Clare's cardiologist called this morning to talk about yesterday. He was concerned both about Clare's complaint of left arm pain and her moodiness and change in sleep habits. He is treating them as two separate issues, even though he acknowledges the fact that Clare's complaint of pain could be a call for attention stemming from the mood swings. However, children with Williams syndrome can have pulmonary and/or coronary artery problems that present suddenly, and some of Clare's complaints match symptoms of a greater issue. (And, of course, she does have severe pulmonary stenosis, which was clinically stable as of two months ago.) Again, the cardiologist stressed that he does not believe Clare is having any vascular problems since she has had great echo and EKG results over the past two years, but he never takes any chances due to the nature of Williams syndrome.
The cardiologist also said that mood swings can be a side effect of taking beta blockers, but her former medication has a higher incidence of this side effect than her current medication does. So the chances are that she would have experienced this side effect on her other medication. However, she is on a higher dose now and, everyone is different, so we are going to trial her off her blood pressure medication for one week. If her mood swings improve and her blood pressure is good, we can continue trialing her off the medication for longer. If her mood swings improve, but her blood pressure is high, then she will have to go on something different. If her mood does not improve, then it's not the medication responsible for her mood swings, and he wants her back on the blood pressure medication, regardless of what her blood pressure reading is. (He would rather keep her on a beta blocker right now.)
So.... in a nutshell, we will see how Clare fares this week and go in next week for an EKG and blood pressure check. If there is something funny going on, the EKG should pick up an abnormality. I am so glad that our cardiologist is on top of this stuff! Sometimes I just want someone to tell me what to do so I can stop second guessing everything I do!