her sedative and paralytic. But that is a good thing because we're aiming to be discharged tomorrow.

We met with Clare's cardiologist after the cath. She did have another stent placed but it was not in a third artery, as we assumed. One of her existing stents was crushed. This could not be seen on the chest x-ray or echocardiogram because of the stent's position, but once the cardiologist was in her blood vessels during the cath, they had a much better angle and could see that the stent was crushed. Thankfully it was not obstructing all blood flow (or else there would be a real problem!), but enough to be worrisome. The cardiologist explained that this was most likely due to wear and tear and that stents used in infants are not as durable as stents used in adults. Another longer stent was placed inside the existing stent and ballooned open to widen the first stent as well. So now Clare has two stents in the same location. They also dilated many of Clare's distal pulmonary vessels in her lungs, which was the primary cause of Clare's exceedingly high pressures. They were able to get the pressures in her heart down 30 points and hope that that number goes even lower once she recovers from the cath.

Clare's aorta looks great, which proves again what a fabulous job her surgeon did 19 months ago. There is no coarctation (a narrowing where the surgical patch ends) this time and, although her descending aorta is narrow, it is not at a point where she needs any intervention on it. Her coronary and renal arteries look good as well. Clare did have some "misbehavior" during the cath (one of the doctor's terms - no, Clare did not throw one of her temper tantrums!) - she had drops in her heart rate and blood pressure swings. But they were able to stabilize her with dopamine and epinephrine. She is doing fine in the ICU and is currently only on heparin, the blood thinner so clots do not form in her new stent.

Clare's latest chest x-ray showed no fluid in her lungs (pulmonary edema), so the doctor is aiming to have her off her ventilator sometime tonight. Before I left the hospital for the night (leaving Clare in Shawn's capable hands - and the nurse's!), Clare was beginning to stir. She is understandably agitated - two tubes going down her throat, her arms are tied down so she cannot pull the tube out, and I am sure she is generally not feeling the greatest. She would open her eyes when she heard my or Shawn's voice, so she knows we are there (or were there, in my case) and is somewhat aware of her surroundings. Right before I left, the respiratory therapist started turning down the pressure in Clare's ventilator to see how she would do with some breathing on her own. If Clare tolerates this, they will continue turning down the pressure and then pulling the tube. The nurse is ready to give Clare morphine if she continues to be agitated with the breathing tube in. If she is extubated early enough tonight, then she may be able to skip spending a second night on the cardiac floor and can be discharged from the ICU to home tomorrow. That would be wonderful news!

Simon and I are back in the hotel now to get some sleep, and we will head back over in the morning and get all the news.

Cath Complete

Clare's cath is over. It's been a long couple of days, needless to say. Pre-op yesterday was pretty tough on Clare - lots of waiting, lots of yucky tests, and lots of needle sticks. Not to mention the fact that we were not allowed to get lunch until 3 pm. Between a 2-year old and a nursing mommy (and the ever-so-patient daddy), we were all on the grumpy side by the end of the day.

Today has not been easier so far. Clare did require another stent placement in one of her pulmonary arteries. Her cath just ended, so we have not been fully update by the cardiologists yet and do not have too much information. But they are not able to take her off the ventilator tonight, so she is going to spend the night in the Cardiac ICU. Usually this means the stent placement has opened up enough increased blood flow to cause some pulmonary edema. Plus Clare needed another blood transfusion. The doctors were hopeful she would be able to go without, but that was not the case. Again, I do not have too much information right now other than she is done, they are bringing her up to the ICU now, and we are waiting for the cath cardiologist to come out and talk with us. As far as we know, she tolerated the anesthesia and procedure well (we'll have to fill you in on Clare's first experience with ketamine - the drug she was given prior to being taken into the cath lab to mellow her out - put it this way, it is a derivative of LSD and it's street name is Special K). Thank you for the prayers so far and keep them coming!