Our all day 32 weeks appointment sure came up fast! We started the day with normal fetal monitoring to assess how Cooper is doing overall while on the inside. NST and BPP were perfect scores and we will continue these weekly until he's born. The Fetal Echo to follow was relatively the same as the ones we have done, stable diagnosis with the HLHS are reassuring of what we have, along with new spots to watch. At 28wks we were watching the opening between the atriums and the ability of the pulmonary pressure to continue to grow the lungs. That all looks beautiful now at our 32wk apt! What's interesting is we do have some mitral valve, aortic valve flutter/function. Blood flow to and into the left ventricle from those valves and from a possible very mild defect opening between the ventricles. None the less, though interesting, all this flow would never cause any increase or addition growth of the already very small, narrow and stenotic LVentricle and Aorta and cannot/will not ever sustain getting adequate blood flow out to his body.

Next, a full tour of where we will be all summer at Children's. The amazing child/siblings playground to utilize for our big brothers so we can have time with Cooper on sitterless days, work space for mom and dad as needed, workout, coffee shops, walking routes to get some air and time to move around away from the bedside. The Ronald McDonald house, which looks amazing(give all your pop can tops)! Then we got to actually walk the Children's Cardiovascular unit both step down and CardiacICU floor which is where we will be for each surgery and recovery. Though we have seen several pictures and tried to prepare ourselves as much as we can for what's to come, it is very hard to actually see these such little babies and kiddos with so many lines, tubes, and vents as they recovery from such a big endeavor. I've never seen so many lines attached to one patient at a time, let alone such a tiny little person. These nurses and providers must be so amazing with their care and knowledge, we are excited to meet them and get to know them and their expertise this summer.

Following our tours we then met with our Pediatric Cardiac surgeon. We both felt very comfortable and reassured after our appointment with him. This is definitely just another day in the OR and office for him, which is a comforting feeling for us. Luckily the statistics keep getting better and better for these kiddos. Our Surgeon and his partner specialize in these single ventricle kiddos. Both of them used to practice and continue to partner with the Mayo and the U, and now these specific babies are generally referred to Abbott's Children's for their newborn cardiac care and specifically this Norwood open heart procedure. Of the about 20 babies a year that they perform this surgery on for this region, they currently have an about 97% survival rate for surgery itself.

Our tentative plan:
39.0week induction to have all needed team members readily available for delivery (and so Chris and I can try to organize our other 3 monkeys). Delivery will need to be in the OR room which is connected by a door to the NICU room to bring him right to after just a few minutes with us. Hopefully he shouldn't need much additional respiratory help initially at birth, though we will need to get his umbilical (Belly Button) line in right away. This line can be used for all blood draws, medications and some vital sign monitoring. This includes getting him started on the progesterone hormone right away to trick that PDA duct of our normal hearts to stay open and not close until we are ready for surgery. Once this umbilical line is in and as long as he is doing good, then they can bring him back over (from right next door) to Chris and I for a little bit of holding time until Chris and Cooper then head to CVICU, where we can both visit in his private room 24/7 as needed/desired. 

Norwood: After a few days when good and stable from transitioning to life and enough of the natural fluid comes off of the lungs from his time living inside, then the pressure of the lungs can be at the best spot for surgery, sometime in the first 3-6days. Multiple tests and monitoring are done to find the most optimal time and according to our surgeon, like 20 specialists review his case and results prior to getting the official go time/call to go to surgery.
This surgery will last 6hrs.
1. Remove the PDA fetal duct, that was needed open to make it this far.
2. Slice open and attach a patch over the main aorta to make it a larger tube.
3. Attach a BTT shunt connecting the Aortic Artery(to body blood) and the Pulmonary Artery(to lungs blood). this allows the blood to mix and the Right side to be able to sustain not just the lungs but also to the body.
When done, Coopers chest will remain open for 1-4days. Whenever we close the chest, then about a day or so after that is when they will hope to ween off the ventilator and start to then bring off of sedation to wake him. 
*In the Gallery tab I broke down the Norwood steps with images. And side note, the movie "Something the Lord made" featuring professor Snape(Harry Potter) is about the first every heart surgery and the invention of this BTT shunt, actually good movie also!

Overall, since diagnosis, with all this information, there really is no changes in our care or plan for Cooper, though it is always reassuring to have the plan gone over again with all parties involved and we will continue to wait and mentally prepare for everything to come. We feel like we are on a well oiled machine and on the right/only path for these single ventricle kiddos. Having the trust and comfort in our team is huge and we feel in such good/caring/experienced and skilled hands at Children's from all aspects of his care laid out for us. What's to come, is coming up fast, and being able to prepare has been hard yet a huge blessing.

Thank you again for all prayers and support for our family and little 32week, 4lb Coops!