For those who have heart: Family finds friendship in cardiologist who treats its youngest member
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When a local family found out their newest addition was dealing with cardiac distress in the womb, they got more heart than they bargained for in seeking care.
Peter and Erin Ruhl met Dr. Avnit Golten three years ago, when Erin was pregnant with their youngest child, Marley.
During Erin's pregnancy, she discovered at a women's health appointment that her baby had a high heart rate.
"I was sent to Geisinger's Maternal Fetal medicine team. They also worked with the pediatric cardiology team, and from 26 weeks until she was born at 37 weeks, my husband and I went to Geisinger every other day, during that period of time, and were monitored by the MFM," Erin Ruhl said.
Erin was 37 weeks along when she gave birth to Marley.
"Our goal was to make it to 37 weeks and she was born at 37 weeks. Marley spent a couple of days in the NICU at Geisinger, and then we were released to come home and the whole time we were under Dr. Golten. The whole time, even while I was pregnant, we were under her care. And we are still under her care," Erin said.
During Erin's pregnancy, she was prescribed heart medicine to help treat Marley.
"We were able to control Marley's heart rate to some degree but we never could achieve perfect control, which is always a challenge. Because, No. 1, you don't know how much is going to the baby because this isn't the medication you're giving directly to the baby. And second, you don't want to give the mom side effects from the medication," Golten said.
During this time, Erin was given an ultrasound every other day to make sure everything was OK with the baby.
"The cardiology department would do an ultrasound of the baby's heart to see if they were able to tell what was happening and to make sure that she was still doing well," said Erin. "Ultimately, what we decided was I started to take some heart medications in high doses that would then be passed on to the baby."
Marley is now 3 years old. Marley is treated with medication for a congenital condition that causes her heart to beat faster than normal. It is now kept under control with two different medications that she takes several times a day.
"It was a really scary time for us, but Dr. Golten treated us like her family. She made us feel confident in the decisions that we needed to make -- ones that, if she was in this situation, she would make for her child. She explained everything to us in detail."
Erin and Peter have two other children, Burke, 9, and Kinley, 7.
"While we weren't new parents, we were definitely new parents to a child that had been in the NICU and needed a little extra care. (Golten) gave us her personal contact information. Any questions we had, we would just reach out to her directly. We still are very much in touch. We share our families with each other. She gets a Christmas card from us every year. We're very pleased with that," Erin said.
"Erin and Peter, first of all, they're wonderful people. I know them so well now and it's almost like being a part of their family and them being a part of my family. It's just such a pleasure and it makes the whole journey more gratifying. We look forward to Marley coming in -- now she talks and has stories to tell," said Golten.
Throughout years of treatment, Marley has always had a positive attitude.
"She's been wonderful. She has gone through these appointments since she was born. She really doesn't know any different. She goes to the appointments every three to six months and she sees Dr. Golten and usually she gets an ultrasound or an EKG or something for her heart at those appointments, but she's very comfortable with it. She takes medicine about eight times a day and she's really good at taking it. She doesn't know any different. So she just thinks it's part of her normal routine," Erin said.
"Marley can do everything a child her age can do. Obviously, the parents have to be cautious and have things to watch out for, but otherwise, Marley, you couldn't tell what's going on inside her heart," said Dr. Golten. "We haven't necessarily seen progress but we haven't seen any changes. She still has the same condition. Nothing has gotten any worse. As she gets older, we're hopeful that she will grow out of it," Golten said.
Erin's advice to other families going through a similar journey is to build a close relationship with your health practitioner.
"My advice would be to ask a lot of questions and to develop a relationship with your provider that allows you to have a level of confidence in what they're providing you. Also be open and upfront to allow that provider to understand you personally in the journey that you're traveling," Erin said.