George’s Heart Journey: A Heart Murmur Leads to an ASD Diagnosis, Caught and Treated at the Right Time at CHRISTUS Children’s
For Shawna and Jonathan Tomes, the past few years have been full of unexpected turns. Parents to Rosie (7), George (5), Katie (2), and their newest addition, Jasper—born on September 7, 2025—their lives have been marked by big moves, medical surprises, and moments of grace.
After eight years in Waco, the family relocated to Missouri in 2023 when Jonathan accepted a library director position at Fort Leonard Wood. But their time there was short-lived. Just eight months later, Jonathan was offered a new role as medical library director at Fort Sam Houston in San Antonio.
“It was a quick turnaround,” Shawna said. “We were only in Missouri for eight months, but everything that happened during that time was setting us up for what came next.”
The week before their move was a whirlwind of events.
On March 30, 2024, Rosie had her first seizure, and her parents rushed her to an ER in Lebanon, Missouri. She was sent home but told to return if she had another. On the way back, she experienced a second, more violent seizure, so they turned around. ER nurses met them at the door, and Rosie was taken by ambulance to Mercy Hospital in Springfield. On Easter morning, she was diagnosed with epilepsy.
The very next night, a tornado tore through their Missouri neighborhood, knocking out power for days. Miraculously, only the fence was damaged, and the house was already under contract. “We were very blessed the buyer didn’t back out,” Shawna said. With the fence quickly repaired and the house sold four days later, the family packed up for a 15-hour drive back to Texas with a child newly diagnosed with epilepsy and two kids under four in tow.
“I still can’t believe all of this happened in under a week,” Shawna added.
Meet George's Doctors
The Appointment That Changed Everything
Because the family was about to relocate, Rosie’s doctors in Missouri referred her to CHRISTUS Children’s in San Antonio for ongoing neurology care. That referral would eventually open a door for George, too.
Shawna said God walked them through extreme, yet perfect, timing, as their new home was just 20 minutes from CHRISTUS Children’s.
Once settled in San Antonio, Rosie continued having follow-ups with pediatric neurologist, Dr. Fred Perkins Jr., for nearly a year. Then, in February 2025, a routine appointment changed everything.
Because Rosie and George shared developmental delays, Dr. Perkins offered to screen George as well. “He listened to George’s heart and said, ‘He has a heart murmur. Did you know that?’ I told him yes, every pediatrician had mentioned it, but they always brushed it off. Dr. Perkins said, ‘No, this doesn’t sound like a benign murmur. I’m referring you to a cardiologist next week.’”
That quick decision became lifesaving.
George’s Heart Diagnosis: Atrial Septal Defect
Within days, George was seen by pediatric cardiologist Dr. Steven Neish. An EKG and echocardiogram confirmed George had a large atrial septal defect, or ASD—a 12-millimeter hole between the upper chambers of his heart. An ASD is a congenital heart defect, meaning George was born with it, though it had gone undetected until now.
Although George had no outward signs of heart trouble, Shawna realized in hindsight that his constant fatigue and quiet nature may have been connected. “He’s always been a good sleeper, and we thought nothing of it. But maybe he was just tired because of his heart.”
Dr. Neish explained the timing was providential. “He told me, ‘This is the perfect age to repair the defect—between four and six years old. You’re coming in at just the right time.’”
For Shawna, the message was clear. “It was another godsend,” she said. “After years of hearing not to worry, it was caught exactly when it needed to be.”
The family also learned that if the defect had gone undetected into adulthood, it likely would have led to serious complications and could have shortened George’s life unexpectedly. While it probably wouldn’t have caused major heart failure during childhood, it would have created more health issues as he grew.
“Since it was caught and treated in time, George gets to grow up with a healthy heart,” Shawna said.
Still, the diagnosis was overwhelming for the Tomes family, who were still navigating Rosie’s complex epilepsy care. “After everything with Rosie, we were blindsided. Now we had to plan for heart surgery too—and I was pregnant. It felt like so much at once,” Shawna said.
She remembers calling her husband, Jonathan, after the appointment, and he just broke down. “He’s a military guy and not usually emotional, but that was his son. After everything we’d been through with Rosie, it was a lot to take in, but we knew we had to be strong for George.”
Preparing for Open-Heart Surgery to Treat A Large Atrial Septal Defect
In June 2025, George was scheduled for open-heart surgery with pediatric heart surgeon Dr. Victor Bautista-Hernandez at CHRISTUS Children’s. The surgical team carefully explained what to expect and walked the family through the process step by step.
In the weeks leading up to surgery, Shawna and Jonathan prepared George using a children’s book called Getting Ready for My Heart Surgery. They also practiced with a toy anesthesia mask provided by the Child Life team at CHRISTUS Children’s.
“We showed him the pictures and told him, ‘Okay, we’re at this part now.’ When it was time for surgery, the nurses told him the bed was a magic boat, and they sang ‘Row, Row, Row Your Boat’ as he went back. He knew what to expect, and that made such a difference.”
On Wednesday, June 25, 2025, George underwent surgery to close the hole in his heart.
“We performed the repair using a minimally invasive procedure without the use of blood products,” explained Dr. Bautista. “George left the operating room awake and without a breathing tube. This minimally invasive, bloodless, fast-track approach supports a quicker, smoother recovery.”
The surgical team updated Shawna and Jonathan by text message at every step. By early afternoon, they were able to see George in the cardiac ICU.
Child Life Specialists made the difference in recovery. “He watched Peppa Pig for 48 hours straight,” Shawna laughed. “Every time he had a blood draw, they gave him a Peppa toy. They had iPads, and his dad stayed by his side the whole time. I couldn’t have asked for better support.”
By Saturday, George was discharged from the pediatric intensive care unit and on the road to healing.
Faith, Timing and Gratitude
For Shawna, the theme of their family’s journey is clear: God’s timing.
From Rosie’s seizure while safely buckled in her car seat, to her epilepsy diagnosis on Easter, to their home being spared in the tornado just before their move to San Antonio, to the pediatric neurologist who truly listened and uncovered George’s heart murmur and referred him to cardiology—it all aligned.
“One thing led to another, but God was directing us every step of the way,” Shawna said.
The family is deeply grateful to Dr. Perkins, Dr. Neish, Dr. Bautista, the nurses and Child Life team at CHRISTUS Children’s.
“The entire team is wonderful,” Shawna said. “They don’t brush you off—they give you their full attention and listen to you. It’s been the best medical experience I’ve ever had. If it weren’t for Dr. Perkins, who knows when George’s heart defect would have been caught? We are so blessed he referred us to the cardiology team and surgeon at just the right time—the critical window for his treatment.”
How George Is Doing Today
Just weeks after surgery, George is healing remarkably well. His scar is thin and his bandages are off.
“He points to his scar and asks, ‘All better?’ I tell him, ‘By Christmas you’ll be cleared for everything you love,’” said Shawna. “The next morning, he woke up, looked out the window, and said, ‘Christmas.’ He’s counting down already until he’ll be free from all restrictions.
By late August 2025, George had already returned to splash pads and most of his favorite activities. His doctors advised holding off on high-impact activity like contact sports until December—six months after surgery. “It’s been a gradual scale, but he’s doing more every week,” Shawna said.
Today, George is an energetic 5-year-old who loves building houses from blocks, digging in his sandbox and going to SeaWorld. He’s still taking it easy while his sternum heals, but his prognosis is excellent. He will continue follow-ups with Dr. Neish for now, but the surgery is expected to be curative.
Shawna shares this advice with other patient families facing similar challenges:
“Take one day at a time, pray through it, and lean on your support system,” she said. “Even when the weight of it all feels overwhelming, trust that God will walk with you through the storm. There will be setbacks, but don’t lose hope—you just need to keep moving forward, no matter how small the steps. In the end, you’ll see His timing was perfect all along.”
For more information about the expert care and advanced treatments offered at the Heart Center at CHRISTUS Children’s, visit Pediatric Cardiology in San Antonio | CHRISTUS Children's Hospital
