Day 5, Post Op Fontan (April 22)

After yesterday's events, Eli started the night by sleeping really well.  By the early morning hours he was grunting a lot with his breathing.  Right before shift change (7-7:30am) we noticed how cold his arms & legs were, yet his head was soaking wet.  His temperature was normal.  I questioned the night shift nurse about his temps through the night and she said all were within normal limits, but she too had noticed the sweating.  When our day shift nurse came on, she was one we remembered from previous visits.  She was immediately concerned with his breathing because it was so labored.  Even more so than when I had talked to the night shift nurse about his temps and medicines. 

We knew cardiology was going to see him (they do everyday) but she, Bryan and I felt they should get an update about him in case they wanted to see him sooner.  When she called, Sara (the surgeon's nurse practitioner) was just getting report on Eli about yesterday.  Our nurse simply said, "I don't like how hard he's working to breathe" and they said they'd be right over.  About 3 minutes from when the nurse left our room to call them, Sara, Dr. Abarbanell, and a cardiology resident walked in to check him out.  They agreed he was working too hard and too many things weren't adding up. 

It was decided to obtain more blood cultures (one from his central line like they did yesterday and one from a fresh draw in case the central line is harboring some bacteria and causing the problem), more blood work, a urinalysis, and a urine culture.  After all that was done then they were starting antibiotics (Vancomycin & another one I don't remember).  Once the cultures come back they'll know if they need to treat him differently but at least they've started him on something.  They also obtained another chest xray to compare against yesterday's as well as an abdominal xray.  Both thought his abdomen was distended today and wanted to make sure he didn't have a blockage.

The abdominal xray showed he had a lot of gas in his bowels.  We figured that out before the xray was complete!  He hasn't pooped today, but he's passing a lot of that gas without difficulty.  Yesterday's chest xray showed a pleural effusion.  Today's showed that it was a lot larger.  Eli had been drinking some milk & juice, but that was taken away and we were told he needed a chest tube so he couldn't have anything for four hours before sedation.

At 1:30 they took us down to the PICU to an empty room.  The nurse who assisted Dr. Abraham with the chest tube had just taken care of him on Friday and was very surprised to see him in this trouble.  She was even more surprised to hear about yesterday.  The PICU hospitalist gave Eli some medicine to put him to sleep for a short time and Dr. Abraham inserted the chest tube and drew off fluid.  He removed 80cc (just shy of 3 ounces) from the right side of Eli's chest.  Then he anchored the tube and they stopped the medicine that had him asleep.  Start to finish, the procedure was eight minutes.  As soon as we saw him we knew he felt better.  His breathing wasn't labored and his color was pinking up. 

He spent a little over an hour in the PICU area as his recovery progressed.  The nurse pulled 10cc more out of his chest tube to make a total of 90 (right at 3 ounces).  Dr. Abraham said Eli would have the chest tube in for at least a couple days.  There's also no guarantee he won't need one on the other side, but as of now he does not.  Eli was brought back up to his room on the general peds floor.  He's been drinking juice and can have some milk soon.  He is very sleepy and still in pain so his Tylenol, Toradol, and morphine are pretty routine for him.  His oxygen sats are 98% on 2 liters and that will be weaned through the night or tomorrow. 

In Zachary news, he's been in Washington since Friday night.  He spent the weekend with Bryan's family and we heard he helped with some landscaping.  I'm pretty sure that means he was fascinated by the wheelbarrow since we don't have one!  Yesterday he went on a treasure hunt Bryan had made for him and got to dig up a treasure box we had filled with goodies.  Today was his first day at preschool since last Monday.  Aunt Kendra spent the night at our house with him and my mom took him to school.  Mom told us he had a rocky morning but by the time he got to school he was smiling.  After she picked him up he talked her into Mr. Gatti's for lunch (complete with game room time of course!).  They played in our yard for a while after that and he's now spending the night at her house. 

We found out about a good deed done for us.  Our neighbor across the street mowed our yard.  That's not a little job because we've got just under an acre.  It's also been a while since we've picked up limbs, etc so he had quite a job.  I'm pretty sure he doesn't read this, but just in case THANK YOU!  

Bryan and I are exhausted.  Bryan's allergies are really bothering him and neither one of us is sleeping very well.  These past two days have been very trying for us.  We know what happened yesterday could have turned out very badly and we are incredibly lucky Eli is still with us.  Thank you for caring enough to read and stay updated about all of us.  Thank you for the prayers.  Here's hoping & praying that tonight is easier on Eli!