38 Hours Post Operative 2/13/15

Yes it is Friday the 13th.  But we are hopeful nothing untoward will happen.

Luke has slept through the night.  The nurse has not given him any pain medications since 11:00 p.m. I am worried that when he awakens he will be in a lot of pain.

Yesterday they removed his IJ (intra jugular) and the arterial line in his right wrist.  He was able to stand up for a moment and to sit in dad's lap for a few hours.  Today the nurse practitioner says his largest chest tube (the mediastinal) can come out.  They want to leave in the two small chest tubes (ponytails) until Luke has eaten more fats.  In surgery there is a possibility of splicing a lymph node.  This is undetectable until the patient eats fats, then fats drain into the chest cavity, and they drain out from the chest tubes.  If this is the case Luke would be on a no fat diet for a few weeks.  So far the chest drainage appears clear but he has not eaten enough to know for sure.  We will try and urge him to eat nice fatty foods today.  Lucky guy!

 IJ Line

 Atrial Line in Radius

 Getting out of bed for the first time.

RA and Foley removed 11:30 a.m.

The nurse practitioner just removed his RA or right atrial line and the nurse his Foley catheter.  They had to give Ativan because he was so worried about being worked on.  He is resting now but not sleeping.  He didn't sleep much, only about 3 hours last night so he is very tired.

This picture shows the RA, white line, just before removal.  It was about 6-8 inches long inside of him.

19 Hours Post Op 2/12/15

Last night they kept Luke well sedated with Versed for anxiety/relaxation and morphine and Tylenol for pain.  Today they have changed the morphine to oxicodone which is an oral narcotic for pain.  They just stopped the Milrinone which is a heart med that helps with the hearts contraction and dilates the vessels to help the blood flow easier.  This med won't be out of Luke's system for about 6 hours so they are going to reevaluate him at that point.

He is still on the pacer, set to go off when his heart rate falls below 82 beats per minute.  He has not fallen that low for a long time.  His chest x-Ray showed a bit of cloudiness in the left lung lobes.  They are increasing his lasix to help him urinate that off.  They feel the cloudiness is just from excess fluids still on board and not indicative of pneumonia.

Luke is awake, drinking, and full of demands.  He has requested lots of toys that he has played with in the hospital from the last few days.  I got to go on a scavenger hunt and try to round them up.  He is watching tv and seems content.

Post operative first visit

Here are some pictures of Luke as he looks post op.  One is a close up of his face.  Notice the pink lips.  They have been blue for so long that the change is amazing!

The surgery is done!  They just finished stitching Luke back up.  We will see him in a few more minutes.  All told surgery lasted about 6 1/2 hours.  Most of the time (3 hours) was just cutting through all of the scar tissue.

The surgeon said that Luke has hundreds of collaterals all over his heart.  But hopefully with this new blood flow they will decrease in size.  Luke had to be paced for a while as they were taking him off the bypass machine because of a slow heart rate.  This could be because of the anesthetics or it could be indicative of problems with the SA Node.  If that is the case he will get a pace maker some day.  I sure hope not (10-15% of kids with the Fontan get a pacer).

Here is the gortex conduit that they attached to the inferior vena cava and the right pulmonary artery.  It is a 20 gauge size, flexible, and stretchable.  See the small hole at the top.  That is the size of the fenestration or small hole going through the synthetic inferior vena cava to the atrium, acting as a release valve for high pressures.

Fontan Surgery 2/11/15

We checked into Primary Children's hospital at 7:00.  Luke was again fasting.  He had to have a bath the night before, have a special antiseptic wipe rub-down, and a nasal swab.  This was repeated this morning.  All new measures to help cut down on infections post operatively.

Before surgery we had another physical, visited with Dr. Burch the surgeon, Dr Greenwood the anesthesiologist, the attending P.A., and other staff.  Luke kept saying "I hate this" and "I want to go home now!" I guess yesterday's cardiac cath left some bad memories.

They gave him some Versed 20 minutes before taking him to he O.R. room.  Mark and I hugged and kissed him goodbye.  Here is a picture of our sleepy-eyed boy as he was leaving us.

Mark and I are in the waiting room.  We have been told to expect 6 hours.  We should get hourly updates.  Thank you to everyone for your love and support!

Cardiac cath 2/10/15

Luke had a cardiac cath today.  He had to be fasting food for 8 hours and no fluids 3 hours pre op.  We got to the hospital at 5:45 a.m. And the procedure started around 8:00.

Doctor Gray was the attending cath surgeon.  He said the atrial, ventricular, and pulmonary artery pressures were all high.  He found multiple collaterals and closed about three off on the right side of the heart. He said he left the one on the left side of the heart there because of tomorrow's Fontan surgery.

Collaterals are small blood vessels that form as the body tries to compensate for low oxygen saturations.  Luke's were running from his aorta to the pulmonary arteries.  The attending physician said about 50% of post Glenn kids develop collaterals.  So it was not unexpected.

 Here is Luke after being checked in but before surgery.

Here is Luke in the postoperative recovery room.