Isaak's Follow-up Surgery Open Post

Hello everyone.

We will be updating this post as the day progresses, so if you are keeping the blog open, just remember to refresh your browser once in a while.

3:50pm: He's out and looking good. We met with the surgeon about 30 minutes ago for his report and then visited little guy. Mom's still in there while I step out to update the wider world. His bowels all looked very healthy and were already showing signs of growth and change. Due to some adhesion, they could not really measure the total length, but they only needed to trim a few millimeters from each end to get to the healthiest tissue to reconnect. That is a best-case scenario! The Broviac was placed in an "external" jugular (not the big one from the head). The surgeon was very happy with the location and placement. G-tube surgery went fine and they were able to use the incision from his initial surgery for both the reanastomosis and the g-tube, also good news. They examined his liver while he was open, and it appears to look like a liver for a baby that has been getting TPN for 2 months. Not good, but not terrible. Hopefully, he will be able to begin feeds soon and can begin getting substantial calories from enteral feeds. If he can get 50% of calories from milk, that greatly reduces the risk of liver damage and long term complications. It will be several days before we really know how well he'll be able to feed short term and a matter of weeks before we understand the overall trend and prognosis. So, all in all, things have gone as well as we could have hoped. Now we wait and let him heal.

1:30pm: Something to report! Isaak's nurse just called with an update from the surgery team. They have completed the Broviac and the reanastomosis and are beginning the g-tube. That should take about an hour. He'll then have roughly an hour in recovery after that, so hopefully we get to see him back upstairs by 3:30 or so. No report on what was found yet - won't have that update until post-op.

1:15pm: Nothing to report. We are clearly hoping this is good. He's been back about 3 hours now and we are a couple of anxious parents. Just took a walk around the hospital locating all of our dining options so we don't get burned out like we did last time. Thanks for all of the kind words of support!

11:10am: Our little guy is in surgery now. He was taken back about an hour ago and the plan is to insert the Broviac Catheter first followed by the reanastomosis and g-tube. It's a lot for Isaak to go through and we are probably looking at a 4-5 hour total surgery time. The anesthesiologist suggested that he be intubated at least through tomorrow due to the stress and the limits to the amount of narcotics they can give a preemie for pain control (They can give more if he is on a vent). OK, so I misinterpreted the conversation and Bekka clarified. It's true they have a limit to amount of narcotics they can give for pain, but the main reason for intubation was to allow full-on general anesthesia. Theoretically, just the abdominal surgery could have been done with a caudal anesthetic (essentially a spinal block). Doing the Broviac nixed that option as they are operating above the waist.  He did really well when intubated last time and came off with no problems so we are hoping for a similar situation this time. They should update us as they finish each procedure and we will try to get something posted.