Arnie took Olivia for her followup with the surgeon yesterday. The incision area is healing wonderfully and at this point we are all set! He made the incision on a skin fold as to lessen the obviousness of the scar – which was a nice gesture. Looking at her stomach / chest area you wouldn’t know that the stomach incision was made at a later date than her chest “zipper”. They are both completely healed over.
They released us yesterday morning around 9:15AM. Olivia and I made it to church for 9:30AM mass (don’t ask how fast I drove, ok?)
The surgical resident admitted she probably was ready to eat on Friday when she pulled her tube out although it’s “highly unusual”. I said “We’re dealing with an unusual child who came home 7 days after heart surgery”.
We had a very good evening. She didn’t go to sleep until Midnight but slept straight thru minus a crying spell at 3:00AM.
Surgical resident came by around 7:30AM and approved feeding her – but only after the surgeon on call approved it. Dang these guys are skittish.
Surgeon on call stopped by at 8:45am and approved her feeding
She can have pedialyte for two feeds, then Breast milk at 50% (mixed w/ pedialyte) for two feeds. If she tolerates it well then she can have straight up breast milk. Once she’s eating well we can head home
She took just over 1 oz of cherry flavored pedialyte. The nurse told me not to push it b/c if she throws up we have to go back to square one (no food for 24 hrs).
We hope that we can go home tomorrow morning!
Surgeon stopped by. What a nice guy.
Olivia is doing great. He said we’ll definitely get her started on pedialyte tomorrow morning. And then breast milk on Sunday.
Very nice nurses as always.
Olivia had pulled out her own NG tube yesterday morning . The resident on the PICU said we could feed her so we gave her about 40ml breast milk which she loved.
The surgical resident had a heart attack when he found out we’d fed her and ordered the nose tube back in
They put it back in around 11AM and there wasn’t anything coming up which meant her intestines were working just fine (sometimes they stop for a few days thus the need for the tube to remove the bile from her stomach).
She had a very good day yesterday although she was VERY fussy because her belly was empty obviously – she’s on IV fluids so she’s not starving – just feeling funny with an empty belly.
She was passing a ton of gas throughout the day and had a bm around 4:00PM which is a huge step. Then again she had one after I left last night (Arnie stayed at the hospital while I went home w/ Miss Maddie).
This morning the surgical resident OK’ed removing the nose tube but ordered NO FOOD. So we most likely won’t be out of here tomorrow … I’m shooting for Sunday.
When I got here Olivia had been given an extensive bath and was looking all cozy and pink. They had removed her oxygen (was in her nose as well) and gotten rid of her nose tube.
Her oxygen levels were better without the tubes and she’s in the high 80’s (Better than she was reading prior to surgery)
Literally as I was typing up my last post the doctor walked in!
Olivia did fantastic. Very small incision. I asked if he saw anything “unusual” and he said he didn’t go looking for trouble.
She’s already breathing on her own (extubated) and we’re just waiting to see her!
She’ll have a nose tube for draining the bile until her intestines start working again (they stop working after “trauma” or surgery). Then she’ll be able to feed again.
He’ll be giving her tylenol rectally and little shots of morphine as needed.
Waiting on Olivia coming out of surgery…
They’ve finally opened the PICU waiting room and there’s a computer with internet access in it so I’m posting while waiting for them to let us know she’s out of surgery.
Let’s see … we had to arrive at 11:30AM – took two cars as Arnie will be heading home tonight with Maddie and we’ll be alternating nights at the hospital.
Olivia was fussy when we got here as she hadn’t eaten since 8:45AM. We didn’t bring in a pacifier or the diaper bag. Of course Olivia nearly had a “blow out” diaper when we arrived and cried most of the time.Â Bad, bad parents.
Tanya was our nurse in the day surgery unit. She checked Olivia’s vitals and put her in these PJ’s that were HUGE. She looked like a sumo wrestler. An adorable one.
Dr. Hechtman stopped in and apparently they don’t re-anchor her intestines but “spread them”. He said it’s confusing and he didn’t even understand why they stay spread.Â He will be operating with resident Dr. George Powlsides.
Anethesia doctors were Dr. McIsaac and Dr. Gerace. Dr. Gerace is a resident and actually remembered Olivia from her first surgery – he was present for it! I got all weapy knowing he was there again for her.
There was some confusion about where her chart was – because she got a new medical record # when she became Olivia (from Baby Girl).
Olivia weighed in at 9lbs, 3 oz. Michelle (4th year medical student) said that Olivia is growing better than they could hope for a heart baby. She’s in the 50th to 70th percentile for weight!!!Â Breast milk seems to agree with this kid.
Oxygen levels were in the mid 70’s.Â Heart and pulse rates were where they need to be and “very good”.
She did an echo and the shunt looks great.
We need to schedule another followup for 6 weeks
She gave me a copy of a letter she sent to Dr. Friedman about Olivia to give to the anethesiologist which I will type in when we get back from this surgery – it confirms the “defect” that will make Olivia’s Fontan (3rd surgery) so much easier
Surgery will take 90 minutes.Â Basically the surgery is “plastic surgery” to relocate the bowels to significantly reduce the chance of her bowels twisting which would cut off blood supply to the intestines which is very, VERY serious.
She will not lose any intestines with this procedure. They will remove her appendix while in there as it is on the wrong side.
They will do the surgery with a regular inscision as lathroscopic could mess up the pressure in her heart.
Average hospital stay is 4 to 5 days. We will be back in the PICU after due to her heart issues.
Most risk is related to her heart.
She will have a nose tube for a few days after to handle the stomach bile until her intestines start working again.
Risks: infection, bleeding.
Surgery is scheduled for 9/1/04.
We’re scheduled for September 1. Not what I was looking for, but better than nothing. We have an appointment with Dr. Hechtman next Thursday at 9AM for a consultation.