Thursday, April 18, 2013

Fontan Surgery Day, 04/17/13

Holy cow.  I was wrong about Tuesday being a long day, Wednesday was LONG!

We were up at 5 to have Eli at the hospital by 6:30.  All the preop stuff went very smoothly and Eli only asked for a bottle once.  Part of Tuesday's preop post was a prayer request for 8am Wednesday morning.  You have no idea how appropriate that time frame was because right at 8 was when we laid his sleeping cuteness on the gurney and he was wheeled away from us to the OR.  I couldn't watch him go.  However, it was easier when I saw what time it was and knew many, many people were praying for him at that very moment. 

Once we checked in with the Surgery Waiting Room staff, we got on the computer to see if we had an internet connection.  Thank heavens we did because that's what made the day bearable for me!  I was completely engrossed in watching Facebook blow up with Eli's MVPs tshirt pictures, sharing surgery update posts, reading encouraging messages, and just being incredibly humbled by the outpouring of support for our miraculous baby, affectionately known as "Cheekers" (because of those adorable chubby cheeks!)

If you read Tuesday's post (click here if you want to read it), you know that his preop echo led to a change in surgery plans.  His Fontan and pacemaker placement were expected to take a minimum of four hours.  He was taken back at 8.  Surgery doesn't start immediately.  After making sure he's really asleep via gas, then they start placing IVs, central lines, arterial lines, urinary catheter, and clean his chest for surgery.  All that took place up to about 9:40 when the surgery actually began. 

About 1pm, the OR nurse called out and reported to our liaison who in turn reported to us.  Eli was doing very well.  Dr. Abraham determined it was the proper time to repair Eli's mitral valve because of pretty significant regurgitation (backflow from the lower left chamber to the upper left chamber).  That's what he worked on for the first 3 1/2 hours of surgery.  Then he was able to start on the originally scheduled parts of surgery.  We were told to expect another three hours.  It ended up being a little less than that for actual surgery time, but he was kept in the OR while Dr. Steinberg adjusted the pacemaker settings.  Eli also received some blood transfusions because of significant loss during surgery (huge thank you again to anyone who's donated because of Eli's story!). 

We got to talk with Dr. Abraham who explained more about the mitral valve repair (in a very generic nutshell:  he put some stitches in around it.  You must know there's more to it than that if it took 3+ hours to do it).  About an hour later we got to see our baby :) 

He was already off the ventilator before he came to the Pediatric Intensive Care Unit (PICU).  He was brought from the OR straight to the PICU, no recovery area.  The PICU is so specialized that it serves as the recovery area for their heart babies. 

Because he was off the vent, he was able to speak.  It was a very sleepy croak with his eyes closed, but he was asking for Mommy & Daddy when we got in the room.  He was fussy and moving a lot as two nurses worked around him trying to finish sorting his multiple lines and other tasks.  He was very agitated but able to calm when we rubbed his head and held his hand while talking to him. 

That's basically how the evening and night went.  He fussed but was able to be calmed.  He was getting too sedated with the pain medicines he was on so they were cut back.  That's when the fun really started.  He got more and more agitated (by the way, agitated is slang for really pi**ed off!).   After he was awake enough with stable vitals, his IV pain medications were increased  and he did get comfortable again.  It's a fine line between keeping his pain under control, but not decreasing his respirations and blood pressure too much.  

He looks so good.  I can't stop saying it.  Here's the big news....Are you sitting down?  His fingers and toes are PINK!!!!  He does not look like he just ate a blue popsicle.  His overall color is sooo good.  After surgery he was on two liters of oxygen.  Overnight it was decreased to one liter.  His sats have been about 95%.  That is absolutely mind boggling to us.  Eli's sats are mid 90s!  He's pink!

Ahhh, we're very relieved.  He's still in serious condition but doing very, very well. The power of prayer is incredible!