Saturday, April 20, 2013

Days 2 & 3, Post Op Fontan (April 18 & 19)

Eli got some good sleep Thursday night but not a lot.  His blood pressure was kind of low so the only continuous pain medicine he was on was stopped.  He did pretty well, but we had to find other ways to control pain without knocking him out.  Also, he hadn't peed since his urinary catheter was removed. He was straight cathed twice but was peeing on his own by Friday morning.  During the night Thursday, his arterial line was removed (an IV that's in an artery instead of a vein, used for obtaining blood gases to see how well his body is adjusting.  It also has a sensor that will monitor his arterial blood pressure).  They also took out an IV that was in the back of his hand.

As of Friday morning, he was down to two dressings (one over the incision on his chest and one over the incision for his pacemaker), two JP drains (draining blood from the surgical area), the central line in his neck, the heart monitor, and his oxygen.  That isn't much at all.  In fact, the central line was broken down and made smaller because he only had one drip going through it (his Milrinone). 

After rounds on Friday, it was decided to start him on Enalapril, a heart medicine that can be taken orally or go through his feeding tube.  Because of that, he could be taken off the Milrinone drip.  For a long time yesterday, Eli was not hooked up to any medicines!  He now has IV fluids going through his central line because he doesn't want to drink anything yet so they're just giving him some fluids.  Eli is also getting a slow & continuous tube feeding of Pediasure with fiber.  His cardiologist said it's not a big deal that he doesn't want a bottle or sippy yet, but if he's got the tube available we may as well provide some nutrition as long as he can tolerate it.  So far so good!

The cardiologist wanted an echo yesterday to see how his heart was functioning with the Fontan and repaired mitral valve.  The valve is leaking some, which we knew it would (it was repaired, not fixed!), but she was really pleased with what she saw.  

His pain meds were changed to Tylenol and Toradol.  Toradol is an NSAID and not often used this soon postoperatively, but if Eli is given Lortab he has excessive vomiting, so we're trying the Toradol.  Throughout Friday, the combination of Tylenol & Toradol seemed to work well.  Well enough that he sat up in bed (propped on pillows) most of the day while watching movies.  Friday night he was pretty fussy for Bryan.  Saturday morning we started using some morphine in addition to the Tylenol & Toradol.  He needs something a little stronger as he's moving around more, sitting up more, and trying to cough more to break up the extra "gunk" in there.  He's chilled out in his bed right now watching Mickey Mouse Clubhouse. 

The hospitalist who's on today just came in to examine him.  He (like all the others) are very pleased with how well Eli is doing.  So pleased in fact, that we've probably spent our last night in the PICU!  No orders have been made yet in regards to a transfer to the general floor, but it will likely happen later in the day.  I know it's a great thing to get discharged from the PICU, but there are so many nurses here we really love.  But now we'll get to go to another floor where there's more nurses we really love!  This is a little bittersweet because, unless something happens, there are no more surgeries scheduled.  We won't be back here,so other than updates I send them over the years, this is goodbye!

Obviously all the prayers for Eli are working!  Thank you all so much!  We are very fortunate and blessed.

Thanks for the cards & packages we've been getting for the boys.  It's amazing how you all pull together for us :)  We've also had a lot of people ask us about ordering tshirts.  Yes, we can still get them!  I won't be placing an order for a couple weeks, but you can message your order (or any questions) to us via FB or through elismvps@yahoo.com


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