Post-operative day 1

We’re having a fairly quiet day in the ICU, which is a very nice change from yesterday.  Christopher did well overnight, with no new issues, and has stayed nice and stable today.   He is certainly sicker now than he was after his first surgery, but that’s to be expected. 

His blood pressure has been high but well-controlled with IV blood pressure medication.  He has also been trying to wake up a lot, and needing a fair bit of sedation to keep him asleep.  He needs to be asleep right now because it keeps his blood pressure low and minimizes strain on his body.  They’re also being very careful to keep his pain well-controlled and he does look comfortable.

The ICU doctor came to see us today and went through yesterday’s scary episode in detail for me.  I just felt that I needed to know exactly what had happened and what was done.  If you’re squeamish, you may want to skip this paragraph and the next.  Basically, he was gradually deteriorating after he came back from the operating room, showing decreasing oxygen levels in his brain (still ok, but not as high as they’d like) and gradually decreasing blood pressure.  He also looked a bit pale, although his bloodwork showed that he wasn’t anemic.  They were taking steps to improve his condition when the blood pressure suddenly started dropping faster (the systolic went as low as 30, for those who understand these things).  They did in fact start doing chest compressions then and that was when they called the surgeon and prepared to re-open his incision.  As soon as the surgeon arrived and did that, he immediately became more stable.  In fact, his blood pressure was already coming back up with the chest compressions.

At the moment, the best guess is that the tube draining blood and fluid from around the surgical site became blocked and the fluid backed up around the heart, which keeps it from pumping effectively.  The chest compressions helped to push the blockage out of the tube and also to make the heart pump better, and ultimately opening up his chest relieved the pressure.  He was taken back to the operating room but no bleeding sites were identified, thank goodness.   So, all in all, a scary episode, but one that ended okay.

 The ICU doctor particularly emphasized that there was a very rapid response so he doesn’t feel that the episode of low pressure will have done Christopher lasting harm.  (Blood flow to the brain is the major issue, as the brain is the organ that is most sensitive to a lack of blood flow.)  They will do an ultrasound of his head today to be sure that all is well, but he said he expects it will be normal.  Please say some prayers that everything looks okay inside that beautiful little head.

Christopher is also quite swollen today, from all the fluids that he received yesterday.  This is a normal and expected thing, and thankfully we were warned that he would look pretty bad.  They are giving him diuretic medication so he will put out more fluid and it’s working well.  Over the course of the day so far, we’ve already seen an improvement in his swelling.  He also has some fluid in his lungs so the diuretics will help get rid of that, which brings us one step closer to getting the breathing tube out.  They are hoping to potentially be able to remove the tube as soon as tomorrow.

Brad and I are doing pretty well.  We were absolutely exhausted last night so we went home for a good meal and a good night’s sleep.  We’re both feeling fairly good today, physically speaking, and although we are still worried about Christopher, it’s nothing compared to how we felt yesterday.

For now, we are focusing on baby steps: getting rid of the excess fluid, keeping the blood pressure stable, controlling pain, and getting the breathing tube out.  He’s going to get a little breastmilk through his feeding tube today.  We are making progress, slowly but surely, and for that we are very grateful.

It's amazing how much he has improved even over the course of the day today.  His colour is better than it was this morning and he just looks more comfortable.

Here are some photos of his little hand and foot yesterday.  I know the photos with tons of tubes are a bit scary, and it looks worse this time than last time, so I think I will wait a day or two to share those ones.  Know that he is improving, though, and by the somewhat skewed standards of a post-operative cardiac patient, he looks pretty good!

 

Comments

[Trina]

I kissed my finger and pressed it to the photo of his little toes. My oldest did the same. If good energy means anything at all. Toe kisses and hugs from us all. Heal quickly, Christopher. Nikki, you and your hubby, hang in there. How's your daughter handling all of this? I'm sure you've been away from home more than usual.

[Farandolae]

So glad to see this & it sounds overall positive. Such sweet little hands & feet. Keep moving forward Christopher. We're all behind you and sending love. Big hug to Katie too & hope she is coping well.