Life For Luke: April 6th- Blood Draws

Friday, April 6, 2012

April 6th- Blood Draws

It is 6:00 a.m. And Luke just got a new IV on his head. The IV team took only 4 pokes before one finally worked. Yesterday he had 3 pokes. The poor kid is constantly getting some new ache. He just finished his bottle and then promptly threw some of it back up. At home he does not spit up much. I wonder if it's the narcotics causing the nausea or something else.

He is going downstairs for an x-ray right now. We are on the surgical floor. Luke got transferred about 4:30 yesterday. It is quieter here and I can stay in the room with him. But the nurse to patient ratio and the available doctors are not so high. I guess this is good because it means he is getting better but he sure seems pretty bad off to me.

The chest tubes only drained 8 ccs out of one tube last night. If the x-ray is clear than maybe some of these tubes can come out. Then I will be able to hold him.

2 comments:

Lorna DooneApril 6, 2012 at 11:02 AM
So glad to be reading these updates Mabry. Our prayers are with Luke as well as with the rest of your family.
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Angee and ThomApril 6, 2012 at 9:13 PM
Severin had a hard time after the Glen. He would cry without any sound, his face would just turn almost black. He was so grumpy, and took weeks to want to nurse again. The only thing he liked was to sit on my lap forward facing. Luke sounds like he is doing great! Way to go, you will be home snuggling your other kids all together in no time at all.
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Hypoplastic Left Heart Syndrome

Hyoplastic Left Heart Syndrome (HLHS) is basically a medical condition where a person is born without the left ventricle. The left ventricle is the part of the heart that pumps blood to the rest of the body. Without the left ventricle life is not sustainable.

All newborns are born with a patent ductus arteriosus (PDA). This is a shunt that takes blood from the right ventricle to the aorta. The PDA is part of a neonate's physiology because blood does not need to go into a fetus' lungs. The blood is oxygenated via the mother's blood. When a baby is born and takes its first breath the PDA begins to close. It usually closes within a few days of birth but can last weeks.

A child born with HLHS will die when the PDA closes unless medical intervention is done. The newborn is first put on prostaglandins via IV to keep the PDA open. Surgery is then performed within a week of birth. It is a staged surgery that is considered paliative, meaning that adventually a heart transplant will be encessary.

The first surgery is called the Norwood and Sano or BT Shunt. Luke had the Sano. It involves openning the chest via the sternum, closing the PDA, creating a hole in the right ventricle and putting a shunt through the hole to the pulmonary arteries (these go to the lungs), seperating the atrial wall to make one large atrium, and sewing the pumonary artery and the aorta together to make a neoaorta. So in simple terms, the blood comes into the body to the single atrium, goes to the single ventricle, and then flow half to the lungs and half to the body.

The second surgery is called the Glenn. It is performed between 3 and 7 months of age. In this surgery the shunt (Sano) is removed (that's the one that goes from the ventricle to pulmonary arteries) and the superior vena cava (SVC) is connected to the pulmonary arteries. So then all blood from the head and arms goes directly to the lungs. This procedure lasts while the baby has a large head. But eventually he outgrows it.

The third surgery is performed between 2 1/2 and 4 years of age. It is called the Fontan. The Fontan involves connecting the inferior vena cave (IVC) to the SVC and all blood goes to the arteries. Now the child's circulation goes from the superior and inferior VC to the lungs, then to the single atrium, then to the single ventricle, and then out to the body. It provides adequate perfusion to sustain life but will not allow for vigerous exercise. Mild, yes, but limits will exist. The right ventricle is not as strong as the left ventricle so eventually it will give out. At this point transplant is the only option.

Now HLHS is the most severe heart disease one can have and still be born alive. 30 years ago no babies lived. Even 20 years ago they had poor statistics. Now 40-50% of children make it through all surgeries. Even then some have to have transplants in their youth. However, many are living into their mid 20s before they require a tranplant. Transplants can last uo to 20 years in adults (60 percent of heart transplants are successful after 6 years). And given time perhaps they can grow hearts from stem cells that will last forever!

Life For Luke

Before Surgery- no chest scars

Friday, April 6, 2012

April 6th- Blood Draws

2 comments:

Finally Home- 16 days post op

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