We got an early update this time because the surgery is progressing well. Julie (the APN) reports that Bobby's heart is now beating again and the shunt is in place.
One of the pulmonary artery branches was a bit narrow so they inserted a patch of tissue from Bobby's heart to expand it. This is apparently a common procedure for this operation. Once the artery has expanded it will receive more blood flow and will most likely grow normally from here on out.
They are currently cleaning up the bleeding from the procedure. The next step is to take him off of the heart/lung machine and sew him up. Then we'll get a visit from the surgeon while Bobby starts to wake up.
Julie says that she hears some joviality in the operationg room which is always a great sign that things have gone well.
2/19/09
The Surgery Moves On
The nurse just stopped by for an update. Bobby is stable and the surgery is uneventful from a surgeon's point of view. Bobby is on the heart/lung machine and his heart has stopped beating for the time being. They are currently closing his pulmonary artery shut - from now on, Bobby won't have blood flowing from his heart to his lungs.
Here's a link to a picture that will help explain what's happening.
http://www.childrensheartinstitute.org/educate/heartwrk/bloodflw.htm
The pulmonary artery is being sewn shut just before it forks to the right and left lung.
The next step is to insert a shunt that will connect the superior vena cava (carries blood away from his head) directly to the portion of the pulmonary artery that lies on the upper right of the heart. This blood will be sent to the right and left lungs and be oxygenated there.
For now, the inferior vena cava that carries blood from the bottom part of his body will continue to connect to his heart. But the blood won't get sent to the lungs - it will just be recirculated to his body. When he's older, it will be redirected. Until this happens, Bobby's oxygen saturation (the % of red blood cells that are carrying oxygen) will remain a little low - he will run at about 80%-85% saturation while a healthy person is closer to 95%-100%. He's been at this level all of his life and, well, you can see that it doesn't seem to be keeping the rosy off of his cheeks.
Thanks for all of the good thoughts! Its immensely helpful to know that you are with us.
The next update will be in a couple of hours.
Here's a link to a picture that will help explain what's happening.
http://www.childrensheartinstitute.org/educate/heartwrk/bloodflw.htm
The pulmonary artery is being sewn shut just before it forks to the right and left lung.
The next step is to insert a shunt that will connect the superior vena cava (carries blood away from his head) directly to the portion of the pulmonary artery that lies on the upper right of the heart. This blood will be sent to the right and left lungs and be oxygenated there.
For now, the inferior vena cava that carries blood from the bottom part of his body will continue to connect to his heart. But the blood won't get sent to the lungs - it will just be recirculated to his body. When he's older, it will be redirected. Until this happens, Bobby's oxygen saturation (the % of red blood cells that are carrying oxygen) will remain a little low - he will run at about 80%-85% saturation while a healthy person is closer to 95%-100%. He's been at this level all of his life and, well, you can see that it doesn't seem to be keeping the rosy off of his cheeks.
Thanks for all of the good thoughts! Its immensely helpful to know that you are with us.
The next update will be in a couple of hours.
The Real Work Gets Started
Not surprisingly, it took the doctors an extra long time to get Bobby's central line in place. It always takes an extra long time to get Bobby's IVs in place. He's a tough stick.
But he's stable and the incision has just been made. Only 4 or so more hours to go. The nurse said she'd be back at 10:30.
But he's stable and the incision has just been made. Only 4 or so more hours to go. The nurse said she'd be back at 10:30.
Surgery Beginning
Valerie and I are in the surgery waiting room, having handed Bobby over to the doctors at 7:30 this morning. We've sat in this room too many times already, but this is the scariest one so far. Today he goes on the heart-lung machine. Today they may have to stop his heart to finish the surgery.
But for now he's just going under anesthetic and having a breathing tube and central line put in place. Then they will do a trans-esophagal echo where they insert a camera through his windpipe down next to his heart. This is just a check to make sure there are no surprises regarding his physiology.
After that's done, they will open up his chest. The APN (advanced practice nurse) will give us updates as we go. The first one will be in about an hour and a half. I'll check in here when she checks in with us.
I learned a lovely prayer this weekend that I keep saying to and for Bobby.
I learn something new each day
Step by step I'm on my way
Thank you God for how I grow
And thank you for the things I know
We're taking a great big scary step today. I trust God will see us all through.
But for now he's just going under anesthetic and having a breathing tube and central line put in place. Then they will do a trans-esophagal echo where they insert a camera through his windpipe down next to his heart. This is just a check to make sure there are no surprises regarding his physiology.
After that's done, they will open up his chest. The APN (advanced practice nurse) will give us updates as we go. The first one will be in about an hour and a half. I'll check in here when she checks in with us.
I learned a lovely prayer this weekend that I keep saying to and for Bobby.
I learn something new each day
Step by step I'm on my way
Thank you God for how I grow
And thank you for the things I know
We're taking a great big scary step today. I trust God will see us all through.
2/15/09
2/14/09
Grandma
Well, Bobby broke the news to us this morning. He has chosen Grandma as his special Valentine's Day lady. I didn't see that coming. But who am I to argue with true love?
We're home (as always) this weekend, trying to keep Bubs healthy for surgery. One of the things I'm most looking forward to post-surgery is being able to take Bubs places. He loves going out. Anywhere. He starts smiling as soon as he sees his snowsuit.
Surgery is now 5 days away. It's crazy that in one week the blood from Bobby's head will be rerouted to flow directly to his lungs. How the heck did someone think up that fix? And how many people have had their lives saved by that crazy idea? I'll be happy to add Bobby's name to the list.
We have a subscription link to the blog above. If you sign up, you will be notified when we post. We'll be posting a lot next week. I try to give updates once a day when we're in the hospital as I know Bobby has a lot of people worried for him.
We appreciate all of the love and support.
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We're home (as always) this weekend, trying to keep Bubs healthy for surgery. One of the things I'm most looking forward to post-surgery is being able to take Bubs places. He loves going out. Anywhere. He starts smiling as soon as he sees his snowsuit.
Surgery is now 5 days away. It's crazy that in one week the blood from Bobby's head will be rerouted to flow directly to his lungs. How the heck did someone think up that fix? And how many people have had their lives saved by that crazy idea? I'll be happy to add Bobby's name to the list.
We have a subscription link to the blog above. If you sign up, you will be notified when we post. We'll be posting a lot next week. I try to give updates once a day when we're in the hospital as I know Bobby has a lot of people worried for him.
We appreciate all of the love and support.
2/12/09
Valentine's Day Maneuvering
Well, it's 2 days before Valentine's Day and Bobby has yet to reveal his special lady for this year. I'm hoping he'll pick Valerie and I, as I do believe all the little girls in play group are already spoken for. Plus, it's good form to choose your mamas in a year when you've sent them to the hospital 7 times and counting. Fingers crossed. If he picks that nanny of his, there's going to be trouble.
Bubs woke up in a great mood. Morning is my favorite time with him. He likes to sit on my lap, facing me, discussing the weather and his dreams from the night before. Every few minutes, he wants to be pulled close for a big hug. There's never been a finer way to start a day.
He had his occupational therapy assessment today. He's doing quite well on his cognitive skills - performing some tasks we'd never seen him do. We just need to get that trunk stronger so he can sit up and explore the world more.
Otherwise, we're focused on keeping him healthy for surgery. We spent last Saturday in the ER, afraid that he'd gotten pneumonia after choking on some vegetable juice. He's OK there, but he does have an upper respiratory infection. And I should make the ritual announcement that his GI woes are continuing.
Hard to believe, in exactly one week he'll be just finishing his next surgery. What a terrifying and yet relieving thought.
Bubs woke up in a great mood. Morning is my favorite time with him. He likes to sit on my lap, facing me, discussing the weather and his dreams from the night before. Every few minutes, he wants to be pulled close for a big hug. There's never been a finer way to start a day.
He had his occupational therapy assessment today. He's doing quite well on his cognitive skills - performing some tasks we'd never seen him do. We just need to get that trunk stronger so he can sit up and explore the world more.
Otherwise, we're focused on keeping him healthy for surgery. We spent last Saturday in the ER, afraid that he'd gotten pneumonia after choking on some vegetable juice. He's OK there, but he does have an upper respiratory infection. And I should make the ritual announcement that his GI woes are continuing.
Hard to believe, in exactly one week he'll be just finishing his next surgery. What a terrifying and yet relieving thought.
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