Wednesday, October 7, 2009
Two in One
Andrew's day started out by making his way to the operating room around 8:45 a.m. It was quite a transport crew that required security blocking the halls to make room for all of the equipment required to transport our sweet little baby of less than 10 lbs to the operating room. He was wide awake and looking all around when they came to get him. Gene handled this much better than I did. I was in complete mother mode and every bit of medical knowledge I had was out the window. We received frequent updates and were so fortunate to have an incredible team of people who love us and Andrew working on him to save his life. We will be forever grateful for them! He returned to us around 3:30 pm with the same amount of equipment and support.
We knew Andrew was to have his aorta repaired and that if the diaphragmatic hernia looked mild, they would repair it then as well. We did have some surprises in this regard. It turns out that his hernia was so severe that they were not able to repair his aorta unless the hernia was repaired immediately to leave room for the aorta to heal and not cause too much scar tissue. His entire left diaphragm was missing and his spleen, small and large intestines and stomach were up in his chest. His liver was down in his abdomen. The left lung that was visible was very rudimentary and did not appear to have normal vasculature. He did not look at the right lung because the heart was pushed to far over to the right side. The good news is that his aorta was pretty straight forward to repair. He was anticipating a very difficult aortic repair, so we were thrilled to have this in Andrew's favor! They attempted to come off bypass, but his lungs were too underdeveloped so he placed Andrew on Venoarterial ECMO which will be able to bypass his heart as well as lungs should his heart have too much of an insult after surgery. The blood clot found the other day was also absent from the direct examination of the heart.
He has two chest tubes to drain fluid from his chest and a Tenckhoff catheter which will help drain fluid from his intestines and is available for temporary peritoneal dialysis should his kidneys suffer a temporary insult from the surgery. The plan from here is too wait and see how much lung development we can recruit- so that is where people can start their prayers! Please pray for lung development and expansion. People can continue to develop lung tissue until 8 years of age- so it is possible that he can make it through this now that his lungs have room to expand! While he is one of the most severe cases of CDH, his surgeon said he still has hope and that is a wonderful thing for a parent to hear!
Thank you for your continued prayers and support. We anticipate the next several days to be rough and hope to make big progress after that. Andrew, Gene and I all appreciate your encouragement and have been overwhelmed by the care and compassion of those around us!