Sunday, December 28, 2008

Merry Christmas!

I hope everyone had a very Merry Christmas!

We had our first Christmas in Nashville this year. Every year we travel home to Louisiana to be with our families but this year my parents, granddad and Aunt all came to our house for Christmas.

We were spoiled with many wonderful gifts for Cain. We know he will love each and every one of them as much as we do.

As you can see...Cain wasn't the only "baby" that was spoiled by the grandparents. Sadie was also spoiled too.

Too many toys...Which toy do I play with first?

Me & my granddad at the airport. Isn't he the most handsome 81 year old ever! And the sweetest too!
Thanks to everyone who made our Christmas wonderful! We can't wait to celebrate next Christmas with Cain!!

Tuesday, December 16, 2008

Our first (and possibly last) garage sale ever!

Well, my plan had been to blog more frequently. I hoped to at least have a new blog posted each week. However last week we were busy working to get ready for our garage sale we had on Saturday. Since I am in the "nesting" stage we have been cleaning out our junk. The funny part is...I now think our attic may be the cleanest part of our house. Here are a few pictures from our first and possibly last garage sale.

The day started out with Sadie mad at us for waking her up so early.

But who can blame her for being mad. As you can see, we were up before the sun came up. And the temp at the time had to be around freezing!

Everything is set let's start making $$$!

By the end of the day we had our neighbors niece and nephew helping us load up the trailer with what we didn't sale so we could take it to Goodwill.

Even though we had a lot left over we at least made a little $$ to put towards decorating Cain's room!

Friday, December 5, 2008


Less than 9 weeks to go! It's crazy to be able to say those words. Crazy for many reasons. Crazy that I've been pregnant now for over 31 weeks. And crazy to think my belly still has 9 more weeks of growing. I don't know if it can stretch much more.

I can't say I'm ready for it to end. I've actually enjoyed being pregnant. I just hope to be reunited with my hips again one day!

Sunday, November 30, 2008

Many People to Thank this Thanksgiving!

I guess the holiday weekend is coming to an end for all of us. Back to work tomorrow! I hope everyone had a wonderful Thanksgiving. We stayed in Nashville this year for Thanksgiving and unfortunately did not get to spend the holidays with our family. With Cain due in less than 10 weeks we didn’t want to be too far away from Vanderbilt. Even though we weren’t able to be with our family, we have many people to thank for helping us to have a wonderful Thanksgiving.

First, we must thank Derek & Andrea for inviting us to join their family for Thanksgiving. Derek is a high school friend of Brad’s who now lives in Nashville. His parents, sister, brother-in-law, and two nieces were all in town from West Monroe. We really enjoyed visiting with his family and eating lots of wonderful food.

Secondly, we thank Dane for inviting us to go see the Rockettes with his family Thanksgiving night. Dane is also a friend from Louisiana that lives here in Nashville and most of his family was in town visiting. The other half stayed back in Louisiana so they could go hunting. I think Brad and Dane both would have enjoyed hunting more than watching the Rockettes! I also think it will be the last time Brad will ever watch the Rockettes and I will probably owe him for life for going with me. But I do know he enjoyed visiting with Dane.

Next, we must thank the employees of the Waffle House where we had dinner after watching the Rockettes. It was Thanksgiving night and at first we thought they were closed. Thankfully, they were open and ready to serve us! I don’t think they had many customers that day and seemed very happy to see us. They even gave us coupons for free drinks on our next visit. It’s the little things like getting coupons for free Waffle House drinks that make me happy!

And last but not least, I must thank my wonderful husband for helping me accomplish much of my “to-do” list this weekend. Actually, he is still working as I type this blog. Even though we weren’t able to check everything off the list, you can see we accomplished A LOT!

Wednesday, November 26, 2008

Ventricular Septal Defect (VSD):

The septum is a wall that separates the heart's left and right sides. Septal defects are sometimes called a "hole" in the heart. A defect between the heart's two lower chambers (the ventricles) is called a ventricular septal defect (VSD).

When there is a large opening between the ventricles, a large amount of oxygen-rich (red) blood from the heart's left side is forced through the defect into the right side. Then it's pumped back to the lungs, even though it's already been refreshed with oxygen. This is inefficient, because already-oxygenated blood displaces blood that needs oxygen. This means the heart, which must pump more blood, may enlarge from the added work. High blood pressure may occur in the lungs' blood vessels because more blood is there. Over time, this increased pulmonary hypertension may permanently damage the blood vessel walls.

If the opening between the ventricles is small, it doesn't strain the heart. In that case, the only abnormal finding is a loud murmur.

Transposition of the Great Arteries (TGA):

Normally, the pulmonary artery carries venous (bluish) blood from the right ventricle to the lungs to get oxygen. Then the aorta carries the oxygen-rich (red) blood from the left ventricle to the body. In transposition of the great arteries, the vessels are reversed. The aorta is connected to the right ventricle so that venous (bluish) blood is carried to the body. The pulmonary artery is attached to the left ventricle so that oxygen-rich (red) blood is carried back to the lungs.

Infants born with transposition survive only if they have one or more connections that let oxygen-rich (red) blood reach the body. These connections may be in the form of a hole between the two atria (atrial septal defect), the two ventricles (ventricular septal defect), or a vessel connecting the pulmonary artery with the aorta (patent ductus arteriosus). Most babies with transposition of the great arteries are extremely blue soon after birth because these connections are not adequate.
To improve the body's oxygen supply, a special procedure called balloon atrial septostomy is used during heart catheterization. It enlarges the atrial opening and helps the baby by reducing the cyanosis.

Two general types of surgery may be used to help correct the transposition. One common surgical procedure creates a tunnel inside the atria. It redirects oxygen-rich (red) blood to the right ventricle and aorta, and redirects venous (bluish) blood to the left ventricle and pulmonary artery. This operation is called a venous switch or intra-atrial baffle procedure. It has other names, too, including the Mustard procedure or the Senning procedure. It's usually done in infancy. Many factors, including the degree of cyanosis, determine how early in life a child may need surgery.

In another surgical procedure, the major arteries are switched. The aorta is connected to the left ventricle, which pumps oxygen-rich (red) blood to the body. The pulmonary artery is connected to the right ventricle, which pumps venous (bluish) blood to the lungs. This arterial switch procedure may be done in the first few weeks after birth or, depending on various factors, slightly later. If there's a large ventricular septal defect or other defects related to the transposition, the repair gets more complicated. Then other surgical procedures may be needed.
After surgery, the long-term outlook varies quite a bit. It depends largely on how severe the defects were before surgery. Lifelong follow-up is needed to be sure that any remaining defects or problems are treated properly. Children with transposition of the great arteries are at risk for getting an infection on the heart's walls or valves (endocarditis) before and after surgery.

Monday, November 24, 2008

Hypoplastic Right Heart Syndrome

Hypoplastic right heart syndrome (HRHS) refers to underdevelopment of the right sided structures of the heart. These defects cause inadequate blood flow to the lungs and thus, a blue or cyanotic infant. The major problem is pulmonary valve atresia (absence). This valve normally opens and closes to let blood flow to the pulmonary artery. Secondary problems include a very small (hypoplastic) right ventricle (lower chamber which normally pumps blood to the lungs); a small tricuspid valve (this valve allows blood to flow into the right ventricle) and a small (hypoplastic) pulmonary artery. Also, the blood flow into the coronary arteries may be abnormal causing damage to the heart muscle.

The infant is born with two connections that help blood flow. These are a foramen ovale (hole between the atria) and patent ductus arteriosus (or PDA, a blood vessel between the aorta and pulmonary artery). As these connections begin to close, the infant becomes critically ill.

Because the blue blood cannot pass through the right side of the heart to get to the lungs, it crosses into the left atrium and mixes with red blood returning from the lungs. This mixed blood is pumped out of the aorta. The only way in which blood gets to the lungs is through the PDA. The PDA must be maintained open with medicine (PGE1). Surgery is usually performed shortly after starting PGE1 to create an artificial connection (shunt) between the aorta and the pulmonary artery to deliver blood to the lungs.

Sunday, November 23, 2008

Tricuspid Atresia

Well, I said I would work over the next few days to describe each defect. Hopefully we can learn together!

Tricuspid Atresia

In this condition, there's no tricuspid valve so no blood can flow from the right atrium to the right ventricle. As a result, the right ventricle is small and not fully developed. The child's survival depends on there being an opening in the wall between the atria (atrial septal defect) and usually an opening in the wall between the two ventricles (ventricular septal defect). As a result, the venous (bluish) blood that returns to the right atrium flows through the atrial septal defect and into the left atrium. There it mixes with oxygen-rich (red) blood from the lungs. Most of this poorly oxygenated mixture goes from the left ventricle into the aorta and on to the body. The rest flows through the ventricular septal defect into the small right ventricle, through the pulmonary artery and back to the lungs. Because of this abnormal circulation, the child looks blue.

Often in these children it's necessary to do a surgical shunting procedure to increase blood flow to the lungs. This reduces the cyanosis. Some children with tricuspid atresia have too much blood flowing to the lungs. They may need a procedure (pulmonary artery banding) to decrease blood flow to the lungs.

Other children with tricuspid atresia may have a more functional repair (Fontan procedure). In this, a connection is created between the right atrium and pulmonary artery. The atrial defect is also closed. This eliminates the cyanosis but, without a right ventricle that works normally, the heart can't work totally as it should.

Children with tricuspid atresia require lifelong follow-up by a cardiologist for repeated checks of how their heart is working. They also risk infection in the heart's valves (endocarditis) before and after treatment.

Friday, November 21, 2008

Congenital Heart Defects

I mentioned in my first blog that I would explain in greater detail Cain’s heart defects and the surgeries he will need. I’m thinking I will explain each defect over the next several days. It is all very overwhelming so I thought I would start off by explaining what complex congenital heart defects are before describing each individual defect.

So here it goes.....

Congenital heart defects are problems with the heart's structure that are present at birth. These defects can involve the interior walls of the heart, valves inside the heart, or the arteries and veins that carry blood to the heart or out to the body. Congenital heart defects change the normal flow of blood through the heart.

There are many different types of congenital heart defects. They range from simple defects with no symptoms to complex defects with severe, life-threatening symptoms.

Congenital heart defects are the most common type of birth defect, affecting 8 of every 1,000 newborns. Each year, more than 35,000 babies in the United States are born with congenital heart defects. Most of these defects are simple conditions that are easily fixed or need no treatment.

A small number of babies are born with complex congenital heart defects that need special medical attention soon after birth. Over the past few decades, the diagnosis and treatment of these complex defects has greatly improved.

As a result, almost all children with complex heart defects grow to adulthood and can live active, productive lives because their heart defects have been effectively treated.

Most people with complex heart defects continue to need special heart care throughout their lives. They may need to pay special attention to certain issues that their condition could affect, such as health insurance, employment, pregnancy and contraception, and preventing infection during routine health procedures. Today in the United States, about 1 million adults are living with congenital heart defects.

Wednesday, November 19, 2008


I had my first appointment with my new OB yesterday. I loved my previous OB and dreaded having to change but had no choice. I had to switch to a doctor who has privileges to deliver at Vanderbilt since that is where Cain will need to be delivered. I guess the appointment went okay except that I’m not sure how many times I will see my new doctor before he has to deliver Cain. I am at the point in my pregnancy where I will see a new doctor at each appointment. What fun! The doctor did let me know I should be able to have a normal delivery and should be able to carry Cain full term. Let’s hope that’s the way it turns out! My next appointment is in three weeks.

Monday, November 17, 2008

Cain Austin Clinkscales

I’m sure most of you know by now that Brad & I will be adding a new addition to the Clinkscales family in February 2009. That’s right; Cain Austin Clinkscales is scheduled to arrive on February 4, 2009.

I was 20 weeks into my pregnancy at the time of my 30th birthday. As a birthday present to myself, I scheduled an ultrasound on the day of my birthday, September 22nd. I was totally expecting it to be the best birthday present ever! How could it not be? I was going to find out the sex of our first child.

We were immediately elated to find out we are having a boy! However, we also received very sad news during this ultrasound. We found out that Cain has a rare congenital heart defect.

The following Thursday, September 25th, we had our first appointment with the Pediatric Heart Institute at Monroe Carell Jr. Children’s Hospital at Vanderbilt. We met with a pediatric cardiologist, Dr. Michael Liske, who performed a fetal echo. Afterwards, Dr. Liske sat down with Brad and me and explained to us that Cain has several congenital heart defects. The following are his defects.
1. Tricuspid atresia
2. Hypoplastic Right Ventricle
3. Ventricular Septal Defect
4. Transposition of the Great Arteries
5. A small aortic valve
I will explain each defect and the surgeries needed in detail in later blogs.

As unlucky as this may all seem, we are very lucky for several reasons. One of those is the fact that we live in a town where we have access to a wonderful team of physicians who are dedicated to the care of patients with heart disease. We are also very lucky that the Children’s Hospital at Vanderbilt has a surgeon who performs surgeries on babies born with Hypoplastic Right Hearts. The surgeons name is Dr. David Bichell. He is the chief of Pediatric Cardiac Surgery at Vanderbilt and is the only surgeon in Nashville who performs the operations that Cain will need.

We were able to have a consult with Dr. Bichell on October 14th. He explained to us that Cain will have to undergo multiple surgeries after birth. As it stands now, he will have his first open heart surgery during his first week of life. They wait a few days after birth to let the lungs strengthen. The second surgery will occur at approximately 4-6 months. The first two surgeries are designed to temporarily relieve blood flow to and from the lungs. His third surgery will occur around 18 months and it is to improve overall circulation. The procedures do not cure the defects, but rather re-routes the blood flow around the defective areas. We were told Cain will be at high risk due to his number of complications. Essentially, when the procedures are completed, he will be functioning on the use of the left side of his heart only. We were also told there is a possibility that he will need a heart transplant later in life depending on the outcome of these procedures and how well his left ventricle holds up under the extra stress of supplying blood to the entire body.

So, with all of this said, I have decided to start a blog. We feel so grateful to have our family and friends. It is during times like this, we realize how truly blessed we are. We can’t thank each of you enough for your prayers and support thus far. My hope is for this blog to keep each of you updated on my pregnancy and updated on Cain’s progress.