Helping hands...

I am amazed at the incredible care and attention we have received today. Every step of the way has brought friends, both old and new, into our path. The day started with many of our friends giving Becky's anesthesia and assisting with the delivery. Once Andrew was out, Dr. Goldberg (my friend Seth's dad) came over show me his immediate care in the OR and later came to the PACU to give us an update. In the mean time, our friend Jamie was sending us comments on who Andrew was assigned to, how cute he was, and just generally making us feel like we were part of the process from where we were.

But, how to sum up today... Since my last post, Andrew has started ECMO in the Pediatric Cardiac Intensive Care Unit. He is on Venovenous ECMO as opposed to the typical Venoarterial ECMO used in Neonates. When ECMO was first offered as a treatment and we posted, we were just becoming aware of his coarctation. What we did not know is the decisions we would be faced with following this discovery.

Our team huddled and determined there was basically three paths available for Andrew. The first was to discontinue his care and make him comfortable until he passed. The second was the use of Venovenous ECMO since he failed to meet the criteria for Venoarterial ECMO. This holds no guarantees but does give him a small shot at overcoming the pulmonary hypertension when used with Prostaglandins to prevent the closure of his patent ductus arteriosus. The third option was to go to surgery right then to repair both the coarctation and his CDH.

The first was a pretty obvious "no". The third was too as far as we were concerned since we really did not think he would be able to survive the insult. This left us with the second and no matter how small the chances are that this will work, it still seemed like the only real option.

The best feelings I had all day were related to the ECMO process. First, our friend Craig, a perfusionist, was kind enough to come in from home on his day off to be with Andrew as he went on ECMO. This was particularly nice since he then took the time to walk back down to the Unit with me to make sure I was comfortable with my new surroundings as well as answer any questions I had. It was also nice to Bob who was running the ECMO. Bob did not know Andrew was mine when I first walked in the room.

So, as I write this, Becky is dealing with a postpartim bleed. She has been passing blood clots and finally had to receive a drug to allow her fundus to contract and stop the bleeding. We are hoping this will take care of it so she does not have to go back to the OR.

Andrew is doing well on ECMO at this point. His sats are 100%, blood pressure is up and they have been able to come off his pressors quite a bit. He looks very comfortable and that helps me with our decision. It is time to sleep now but we will be back to his bed side as soon as we can.

While today has been made significantly easier by our friends, we have to ask that you not stop by to see Andrew or either of us. With the current flu situation at Duke and his present condition, we feel it would be irresponsible of us to risk exposing him to something. Thank you to all who are following this blog. Your thoughts and prayers have been a HUGE help throughout this process.