Asher had a checkup at the cardiologist a few weeks ago, after 10 months. The last time, we left there filled with gratitude. This time, we left knowing that we are going to have to make a plan for when to fix Asher's heart condition one more time.

The doctors have waited mainly so that he could get bigger which would make the surgery technically easier for the surgeons. And, so that it would (hopefully) be the last time he would have to have this procedure. By procedure, I mean major open heart surgery.

But I guess, no matter how many times they have told me, I can't help but wonder, why not just keep waiting? Why not wait indefinitely?

In no uncertain terms, the doc clarified. And then our old cardiologist from Charlotte chimed in and confirmed. The irregular tissue growing causes turbulent blood flow to the valve, and the valve can not withstand that kind of blood flow for an extended period of time. It will weaken. As it weakens, the left ventricle works harder and harder to pump blood through the valve, and the walls of the heart thicken in a condition called hypertrophy. Neither of those things are good. Both of those are irreparable. Valve replacements require chronic maintenance. Doctors do everything possible to prevent needing that. The other also impacts heart function.

We have spent the last few weeks putting one foot in front of the other and gathering information. We have been trying to take it slowly and reasonably. We have been trying to quiet our minds and make one decision at a time.

First major step: Asher is going to have the surgery this summer. He doesn't know yet. He doesn't need to know for a while.

Next major step: Who will do the surgery and where? Should we stay here at Duke or UNC, or should we travel? We need the best surgeon for this problem. So while there are many recommendations flying at us, they are hard to sort through. What I need to know is the statistics. How many have you done? What are your outcomes? It doesn't matter if you have 50 years of experience on valve replacements, if you don't do this regularly, you are not good enough. It's important to me that the nurses, CCU staff, and facilities are well staffed, and reputable. But I need the man with the scalpel to know exactly what the hell he is doing.EXACTLY. Like, he could do it in his sleep. He can be the biggest asshole that has ever walked the planet, as long as he can safely get Asher on and off bypass, resect the tissue, and put it all back together nicely. I don't have to have dinner with him.

The challenge is gathering the appropriate information. One tiny step at a time. One phone call, one conversation, one small decision that everything hinges on.... Can that one do it? Do I trust this one to hold my baby's heart in his hands?