I’ve written before about how strange Parker’s heart rate can be……and what an indicator it is of an upcoming illness or aspiration issue.
Last night Parker sleeping heart rate was beee-u-tiful.
Today his napping heart rate is ‘cycling’ again.
This is when his heart rate goes up and down rather quickly while his O2 sats stay in the really good range. Only his heart rate is going kinda nuts…..NOT is O2 sats.
I have a hard time getting anyone to take me seriously about this when I bring it up at PCMC. Although one of Parker’s former Pulmo’s (whom we adored) did say that it looked like a classic aspiration and put our Hero on Flovent which does help. But he’s on it NOW and we are still ‘cycling’.
Parker is on the back end (fingers crossed) of double ear infections as well as a sinus infection. Week three of clindamycin and the last day of a 5 day steriod burst. So……his heart rate should still be beeee-u-tiful, you know?
See how his heart rate goes from the 60′s to the 80′s in the blink of an eye? As soon as I quit filming it went back up and then back down to the upper 50′s and then hung out in that cycle for the next hour until he woke up. I can tell when Parker is going to wake up simply by his heart rate…..it gets higher as he starts to wake up.
Does anyone else have this issue with their kids heart rate?
I don’t think it’s because he’s starting to get sick….if that were so it would stay in the 80′s or 90′s. But then again tonight and tomorrow night’s heart rate may tell us more.
Perhaps he’s aspirated on his saliva again? If so then by tonight his heart rate could be back in the beee-u-tiful range.
See how easy it is to make this Mama crazy? Especially with a right heart cath coming up on Friday?
sigh.
Okay, now you’ve got me thinking. Because Aaron also has PH and his heart rate can fluctuate quite a bit too. When he’s sleeping he can be as low as low 80′s or up to almost 110, and it will go back and forth a lot. I’d be interested in knowing what they tell you. I’ll also have to ask our cardio when we see him on Thursday. We weren’t supposed to see him until Dec, but after his 1st surgery, Aaron developed a split S1 sound. That’s supposed to be near impossible to do, but yep, he did.
That looks a lot like Jax! I have his low set at 70, because he used to be low 100′s asleep, but its getting lower so I’ve had to lower the alarm to 60. But it would alarm, I would go in there and it would 90, it jumps all over the place as well. They actually did a holter monitor because I was concerned, it did show some brady’s, but not low enough to cause problems. My guess is its the same thing with Parker!
Rebekah,
The only time this has been a big concern with Parker’s PH has been when BOTH his heart rate and O2 have been cycling like crazy.
It is usual for his heart rate not to stay the same each second. Especially if he coughs or twitches or moves. But it usually only varies a few degrees or much slower. Like from 65 to 68 to 64 to 69 back to 64, etc.
He hasn’t been able to be on his Passy Muir valve due to his sinus infection, so I’m wondering if this is a sign of him aspirating on his spit.
I don’t know what a split S1 actually is. Is it related to the PH?
Do you see Day?
My daughter has always had extremely HIGH heartrates with Large drops that no one would even look twice at unless in PICU. Like sleeping in the 150′s down to 60′s frequently. Her heartrate has settled down a bit as she has gotten older but still a sleeping heartrate of 100 is great for us. The consensus I have gotten from all the doctors is that the drops in heartrates have to do with possibly a slight reflux but not to the point of aspiration. (And believe me we have had our boughts of aspiration!!) Okay so I have a hard time explaining but it has something to do with the most bottom part of the trachea and the acid reaching it for just a second??? But then it goes back down and so the heart rate comes right back without any questions. But if Parkers is going up – who knows?? Maybe he is having an awesome dream about something fun and exciting
. Maybe he is going super fast on his awesome sled.
But our kids all seem to do their own things at their own times!!
Oh, and I have learned through my mommy crash course as a doctor for my daughter that resting heart rates are lower that awake heart rates. But if this isn’t normal for Parker then you are probably on to something….. Good luck with the heart cath!! Always scary until you have them in your arms at the end!
Pulse oximeters aren’t the best way to monitor heartrate because they are so susceptible to interference and other factors. Having said that, his waveform is pretty solid. Here’s a really important point, though- the rate will be measured between TWO beats- the distance from one beat to the next determines the rate read on the screen. So, he only has to have one premature beat to cause a heartrate ‘spike’, and then if the heart resumes normal rhythm, it will go right back to the baseline rate- until the next premature beat. The way they are conducted (well conducted, almost full size) tells me if they are premature beats, they are PAC’s (premature articular contractions) which aren’t uncommon with PH, many other normal conditions, and even asymptomatic people. It’s all speculation, though. To really know what’s happening you need a continuous EKG or holter monitor.
Twitter: kadiera
says:
Do you see the same blips in the hospital? If not, I’d look at the setup of your monitor. We found that there are settings that look at how long things are averaged over – changing one of them made the sat not alarm for random blips, but meant that the heart rate was more bouncy.
That said…it does look a little odd. Alexander does that occasionally too though, so who knows…
My daughter does the same thing.
I have talked to her pulmo at lenght. The variation when she wakes up is completely normal and everyone does it. It is also normal for the heart rate to vary during certain stages of sleep especially during REM sleep when you are dreaming. Some people when they are dreaming will have heart rates the same as when awake.
Our pulmo says the variation of quick blips up and then right down is nothing at all. He says it is because of beat to beat variation and also small movements. I have noticed that if my daughter moves the finger or toe the sensor is on that she will blip up and then right back down. Also if she moves or rolls over she will blip. I have also noticed that if our sensor is getting a little old we have bigger variations.
My daughter does not have aspiration issues at all and does the exact same thing all the time. She only has sat issues when she is sick and her heart rate does that all the time, sick or not.
Both of my youngest sons heartrates do the exact same thing.. My 5 yr old especially. I’ve brought it up to numerous cardiologists (he has a pacemaker) and they all say it’s “interesting” and they don’t believe it does any harm… Not a single one can explain WHY it does that. We’ve had multiple holter monitors on both boys and it’s never been explained.
I KNEW there was something else I wanted to ask about. Forgot until I came back on here and read your comment back. We see Dr. Menon, and I really love him. He said the split S1 wasn’t any problem at all, just sometimes happens. He said it actually is always split, but that it’s just usually really hard to hear. It’s when his two valves on the right side don’t close quite together. But that it’s fairly normal, just really, really hard to hear. But, yeah, Aaron does it, sometimes. And it probably is related to his PH & his vent pressures.
He’s talking about sometime in the future looking at a heart cath to see if we need to close his VSD, but not for a while. We still like it’s safety valve function for his PH. I’ll be praying for you guys and the docs tomorrow. Is it an outpatient procedure, or are you staying at Hotel Primary’s tomorrow? Good luck!!!!