Tuesday, July 7, 2009

Pleasant Surprise

Day 11: Tuesday, July 7

This morning as Blaise was getting ready to go to his part time job he stopped and suggested that we go up to Salt Lake now and he could just go in to work for the afternoon.

On our way to the see Will, I got a funny phone call from University Hospital. They said that they thought they had me scheduled for an induction the night before and was wondering why we didn't show. I told them we wouldn't be needing that. : )

When we got to the NICU and approached Will's bed there were two respiratory specialists there. The nurse happily informed us that we had arrived just in time for them to take him off of the ventilator (remove his breathing tube). Apparently Will had responded so well to the weaning they had been doing since his surgery that they decided to let him try breathing all on his own. We couldn't believe it! They took the breathing tube out and just gave him a cannula for his nose to help him out with a little oxygen (just 30%). So we were there to watch him struggle taking his first breaths flying solo. He did so well. The nurse said that they planned to watch him very closely. She said they would keep him off the ventilator if he could "prove himself". That meant having a respiratory rate between 30-60 and not being too stressed or strained. We sat at the bedside for a little over an hour and he passed with flying colors. We cheered him on as he got the hang of the breathing thing.

Along with taking him off of the ventilator they needed to take him off the sedation so that he can be more aware of trying to breath on his own. With that we are hoping he will be more awake for us in the coming days. Maybe we'll get to see what color his eyes are soon. They also decided to scale down his pain medication. Up until now he has been on a constant flow fentanyl which the nurse said was many times stronger than morphine. Now they have him on scheduled doses of morphine for pain.

Will reached yet another milestone or two today. They removed the cathiter; just one more thing that he gets to do on his own now. Also, he has had a direct line into an artery in his arm (that's is why he has a splint on his left arm) that they have used to draw blood regularly for blood gas tests. Well, those blood tests have been coming back with such normal levels that they decided to remove that as well.

He is just shedding these needles and tubes left and right! The nurses seem confident that we will get to hold him tomorrow. We are hopeful that this is the case and we've made plans to go up first thing tomorrow morning. We can hardly wait.
Posted by Picasa
Posted by at

4 comments:

  1. Joseph & AngelaJuly 7, 2009 at 8:44 PM

    That is awesome to hear that he is doing so well, and that would be great if you got to hold him tomorrow. Hope all goes well in the the coming weeks, and that he will continue to shed those needles.

    ReplyDelete
  2. JessJuly 7, 2009 at 8:46 PM

    That's so exciting! I'm glad to hear that he's doing so well. I hope you get to hold him tomorrow, that will be a sweet moment. We will continue to pray for all of you.

    ReplyDelete
  3. BeccaJuly 7, 2009 at 9:49 PM

    I have loved seeing your updates every day. I am totally cheering Will on and couldn't be happier that he is doing so well. He's lucky to have a mom and dad who are so involved and on top of his situation. Keep up the good (
    and strong) work! My fingers are crossed that you get to hold him tomorrow--you'll be in our prayers tonight!

    ReplyDelete
  4. Teancum and BrookeJuly 8, 2009 at 9:34 PM

    You are in our prayers and we hope all is well! He is very cute! Let us know if you need anything!

    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.