With all of the coughing that Elijah has been doing lately, his respiratory health has been something I have been thinking about a lot. (We did get his lungs listened to today and all is clear, phew!)
About a month ago, the three of us were driving home from somewhere in the city at night. As we cruised along the freeway, I spotted a huge tree in the distance that someone had intricately decorated with Christmas lights. It must have taken forever to get the lights on this tree because every single branch and every little twig attached to every branch had a string of lights wrapped around it. I am one to appreciate projects that take a good chunk of time to complete, so I thought it was really cool.
A few weeks before I saw this tree, during Elijah's most recent heart cath, Dr. G sat down with Dan and me and described to us in detail the way blood flows into and through the lungs. He drew two diagrams. One was of a healthy, normal set of lungs and the other was of Elijah's lungs. A diagram of the blood flow in healthy lungs has an uncanny resemblance to the super-lighted tree I saw from the freeway last month, so this is the first thing I thought of when I saw it. WOW, THAT TREE HAS HEALTHY BLOOD FLOW!
In healthy lungs, blood flows through many big branches, which lead to many smaller branches, which lead to many twig-sized branches, covering a majority of the area in each lung. In Elijah's lungs, blood flows into a couple main branches, which lead to a handful of smaller branches, which lead to very few twig-sized branches, covering maybe two-thirds of the area in each lung.
The limited number of blood pathways in his lungs is a result of the MAPCAs portion of his heart diagnosis, which is a result of the Pulmonary Atresia portion of his heart diagnosis. Because certain pathways in and around his heart were missing (Pulmonary Atresia), his body created these collaterals (MAPCAs) to try to compensate for the absence of proper blood flow. And because these pathways weren't in his body to begin with, they were not necessarily formed the correct size and with the correct quantity or quality than they would have been had he not had his heart defect.
It's actually pretty cool when you think about it. His body recognized a lack of blood flow in a very important area of his body, so it created its own pathways so his body would be able to function. And thank God the human body is amazing enough to do something like this because the alternative is, well, a body that cannot survive.
Those pathways, although life-sustaining and adequate, are limiting. They were his body's Plan B, so they do not provide his lungs with ideal blood flow. Elijah's lungs will never be normal, and this is something that will not change.
I guess we had always kind of known this, but when Dr. G described it so vividly it bummed me out. Not only will Elijah never have a normal heart, he will also never have normal lungs. This means he will tire easily and he will always be more susceptible to infection and illness and respiratory issues. This is a life-long thing for him.
While that is definitely a bummer, I do know that he is also very blessed. Dr. G also explained that Elijah's body did a way better job of implementing that Plan B than a lot of other little bodies do. Some babies with MAPCAs have one or two main tree branches, with one or two littler branches coming off of those, and that is it. Those babies don't live for very long. Considering the diagnosis Elijah has, he is a VERY blessed little boy. As a last resort, his body did an amazing job of creating sufficient pathways for blood to travel through. His blood flow will never resemble the tree I saw from the freeway, but we are very thankful for the branches that are there.