TYSON MATTHEW KOTTELENBERG

This blog is about our 16 year old son Tyson. Tyson was born with serious complex congenital heart defects, (Hypoplastic Right Ventricle, Tricuspid Atresia, Coarctation of Aorta, Transposed Great Arteries, with VSD and ASD.) In short, the right side of his heart is completely under-developed (he has half a heart,) his main arteries are mixed up, and his aorta is narrow. He has undergone 3 open-heart surgeries and 5 heart catheterization procedures to try to 'repair' his heart. Tyson also has severe narrowing in his pulmonary veins which is causing higher venous pressures. He's still doing AMAZINGLY well all things considered. We entrust our dear son into the hands of God, knowing that in all things God works for the good of those who love Him!

Not Going Home Yet

Unfortunately we are not going home today. Ty had a really good evening last night with sats at 89-90 without oxygen. He was so happy and had a good time playing Xbox with his friends online. 

He slept well from 12am-4:30am until the nurse came in for vitals. Then he couldn't get back to sleep because he was 81-82 so he was too scared to go back to sleep. The doctors want him above 80 when sleeping and above 85 when awake. Ty knows that his sats drop when he's sleeping, and he really didn't want to have the oxygen put back on, so he just didn't sleep. Then suddenly he started desatting to 78-79 for several minutes, then he'd go back to low 80s, then back down to high 70s. This went on for a while between 5:30-6:15am. He tried changing positions, coughing, deep breaths, etc. but nothing worked so at 6:20 the nurse put him back on oxygen. He was weaned off oxygen to room air again by 8am, but shortly afterwards he was back to mid 70s. So now he's back on oxygen again.  

The doctor has ordered an echo to see if it's heart related. The echo is happening right now as we speak. I imagine we won't hear results until tomorrow. 

The nasal swab taken in emerg on Sunday came back positive for RSV. RSV can be challenging for healthy people to overcome, let alone someone with an underlying heart condition. The doctors said it's not uncommon for people with RSV to feel better one day and then go downhill the next day. We also can't forget that Ty's not just a cardiac kid, but he also really only has one good lung. He has stenosis in his left pulmonary artery (and veins) and the blood flow distribution between the right and left side is 88% to 12%.  So that's a huge disadvantage. And the pneumonia always seems to be in the left lung. 

Tyson is pretty discouraged about being back on oxygen and being here longer, as expected. Hospital life seems to always be one step forward, two steps back. Prayers for patience, for both of us, are always appreciated. 

Here we go again...admission #3 for 2025

Tyson has been admitted to SickKids for a couple of days. He's been struggling with energy and feeling crummy the last two weeks, he's been coughing and his sats were hovering around 80. We were worried maybe he has pneumonia again, so we decided to take him in. We bypassed our local hospital and drove straight to SickKids because we knew they'd likely transfer him to SickKids anyway and that is always such a long process.

We have absolutely no regrets coming straight here. The emerg was fully packed but Tyson was triaged straight into a room immediately. It probably helped that he had our oxygen monitor clipped to his finger so the triage nurse saw his low sats when we came in. She called a nurse who put us in a room where Tyson was put on 6 liters of oxygen, given an IV, and had blood work done within 5 minutes of arriving to the ER. We saw both a doctor and a respiratory therapist within 15 minutes. They did a chest X ray, ecg, bloodwork, nasal swab, and called the cardiology team for consult. 

The cardiology fellow said it doesn't look like pneumonia compared to his last xrays from his pneumonia in January, but the ER dr said it is pneumonia, so he was started on IV antibiotics. We made it into a room on 7C around 8pm, less than 6 hours from arrival. We are happy to have saved ourselves some time so Ty could get settled in for the night much sooner. By the time we got to 7C he was already weaned down to 1 liter of oxygen.  He slept fairly well and was weaned completely off by about 1am, with a 0.5 liter of support between 4-5am when he was in a deep sleep, but he is off oxygen again this morning. We will see how that holds! The doctors on rounds this morning said they'd like to see him off oxygen overnight before sending him home. So we appreciate prayers that his oxygen level improves so that he can go home tomorrow. 

People are asking how Tyson is feeling being back here again. He was actually more upset yesterday morning when I told him we had no choice but to bring him in. He actually took the news of being admitted very well, and since he always responds so well to the oxygen support he is very at peace knowing he's in the best place possible. He has been praying for God's peace a lot these days. 

BUT NOW we have the question of WHY, after doing so well for almost ten years between 2015-2025, why has he had three hospital admissions this year? I can tell you that over the last ten years, he has definitely been WAY sicker than this before and we've been able to keep him home because his oxygen levels didn't get beyond our comfort level. This time he didn't even have a fever, he was still eating and drinking well, he was coughing a little but not as bad as some of the colds he's had in the past! It was really his lack of energy and low oxygen that brought us in. We have a ton of amazing tools and resources to use at home when he gets sick, but the one thing we do not have is oxygen. So if he's consistently dipping below 80 even at rest, his body is just working too hard and it's unfair for him to be at home. Even though being in the hospital isn't fun either, at least his body gets a break. 

This pic was taken yesterday in the ER, just before we were taken up to 7C. You can see how the oxygen helps his colour and he's obviously in a pretty good mood.  He's been praying for peace and that he can trust God's plan for his future.



I just spoke with the cardiology fellow on call and she agrees that we need to get to the bottom of why this is happening. She has two theories. Either his teenage growth spurt is making it so that his lungs aren't able to oxygenate his whole body anymore. Or the recent worsening in the scoliosis of his spine (also caused by teenage growth spurt) is squishing his already compressed left pulmonary artery even more, hindering his left lung from oxygenating as well.   This morning he had a panel of scoliosis x-rays and he will also be seen by the respirology team here before we go home to see if there are further tests that can be run once he's better. He had a pulmonary function test done in October and the results of that are definitely worse than his last one. 

It's not realistic that we will find answers to all our questions before he's discharged from this hospital admission, but the cardiology fellow assured me that they are all asking the same questions and they'll be digging into things to find answers. It may mean they have to move up his heart cath date, which is currently scheduled for July. This heart cath (aka cardiac catherization - like an angiogram) was supposed to be a 'routine' cath that they'd do before he leaves SickKids and moves on to Toronto General. But it sounds like he could use a little tweak somewhere to help his lungs out. I can't imagine him being admitted for every virus that comes his way over the next few months. 

This picture was taken this afternoon as we were waiting for his scoliosis xrays. You can see he's off oxygen but his oxygen level is barely holding on. Hopefully he can stay off oxygen today so we can go home tomorrow. Please pray with us for this!