Action stations, action stations. Set condition one throughout the ship. This is not a drill.
October 15, 1962. CIA informs the State Department that the Soviets have medium-range ballistic missiles on the ground in Cuba. The next morning, President Kennedy begins reviewing photographs. By 6:30 p.m. Kennedy convenes 14 military and national security advisers to come up with options.
They came up with six:
- Do nothing.
- Diplomacy to get the Soviets to remove the missiles.
- Warn Castro and scare him enough to remove the missiles.
- Blockade any Soviet attempts to bring more missiles to Cuba.
- Air strike on missile sites by the US Air Force.
- Full scale invasion of Cuba.
After serious consideration of all options, the U.S. went with option 4 – Blockade. Krushchev famously stood down and removed the missiles from Cuba, and we all went back to our happy little Cold War.
Like the Americans in ’62, we had indications that something was brewing with the enemy for a little bit now, but we didn’t get confirmation until today.
Ari’s pulmonary valve has failed. We’ve reviewed the photographs. It’s toast.
Attention all Colonial units. Cylon attack underway.
Here are our options:
- Do nothing: Ain’t gonna happen.
- Diplomacy and warnings: No minor changes will help. The time for outpatient treatment is over. We’ve been admitted here at Children’s.
- Blockade: We send a clear signal of our military might by starting in with serious medications to “buff up” Ari’s heart, and get the problems created by the failed pulmonary valve to back off.
- Air strike and full scale invasion. The joint chiefs in ’62 were unanimous that this was the best option. It might seem on its face that if the valve’s failed this is the first stop. Perhaps not just yet. Stay tuned.
As you might have guessed, we’re going with blockade. We are now back living at the hospital so we can treat the problems with all due speed and options just shy of all out war.
By the way, the problems are:
- Higher arterial blood pressure.
- Higher pulmonary blood pressure.
- Faster heart rate.
- Faster breathing.
- Difficulty keeping food down.
- Almost non-existent weight gain.
- Worsening heart function, especially in Ari’s right ventricle.
We’re starting digoxin to help his heart squeeze and lower his heart rate, and starting Enalapril (which, by the way, our dog Toby takes for his heart condition…coulda just grabbed some from the kitchen) to lower his blood pressure and reduce the workload his heart has to bear.
If these work, his heart function should improve quickly. That will help slow his breathing and, we hope, allow for weight gain. While the enemy will still be there, he’ll effectively be back down until he regroups. Ari needs a new pulmonary valve – this is a given – it’s just a question of when.
The enemy could stay down for a while. Some kids can live with faulty pulmonary valves for years. Others can’t. With Ari’s other challenges, we just don’t know.
When we were talking to the cardiologists today, they said they’re hopeful that the medications will work and we can kick the surgery can down the field for a while. He needs to be 3 or 4 or so years old before he can get a decent replacement. Until then there are no good options.
You might remember that this pulmonary valve is a homograft, or cadaver valve, which we put in because it was the only valve available in his size when he had his Ross procedure. The valve lasted about 4 months. Failures every 4 months would be bad.
If we can back the enemy down temporarily, we’ll know sometime in the next week or so. If we can’t, we yield to the joint chiefs and go full scale assault with a new valve. This would mean open heart surgery.
Here’s hoping Krushchev is feeling reasonable these days. At least enough that he goes back to his trench, we go back to ours, and we just aim at each other but no one shoots for a while.
Further updates, as we get them.