Sunday, May 22, 2011

Surgery Q&A

Many people have asked me about Cain’s surgery so I thought I would answer some of those questions as best as I can.

When is Cain’s surgery?
Cain’s surgery is tomorrow, May 23rd.  He will be the only case Monday due to the length of the surgery.  We have to be at the hospital no later than 6AM.  They anticipate surgery to start around 7AM and will last anywhere from 4 to 6 hours. 

What surgery is being done?
This is Cain’s 3rd scheduled open heart surgery that we have known about since I was 20 weeks pregnant (September 22, 2008).  It’s called the Fontan surgery.  To be even more specific it’s actually called the extra-cardiac Fontan

What will take place during this surgery?
The Fontan surgery re-routes oxygen poor blood (blue blood) from the lower body to enter the lungs instead of the right atria of the heart, where in Cain’s heart it mixes with the oxygen rich blood (red blood) that has just entered the left atria of the heart from the lungs.  Instead of being delivered to the right ventricle, his blood flow will be re-directed to flow passively back to the lungs and then it will return to the heart oxygenated via the left atria (like a normal circulatory system).  They achieve this by taking the Greater vessel of the lower body (Inferior vena cava) and connecting it to the pulmonary artery where it will flow into the lungs. This will give Cain an effective, closed circulatory system in which red blood is pushed to all the organs and the body, without being mixed with blue blood (which reduces his overall oxygen saturations and the amount of oxygen that vital organs receive). That is the basic principles of the Fontan to our understanding.  There are various methods used to achieve the same result.  Cain’s surgeon will be performing an exterior Fontan which utilizes a gortex tube to bypass the right atrium.   Also, they will be stopping his heart during surgery to widen the current ASD(aterial septal defect) so that it will have a greater filling chamber when blood returns from the lungs.  Finally, they will also leave a Fenestration hole in the gortex tubing and into the Right atrium.  This allows for a reduction in overall hemodynamic pressures, and causes less backflow pressure/stress on the liver.   The Fenestration hole will either close on its own over time or will be closed in the future using a heart catheterization.

How long will Cain be in the hospital?
I wish there was a way to answer this question but there really is no way to know for sure.  It completely depends on Cain’s recovery.  We have been told to anticipate a 7-10 day hospital stay.  To our understanding some complications may result from the passively flowing blood trying to enter back to areas of higher pressure as it reaches the lungs.  This increased pressure may cause increased fluid in the chest (pleural effusions), abdomen  (ascites), or general puffiness in face/limbs (edema).    These complications will make a difference on the length of Cain’s hospital stay.

Do you have family coming in town to help out?
Thankfully YES WE DO!!!  We have the best family ever and no words can say how much we appreciate them.  Brad’s mom flew in on Wednesday and will be here through Tuesday, my parents arrived yesterday, and my granddad is flying in today.   Most likely my parents will go home on Memorial Day but Brad’s stepsister plans to visit the first two weeks of June.

Is this Cain’s last surgery?
Thankfully this is Cain’s LAST scheduled surgery that we know of at the moment.  The most important word there is ‘scheduled’.  Cain will never have a 4 chamber heart.  After this surgery, his heart will be functioning on 2 chambers alone doing the workload of a 4 chamber heart.  It’s hard to know if Cain will need future surgeries or a heart transplant.  He will most likely need ‘tune-ups’ though life but we will cross that bridge when we get there.  The good news is that this is the last scheduled surgery that was always lingering in my mind at all times.

A few things we already know about recovery.
-We will have to be very careful with who comes around Cain during the next 6 weeks.  We are already on ‘house arrest’ keeping Cain away from germs.  For 6 weeks after surgery we will need to keep Cain away from anyone who is sick or could be sick and also keep him away from crowded places.
- We will not be able to pick Cain up under his arms for 6 weeks.  Try that with a squirmy two year old who weighs almost 30lbs. 
-During the surgery they will puncture what is called a fenestration hole.  This allows the body to get used to the new pressures.  This hole could close on its’ own but most likely Cain will go back in a year to have this hole closed by way of a heart cath. 

Is there anything we can do for your family during this time?
PRAYERS!!!  Please keep our little guy in your thoughts and prayers.  That is really all we need at this time.  So many of you have already asked what you could do or how you could help.  This means more to us than you can imagine.  We couldn’t get through these surgeries without the support of our family and friends. 

Where will Callie be during this time?  Is she taking a bottle yet?
-The grandparents will be taking care of Callie.  Having two kids to care for is certainly a different stress than I’ve had during Cain’s last two surgeries.  Callie will most likely be with us all day in the surgery waiting area during Cain’s surgery.  I’ll want her there to hug on. While Cain is in the hospital my mom will bring Callie to visit us.  This is going to be so hard since I’m used to caring for her all day, every day. 
-Is she taking a bottle yet??  I WISH!  She is still only nursing.  I’ve been pumping every day to get some milk stored up but honestly don’t have much for my mom.  Just a few days worth.  I try mixing my breast milk with formula but she never seems to like it.  I’ll be pumping every 3 hours while at the hospital and giving this to my mom as I see her.  I will also be able to nurse Callie some at the hospital or when we come home for showers. 

Where can you get updates?
I’ll certainly do my best to update the blog and facebook throughout the day tomorrow.  The hospital is wonderful about calling out to the waiting areas to give us updates though out the day.  As I get these updates I’ll post them on our blog and facebook.  I know many of you are praying for Cain and would like to be kept up to date.  I also plan to write posts on my blog about his recovery.  The last two surgeries I did this while Cain was resting but this will be more difficult this time.  I have a feeling when he’s resting peacefully I’ll want Callie at the hospital to visit. 

I think that covers everything for now.  If you have a question I haven’t answered please let me know.  



Prayers for you all, as always, from Cain's heart buddy Tyson and his family :)

Shauna said...

Great job on this post! Will be praying!

Anonymous said...

Catherine, this sounds all too familiar. I am thinking of you all and just was reading back to learn more about your Cain. What a blessing he is to you!!!

I think Charlie probably told you S came home in just 8 days. We'll be praying specifically for Cain to have a wonderful recovery as well. I know tonight will be the toughest.

BTW, I know you have lots of support but please email me (cljjs (at) yahoo (dot) com) if you need to chat/vent/etc. We are headed out-of-town tomorrow. Plus S just got over strep throat so I would not come around you for anything!

But, I'm an email away and I'd be happy to share my cell# too if you wanted to talk. I hope we can meet one day soon!

Father God, I pray your protection over Cain today. God, please surround his sweet family with YOUR peace, peace that passes all understanding. Please heal Cain's heart through this surgery today Lord. We pray Your strength for Dr. B and the entire team. Thank You for giving Cain life Lord. In Jesus name, Amen