Monday, May 23, 2011

Surgery Day Updates

Update #7 @ 10:20: As soon as the previous post was completed, we had a bit of a scare.  There was a suspected leak in a chest tube and they thought it may be pushing air into the thoracic cavity causing additional pressure and pain.  At this same time Cain was becoming very irritable and hard to comfort. His blood pressure and O2 saturations were dropping.   At one point we had a team of 2 doctors, a nurse practitioner, and 5 nurses working to resolve the issue and stabilize him.   Having that many people work on him at once is slightly unnerving.  The chest x-ray was negative for additional air around the lung and the leak was found further down the chest tube and easily repairable.  However, it also showed a partially collapsed lung due to a mucus plug and secretions.  Cain was given additional doses of Morphine and started on Versed and a low dose of Precedex. These medications combined with positive pressure oxygen managed to stabilize him temporarily, but his oxygen sats continued to dip.  He was eventually started on a Vapotherm (a high pressure nasal cannula).   The final medical decision was to manage his medications throughout the night so that he is balanced between a state of being awake (so he is able to take deep breaths), and medicated only enough to barely control his pain enough for him to take deep breaths.  The goal is to get him to breath/cough/cry enough that it clears the lungs and maintains a consistent balance of O2 intake and CO2 output.   From the looks of things it will be a long night.....

Update #6 @ 7:33: Cain's surgery went well, but the last five hours have been long.  Overall he looks really good when compared to his previous two surgeries. His oxygen saturations have been 90-92 all day and he was breathing well on his own so they removed his ventilator already.   As far as the surgical repair and post-op recovery, things have gone as expected.  However, as they have been weaning his sedation he is beginning to wake up and is clearly in pain, unhappy, confused/scared.  Seeing him like this and so miserably gut-wrenching and borderline unbearable.  We stand beside his bed to comfort him the best we can, but we can not hold him to comfort him.   It is such a helpless feeling not being able to console him as he moans and cries.  

Update #5 @ 2:30:  Checked again to see if we could see Cain but he is not ready to be seen.  His nurse came out to see us and explained that they his arterial line stopped working so they are trying to replace it which takes a sterile environment so we couldn't come back yet and this is the reason it is taking so long.  She did indicate that he is doing well, sedated and resting, and everything is going as expected.  Cain required some blood when he first got to the PICU, but his HCT is normal now.   He has also received lots of IV fluids  (500cc's) which is to be expected after the Fontan surgery.  The nurse indicated that they should be done with placing the arterial line in 15-30 minutes and then we will finally get to see him.  

Update #4 @ 1:15PM:  We just checked with the nurses to see if we could see Cain yet.  We were told it would be at least another hour.

Update #3:  CAIN HAS PREVAILED ONCE AGAIN!!!!  Dr. Bichell, Cain's surgeon, came out to talk to us around noon.  He said that surgery was complete and everything looked good so far.  He even said that Cain must heal well because he didn't have as much scar tissue as expected.  Getting through the scar tissue can sometimes take awhile.  He said that it would be at least an hour or longer before we could see Cain.

Update #2:  We received an update at approximately 11:00.   The primary procedure is complete and they are awaiting Cardiology to review/confirm the repair and ensure no other repairs are needed at this time.  If all is well, they will start re-warming his body and remove him from the bypass machine.  We expect another update around 12:30.

Update #1 @ 9AM:  All the lines have been inserted and the incision was made.

We left the house this morning at 5:45 with a very groggy little guy.  We were able to be in a private room with Cain until it was time to take him to surgery.

Shortly before he was carried away we were able to give him a dose of Versed.  This is a medicine that is used to cause relaxation and basically block memory.  I'm thankful for this because they were able to quickly slip Cain away around 7AM without him crying for us.

We are doing okay.  The hardest part was when they left the room with him.  Now it's just the waiting game for the next several hours.

Here is a picture of Cain's chest right before he went into surgery.  They will use the same incision area but I'm sure he will have some new scars to add to this little chest.  I'm sure there will be many girls that think those scars are super cool one day!


Anonymous said...

PRAISE GOD!!! Hopefully that pesky line is working again and you are with him by now.

WE LOVE Dr. B!!!! Thank God for gifting him with the ability to work on our little one's hearts.

Those pics sure do bring back memories. I remember the fluid deal. Scared me so much, but the nurses assured me the fontan patients require a lot at first. Those nurses amaze me! Thankful for them too!

Hope you all have an UNEVENTFUL night. Praying specifically for that.


Tiffany Lockette said...

I have been so out of the loop for so long. I had no idea Cain was having his surgery. All my prayers are with him and your family. Please keep us updated. Hugs

Sarah said...

Thanks for the update, I have been praying for Cain since I woke up this morning. I hope he is doing well this evening! Praying for you all!!

Krista Phillips said...

Praying a ton!!!! Glad the surgery went well and praying that recovering is swift!!!!

Jen, Paul and Gracie said...

Thinking about you and saying prayers for a quick recovery for Cain. I am so sorry to hear about the setbacks last night. I hope the worst is now over and Cain is getting one step closer recovering and going home!