Jack marched himself down to the cath lab and it began at 1:30. (remarkable..) They buzzed us around 3:30 and Dr. Gray explained the readings from the cath. The news was bittersweet. The heart function is good, pressures look great, and the only problem is that the left PA is small. Not narrow, small. And it should grow as Jack grows. That is all wonderful- however it doesn't present an obvious cause of the multiple pleural effusions. After the doc's bounced some theories off of eachother in front of Josh and I sitting there wondering what in the world they were getting at- they told us they'd talk to the surgeons and then get back to us.
Jack was in recovery screaming for me and fighting off the nurses holding his body straight, as you MUST lie flat for 6 hours after the cath to prevent bursting the arteries and veins that they used for the cath. Jack calmed a little and we went back to the room.
Dr. Kouretas came up in a timely manner and explained VERY CLEARLY what his thoughts were. He said there were 3 options, and described each, then plainly told us which one he thought was best for Jack. It is much easier talking to him than it is the little pack of doctor's that run in and out of our room. He has a way of explaining things in a way that we understand, without too much context and a confidence about him that makes us feel like the choice of what to do medically isn't left up to us... Love him.
So his decision was to do surgery tomorrow called "thoracic ligation" where he will tighten the thoracic duct to prevent the fluid from filling up and accumulating again. He says this should take care of the problem.
Though surgery wasn't exactly what we had in mind, after the fontan, we are comfortable with his choice and feel satisfied with the plan.
He will go in tomorrow sometime after noon. I'll let you all know tomorrow's events.