Recovery: 3rd Surgery, 1st Day

Caelin after Aortic arch repair. 6.5.12

His first post-op night went well. He did not have any major complications or really even many minor ones. The night nurse, Kelsey, had to manage and treat the normal things of any post-op child. Some of these were balancing and adjusting medications, giving doses to increase his glucose and other levels, repositioning, suctioning, stripping his chest tube, tweaking his ventilator settings, etc. She said the only concern throughout the night was an isolated incident of Caelin's pressures and heart rate spiking but she suggested this happened because he woke up and fought against the sedatives and paralytic. He did settle with an extra dose of pain medication and his heart rate and pressure lowered.


Throughout the day the nurse had to constantly monitor his blood pressure and heart rate because they were on the higher side. Of course this is expected to an extent because he just had a major surgery, but it also did not help that he was being stimulated by (necessary) visitors. He had an EKG, an echocardiogram, CPT (chest physical therapy- for his lungs with being on the vent) every 4 hours, was rotated (with a chest tube coming out of his abdomen & his chest being freshly cut open), got his chest tube stripped and manipulated to try to rid it of any clots, and had many visits from doctors and specialists. Once he was left alone, his pressures and heart rate lowered but he did have to receive an extra dose of Morphine and Versad here and there. 


He was on the paralytic until about 5:00PM. The intensivist, Dr. Bingham, decided to take him off of it to see how he does- they do not like to keep children on it any longer than necessary. Within 15 minutes of turning off the drip, Caelin started to suck on his breathing tube. Sean and I love when he does this because, like we said before, it shows a sign of comfort and that his personality is still there. So he is doing fine off of it. We think he is enjoying being able to move a little, although it must still be painful. He cannot focus yet with his eyes because he is on Morphine, Versad, and Tylenol but he opens them, especially when we talk to him they get really wide.


He has been on a medicine called NiPride to help with his heart function, in addition to the Milrinone. The NiPride was on the maximum dose but this afternoon they were able to almost half it (a little at a time) because his blood pressures and heart rate lowered. They would not lower it until his pressures were consistently 95 systolic or below. So it is a good sign that they were able to lower the dose!


Also, this morning Caelin started at 85% oxygen and now he is down to 45% oxygen. Since they took him off the paralytic, he is even initiating a good amount of breaths on his own when he is awake- another very good sign!


His chest tube has not drained anything since around 7PM Monday night. This is shocking because normally fluid has to drain from around the heart after surgery. A couple PAs came in to manipulate the tube to see if a clot formed on the tube, but even with working their magic, they could not get any fluid or blood to come out of the tube. We are just really hoping fluid does not start building up in his body or around his heart because that could be dangerous. He does receive a dose of Lasix every 8 hours to help with getting excess fluid out of his body. His whole body is very swollen, which is typical for him after surgery, so the Lasix is helping this, too. His G-tube is being continuously vented and has some bloody fluid draining out slowly; the day nurse, Laura, said it is not really concerning.


His echocardiogram from today revealed there is no fluid around his heart, he still has mild tricuspid regurgitation, and his function is still moderately to severely depressed but with an ever-so-slight improvement. The cardiologist, Dr. Wilmot, said he feels Caelin is in a good place right now considering where he came from. That is all we need to hear- that our baby boy is heading in the right direction. We know time will be his friend and help him heal. And also, that even the slightest improvement is still an improvement, so we will gladly welcome it.


As usual, the staff here at All Children's is wonderful. They are so compassionate and dedicated toward Cael. They will never know how much we appreciate them. Even tonight Cael's nurse, Kelsey, brought him a present! She and Mommy had a discussion a few weeks back about something called a WubbaNub for Caelin's binky. It is an adorable little stuffed animal attached to the back of his big, green obnoxious binky (which he refuses to give up for smaller, cute ones) to help keep it in. Mommy and Daddy had debated buying one but decided to wait until he was home (thinking home would have been sooner than later). So tonight Kelsey brought him an elephant WubbaNub! It is perfect because we love elephants and what they symbolize (Again, Mommy is really in to the meaning of names and figures). As a Chinese symbol it represents longevity, good luck, and happiness- that is exactly what we wish for Caelin. In Western culture it often represents strength, royalty, and stability. So ultimately, it is the best WubbaNub animal for Caelin and this gift means more to us than she could know. Thank you, Kelsey!


As a side note, Caelin almost rolled over over the weekend. He came extremely close twice to where he is on his side completely and would have required just the slightest tap to complete the roll. We were so excited and hoped he would get it before surgery but he didn't. We are looking forward to watching him accomplish this milestone and many others after he has recovered from this procedure; however, we are a bit nervous now because his chest is going to be fragile for quite a few weeks and Caelin is such a strong little boy, we hope he does not try to overdo it too much!


As always, thank you for your prayers, thoughts, positivity, and support. Love, love, love to you all!