AV Canal Repair - Nicholas Mark on Tuesday Jan.4th.

AV Canal repair is also known as atrioventricular canal defects or endocardial cushion defects, they account for about 5 percent of all congenital heart disease, and are most common in infants with Down syndrome. (About 15 percent to 20 percent of newborns with Down syndrome have an atrioventricular septal defects).

The primary defect is the failure of formation of the part of the heart that arises from an embryonic structure called the endocardial cushions. The endocardial cushions are responsible for separating the central parts of the heart near the tricuspid and mitral valves (AV valves), which separate the atria from the ventricles.

The structures that develop from the endocardial cushions include the lower part of the atrial septum (wall that divides the right atrium from the left atrium) and the ventricular septum (wall that divides the right ventricle from the left ventricle) just below the tricuspid and mitral valves.

The endocardial cushions also complete the separation of the mitral and tricuspid valves by dividing the single valve between the embryonic atria and ventricles. An atrioventricular septal defect may involve failure of formation of any or all of these structures.

Problems With AVSD

The specific type of defect strongly influences the symptoms that may develop and the timing and details of surgical repair.

A complete atrioventricular septal defect allows oxygenated blood that has returned from the lungs to the left atrium and ventricle to cross either the atrial or ventricular septum and go back out the pulmonary artery to the lungs.

This re-circulation of blood to the lungs, called a left-to-right shunt, is inefficient because the left ventricle must pump a volume of already oxygenated blood back to the lungs while trying to meet the body's usual demand for its own oxygenated blood.

The amount of extra blood pumped by the left ventricle is often an additional 2-3 times that required of a left ventricle in an anatomically normal heart.

Because there is a large hole in the ventricular septum, the high pressure normally generated by the left ventricle to propel blood throughout the body is also transmitted to the lungs. Under normal circumstances, the lungs have a blood pressure much lower than that in the rest of the body.

The presence of a large left-to-right shunt and the associated increased workload on the left ventricle and high pulmonary artery pressure cause the lungs to become engorged with blood, and causes fluid to leak from the bloodstream into the air spaces of the lungs.

This condition is called pulmonary edema and makes it harder for a baby with this condition to move his or her lungs and breathe comfortably. The combination of increased heart and lung work uses large amounts of calories and results in the constellation of symptoms referred to as congestive heart failure (CHF).

Repair of the atrioventricular septal defect lowers the pressure in the pulmonary artery and allows these muscles to relax before they become permanently constricted.

Treatment for AVSD

Symptomatic infants with atrioventricular septal defects may improve with medicine, but in all cases corrective heart surgery will be necessary.

Medicines commonly used to treat congestive heart failure from left-to-right shunts in infants include diuretics such as lasix (furosimide), angiotensin converting enzyme (ACE) inhibitors such as captopril, and digoxin.

These type of defects will never close on their own and will always require corrective surgery for treatment.

Medical treatment of infants with atrioventricular septal defects is usually used to relieve symptoms and allow the baby to get big enough to undergo surgical repair with lower risks.

This usually occurs at 3-6 months for infants with a complete atrioventricular septal defect and 6-18 months for infants with a partial atrioventricular septal defect.

Atrioventricular Septal Sefects Treatment Outcomes

The usual recovery period following repair of a partial atrioventricular septal defect is relatively brief. Most patients are out of the Intensive Care Unit (ICU) in 1-2 days and home in 4-5 days following surgery.

Reported surgical survival is greater than 97 percent but is probably close to 100 percent in the current era.

If you would like to read more click: AV Canal

Nicholas Mark's surgery is schedule for Tuesday January 4th first thing in the morning. Your prayers are appreciated. You know we love ya, Don

Friday Funny - "Happy New Year"

It is Friday and New Year's Eve. These holidays are filled with get together and parties...so I thought the following might bring a chuckle:

As in many homes on New Year's Day, Janet and Nigel, a happily married couple, faced the annual conflict of which was more important: the football match on television, or the lunch itself.

Hoping to keep the peace Nigel ate lunch with the rest of the family, and even lingered for some pleasant after-lunch chat before retiring to the living room to turn on the television.

Some minutes later, Janet looked in to see how he was and graciously even bought a cold diet coke for Nigel. She smiled, kissed him on the cheek and asked what the score was. Nigel told her it was half time and that the score was still 0-0.

'See?' Janet said happily, 'You didn't miss a thing.'

It is hard to believe the first decade of the new millennium is over already. Praying 2011 is awesome in your life. Keeping our eyes on Him and He will never let us down. You know I love ya,
Don

Keep praying for Nicholas and us. His surgery is scheduled for Tuesday, January 4th. I will let you know as I know...

Happy New Year is a grateful New Year!

Teach us to number our days,

that we may gain a heart of wisdom. - Psalm 90:12

It is hard to believe that the first decade of this new millennium is already over. What a ten years it has been. I am thankful for the gains of children, new friendships, new ministries. I am also thankful for the new disappointments that have increased my reliance on a great a mighty God. I am reminded of what Lin Trantor wrote:

"I don't do any housework on New Year's Day," my aunt said, "because what you do on New Year's Day, you'll do all year." When I was young, I thought my aunt had the right idea. I didn't like housework, and so on January 1st I tried to do only the things I enjoyed.

Over the years, as I cared for my family and began to cultivate a more grateful attitude, I decided that doing some housework on New Year's Day would be a good way to begin the year. Washing dishes reminds me to be thankful for the food God has provided in the preceding year and to anticipate all that God will provide in the future. When I do the laundry, I remember to give thanks for warm clothes in the winter. Cleaning house helps me to be grateful for the shelter of a home and reminds me to give thanks for family and friends who are welcome visitors. With each of my New Year's Day chores, I find reason to give thanks.

When I pray on New Year's Day, expressing thanks for all that God provides, I hope the saying is true: What you do on New Year's Day, you'll do all year.

My grandmother was one of my losses in the last 10 years. I truly miss her and her ability to always give me a boost. She also would recite the saying of whatever you do on New Year's you will do all year long...the legacy lives on because my mother says it now.

In 2011, I want to be known as a servant, a follower of Christ, and one that is thankful for that which we have. With this mind set, I think it will be a good year, regardless of the joys or challenges.

Happy New Year to you and may the next year bring you all you desire and need. You know I love ya, Don

Merry Christmas!

From the Crane's

You we love ya,
Don, Karen, Matthew, Alice, and Nicholas

Luke 2 - The Christmas Story!

Luke 2:1-20 - The Message Bible

The Birth of Jesus

^1-5About that time Caesar Augustus ordered a census to be taken throughout the Empire. This was the first census when Quirinius was governor of Syria. Everyone had to travel to his own ancestral hometown to be accounted for. So Joseph went from the Galilean town of Nazareth up to Bethlehem in Judah, David's town, for the census. As a descendant of David, he had to go there. He went with Mary, his fiancée, who was pregnant.

^6-7While they were there, the time came for her to give birth. She gave birth to a son, her firstborn. She wrapped him in a blanket and laid him in a manger, because there was no room in the hostel.

An Event for Everyone

^8-12There were sheepherders camping in the neighborhood. They had set night watches over their sheep. Suddenly, God's angel stood among them and God's glory blazed around them. They were terrified. The angel said, "Don't be afraid. I'm here to announce a great and joyful event that is meant for everybody, worldwide: A Savior has just been born in David's town, a Savior who is Messiah and Master. This is what you're to look for: a baby wrapped in a blanket and lying in a manger."

^13-14At once the angel was joined by a huge angelic choir singing God's praises:

Glory to God in the heavenly heights,
Peace to all men and women on earth who please him.

^15-18As the angel choir withdrew into heaven, the sheepherders talked it over. "Let's get over to Bethlehem as fast as we can and see for ourselves what God has revealed to us." They left, running, and found Mary and Joseph, and the baby lying in the manger. Seeing was believing. They told everyone they met what the angels had said about this child. All who heard the sheepherders were impressed.

^19-20Mary kept all these things to herself, holding them dear, deep within herself. The sheepherders returned and let loose, glorifying and praising God for everything they had heard and seen. It turned out exactly the way they'd been told!

And that's why there's a Christmas Day!

When I was growing up, Lloyd Menning was our preacher at Church of the Cross in Modesto, CA. I remember a Christmas morning worship service and he had all the children come forward. I was about nine or ten years old. He asked us many of us if we knew why there was a Christmas?

We answered with the many typical answers; Jesus, presents, food... Then Pastor Lloyd began to sing this song:

"C" is for the Christ Child born upon this day;
"H" for herald angels in the night.
"R" means our Redeemer;
"I" means Israel;
"S" is for the star that shone so bright.
"T" is for the three wise men, They who travelled far.
"M" is for the manger where He lay.
"A" is for all He stands for;
"S" means shepherds came, And that's why there's a Christmas Day.

"T" is for the three wise men,
They who travelled far.
"M" is for the manger where He lay.
"A" is for all He stands for;
"S" means shepherds came, And that's why there's a Christmas Day.

And that's why there's a Christmas Day...I have never forgotten that moment. I was touched and still recalled its effect on me.

Today, as an adult that is in the profession of ministry, I wonder if he truly knew how much he touched me or for matter how many people God was touching through him. I have since asked him and his answer 20 years later was, "I was praying God was and worked to present the message, but truly did not know it at the time. It is nice to know it now."

I agree, many times we don't know it at the time and we rarely get to see its results. I am thankful for an true man of God that sang a beautiful song on a simple Christmas day and I rejoice in the opportunity and honor to following in his example.

Merry Christmas! You know I love ya, Don

Thanks to the Worship Choir...Mary is Safe for another year!

Merry Christmas and it is Friday!!! Also, thank you to a wonderful Worship Choir at Park Chapel. They surprised me last night with a gift I have wanted to while and also stunned me enough that I didn't know what to say... SO, in honor of them and their generous spirit and dedication to Worship this Friday Funny is for them:

About two weeks before Christmas, a little Catholic boy decided to write a letter to Santa. He started "Dear Santa...", he thought "No, I will go to a higher authority", so he decided to write a letter to Jesus.

"Dear Jesus, If you get me a bike for Christmas, I will be good for two weeks.."

"NO NO NO NO I can't be good for two weeks", he thought to himself.

So he started all over again...

"Dear Jesus, If you get me a bike for Christmas I will be good for one week."

"NO NO NO NO I can't be good for one week", he thought to himself.

So he quickly ran to the Study room and grabbed their statue of Mary, and quickly wrapped it up in a blanket.

He started all over again.

"Dear Jesus, I have your mother...if you ever want to see her again...get me a bike for Christmas!"

The gift was season 5, 6, & 7 of Star Trek: The Next Generation. I watched my first episode this morning while working out and Mary is safe for another year!

Keep smiling, laugh some, and you know I love ya, Don