Pre Op Day, 04/16/2013

Today was a very long day.  We left Washington about 7:30 (had planned on 7!).  The weather was kind of sketchy in areas, but we made it through without difficulty.  Well, I guess we didn't have problems.  I was asleep soon after getting out of town.  I was up until 3:30 to finish packing.  DO NOT feel sorry for me about that night -- that's procrastination at its finest!

Once in Indy we ate a quick lunch and headed to the office to start Eli's pre op obligations.  Bryan and I went into the exam room with him while my mom, God love her, took care of Zachary in the lobby.  They always find things to do no matter what their surroundings so I knew he'd be entertained. 

On the agenda for Eli was an echocardiogram (ultrasound of the heart and vessels), an EKG (shows the electrical rhythm of the heart), chest x-rays, bloodwork, and meetings with Dr. Steinberg (cardiologist who will place and set the pacemaker) and Sara (surgical nurse practitioner).  Because of Eli's recent bout with bronchitis, it was decided to obtain an RSV swab with his labs.  If it came back positive, surgery would be rescheduled.  Everyone agreed his lungs sounded clear and he didn't exhibit any signs to indicate a positive test, but no one wanted to chance it.  It was the last thing he had done and we got a call three hours later from Sara:  Negative for RSV, surgery as planned on the 17th. 

During the echo, Dr. Steinberg noted that Eli's mitral valve insufficiency was worse than they originally thought.  We've known about this since his first surgery and, in fact, it's somewhat expected with Eli's condition.  However, it's progressively getting worse and now there's a decision to be made.  A valve replacement is not an option, Eli needs to keep his valve.  Dr. Abraham (surgeon) reviewed the echo & talked with Dr. Steinberg & Dr. Parikh (Eli's main cardiologist).  He will decide what to do once he's "in there" tomorrow and can better determine what option is best.  Are you asking, "what are the options?"  Because if you are, that's a fair question.  To be completely honest, we didn't get into all that with them.  It had been a long day already and we weren't halfway through our Pre Op Checklist.  We know they will do what's best for Eli and we will find out what that is after surgery.  We didn't need to stress over something we can't control.

"Why does the discovery of increased mitral valve function change surgery?"  Another great question, blog readers!  Eli is scheduled for a Fontan with pacemaker placement.  We've been told to expect a minimum of 4 hours for surgery.  Eli's heart does not have to be stopped with this surgery (something I didn't realize until today!), but if there is repair work to do on the mitral valve, his heart will be stopped and he'll be placed on the heart/lung bypass machine.  All that means the surgery will be longer, more invasive, and have a longer recovery.  The advantage to doing it now (if Dr. Abraham thinks he can improve the valve's efficiency) is that Eli's already going to be asleep, chest open and the docs will be working in that area anyway, so why not proceed at that time. 

We had expected today's appointment to be two to three hours.  It was five and a half.  Eli tolerated it very well.  Zachary did great, although he once told Mamaw Betty that Eli's check up was taking an awfully long time.  We left the hospital just in time to get into rush hour traffic.  By 6:00 we were at my sister's house and she was cooking supper for us (mmm, mmm, good!).  We had to work to get Eli settled down for sleep tonight.  He can't have anything to eat or drink after 11pm so we wanted to get a good tube feeding into him up until that point.  He finally settled down for daddy and is sweetly sleeping beside me as I write this.  I should go to sleep, but I really just want to lay awake and listen to his breathing and feel him kick me in the face/groin/leg/chest (he's an octopus when he sleeps). 

The boys love taking baths in my sister's large tub.  They had a long one tonight and I kept leaving the room (Bryan and Ashley were in there!) because it was too emotional.  In no way do I want either of my boys to hurt or be sad, but it was hard to hear their laughter tonight because I don't know how long it will be before they laugh and play together again.  I was trying to soak it up, but it was painful and I had to leave so the boys wouldn't see me cry.  

Please wear your Eli's MVPs shirts on Wednesday.  Surgery is scheduled to start between 7:30 and 8am.  Many people have told me they're going to have a moment of prayer for Eli at 8am Wednesday morning.  I love the idea and am asking you to do the same.  Thank you!

Sometimes we don't get a good internet connection at the hospital.  Ideally, I'll update our FB page with the surgical updates as we receive them and then do a daily blog post about that day's events, but if I can't connect that will not happen.  Please don't assume no news is bad news on our end.  We will find a way to get updates out there, but it may not be as timely as I'd like.

Specific prayer requests:
- for Dr. Abraham and the surgical team to be well rested and have their game faces on!
- for Eli to be strong and amaze us with his resilience yet again
- for Zachary as he tries to understand what is going on.  It's hard to explain this to him without freaking him out.  He's never seen Eli right after an operation and we're trying to prepare him for that. 
- for our family who is traveling in a few hours so they can be with us during the surgery. 

Thank you all so very much.  I will keep putting updates out as much as I can with regards to internet and available time.  Until then, remember to cherish Every Little Beat...