Monday, July 6, 2009

On the Mend

Day 10: Monday, July 6.

Today was the first day that niether of us were able to go up to Salt Lake to see Willem. It was hard not to see him, but we called a few times to check in with his nurse and see how he is doing. Last night after surgery his heart rate was quite high - in the 190's. It came down to 170 bpm before the night was through. This morning when we called he had dropped to a more comfortable and obviously sedated rate of 130 bpm. We were happy to hear later this afternoon that he has arrived at the 150's - exactly where he should be.

All of the extra fluid that he had received yesterday to aid circulation was successful. His system handled it well since the nurse happily informed us that he has urinated a lot today and his swelling has gone down.

Another sign of his good recovery from surgery is that they have already begun to wean him from the ventilator. His progress today was that they were able to decrease the breathe rate from 25 to about 20. The nurse seemed optimistic that they would be able to wean even more over the course of the coming night. We just hope that these good tidings continue as he recovers from surgery.
Posted by Picasa
Posted by at

2 comments:

  1. JeriJuly 6, 2009 at 10:40 PM

    Such great news! I can't imagine having to wait so long to hold my new baby. I don't know how you are doing it. You and Blaise are amazing! I can't wait to see THOSE pictures too!

    ReplyDelete
  2. UnknownJuly 7, 2009 at 2:22 AM

    The little man is doing well! Sounds like you all are holding up magnificently. Soon enough all this hospital stuff will be past and you'll have the joys of middle of the night feedings. I bet you'll really start missing those hospital nurses :D. But seriously, if I can hardly wait to hold the little bugger, I can't even imagine what you guys are feeling...

    ReplyDelete

Subscribe to: Post Comments (Atom)

About Gastroschisis

I have posted some links for your information and research, but here's the run down on gastroschisis.

What is it?
Gastroschisis is a birth anomaly in which the baby's abdominal wall does not close all the way during early development. These abdominal defects can result in several problems, the least of which is gastroschisis. This is when some of the intestines escape through the small opening in the abdomen and are now outside the baby's body. During pregnancy these organs are exposed to the amniotic fluid for some time which makes the once maliable and functional bowel stiff and swolen.

How is it treated?
Since gastroschisis is not as serious as other similar defects, it is not dangerous to still deliver the baby vaginally. Upon delivery the baby will go to the NICU and be examined by the pediatric surgeons. At this point of evaluation, there are several courses of action. What needs to happen eventually is that the bowel needs to be surgically put back into the abdomen of the baby.

Option 1: If the bowel has little damage, is quite maliable and healthy, and the baby's belly seems to have the room to accept all of the intestine at once, the surgeons will perform a "primary closure". The surgery is fairly simple. They will make an incision to enlarge the opening enough to push the bowel back inside and sew it up once it is finished.

Option 2: If the bowel is stiff and swolen and or the baby's belly does not have the room to accept it all at once, they will perform a "staged closure". This is more complicated and takes some time. This invloves placing a "silo" over the bowel (this is basically a bag that holds the bowel suspended above the opening). This silo will be somewhat inserted into the baby's belly so as to allow the abdominal fluids to enter and thus healing the bowel by bringing the swelling down and making it malleable again. As the bowel heals and with a little assistance from the doctors the bowel will slowly but surely re-enter the baby's abdomen.

Recovery
A staged closure can take up to a week or two. So you may ask why does he have to be in the hospital for 5 to 6 weeks. Since the baby's system is not used to the pressure introduced by this bowel that is now inside the abdomen, and the bowel has been exposed to the amniotic fluid for so long, it simply takes time for the baby's digestive system to normalize. Aside from the digestive system, other things may be affected such as breathing due to the increased pressure inside the body. The baby's recovery can be broken down into three distinct stages. Pre-Surgery, Post-Surgery/Pre-Feedings, and Post-Feedings.

The first is simply the waiting period before the baby's bowel can be put back inside.

The next period is after surgery, the baby's system is still very fragile and can only be fed interveinously. During this time the amount of nutrients is slowly increased until the baby is ready for the final stage, when his body can accept real food.

Once on breast milk feedings from a bottle, the baby is closely monitored. The process is slow as the baby must phase into these feedings from the IV. Once the baby is up to full feedings and is gaining weight, we can all go home!

Long term effects
Once the baby has fully recovered and is ready to go home, he should be fit as a fiddle and have little or no related complications thereafter. The main thing that he may experience is a case of acid reflux, but this can be treated with medication and it usually will go away as he grows and gets older.