Fontan Surgery: December 7, 2010

This morning before surgery...

Sporting the hospital gown...

Getting sleepy...

Almost time to say good-bye...

10:23 am
Praise the LORD, Tyson finally made it to the OR! That's farther than he made it last time :) Passing him on to the anesthetist was not too traumatic for him or us. After taking some sedative medication, he was in a happy, drunken stupor and kept giving me silly grins. Once he finally went to sleep peacefully, they took him from my arms and carried him into the OR. Even though we had to let go of him, we know that God will never leave his side. The surgery is expected to take between 4-6 hours and we will post an update as soon as we can. Considering it's going to be a very busy, draining, tiring day, the update may not come until later in the afternoon/early evening. We will update on Tyson's progress by adding on to this blog post.
Please keep praying for our little fighter, and of course the hands of the surgeons.

12:37pm
Dr VanArsdell just came out to tell us that he has completed both the Coles procedure and the Fontan. YAY! The left pulmonary veins are still small, Dr. V could not shift the veins as far as he had hoped, thus he couldn't make the openings as wide as he had hoped, but he did the best that he could. We will wait and see what happens. Once the scar tissue from this surgery has completely healed, it is "conceivable" that he could try again to open them further, but we won't know if that possibility would become a reality for quite some time. Time will tell. It's so tough not knowing exactly what God has in store for our little guy but we entrust him into our Father's hands, knowing that our only comfort in life and death is that we belong to our faithful Saviour, Jesus Christ.
Tyson still has to be stitched closed, and then they hope to take the breathing tube out. It will still be a few hours before we can see him, since closing the chest takes time and he also has to be stable in CCCU before we can go in. Please keep praying :)

2:45 pm,
We just saw Tyson for the first time. He is stable in CCCU, but he had to be reintubated in OR because he wasn't quite ready yet. I hate seeing a breathing tube in his mouth...I was hoping he'd pass that milestone with flying colours. He was still pretty sedated when they tried extubating, so they think he was just still too sleepy to breathe properly on his own. The settings on the ventilator are quite low, so he is doing most of the work on his own. They will give it a try again later this evening, after he wakes up a bit more. These trials with extubation/reintubation are tricky, because he has to be awake enough to breathe well on his own, but with Tyson's temper, we don't want him too alert that he starts yanking at tubes and wires. The breathing tube is in his mouth, which is a good sign. Usually with prolonged intubation, they insert through the nose. So at least we know the plan is to extubate quickly.
His O2 sats were 92 when we got there! We've never seen numbers that high with him ever! Dipping to high 80s over time. His blood pressure was a little low immediately post-op, so he is on appropriate meds for that too.
Right now he looks pretty sorrowful. Sleeping peacefully and not aware yet of what just happened. But he's full of chest tubes and pacing wires, a catheter, breathing tube, and other things. Slowly but surely though, these things will be gone.
Keep praying for his stability :) and wisdom for the doctors/nurses caring for him.

7:25 pm
Tyson is slowly waking up. He's a Kottelenberg, it takes him a while :) There are a few computers right in the CCCU waiting room, so it is MUCH easier to get to a computer to update regularly than the last surgeries :) So you can expect to hear from us frequently! And we LOVE reading your comments, so please don't be shy and let us know you're checking in :D
The plan is to extubate as soon as he is fully awake. Of course, I want him to hurry up and wake up so that we can sleep peacefully tonight knowing he is breathing well on his own. So I was coaxing him and taunting him a bit this afternoon.... "Tyyyy-sonnnnn! Wake uuuuuup!" He would frown, shake his head, and say "No." Even though the breathing tube is in and we can't hear any sound coming from him, I knew he was saying "No" because we can lip-read well :) LOL

We're in pretty good spirits. Right now we are laughing at Brian's Dad making friends with complete strangers. We met a pastor and his wife here in the CCCU waiting room, so Brian's Dad figures that they've got a lot in common and yaps on and on about his trip to Israel last year. We all cracked up pretty good when he asked the pastor if he's ever ridden a camel before :)

It's been nice having my parents and Brian's parents with us all day. No one's in a hurry to go home; they're all hanging around because they are waiting to see Tyson without the breathing tube.

Once shift change is over and we are allowed back in the room (8pm) then the first thing on their agenda is to pull the breathing tube out. Hopefully Tyson responds well to this. His sats have dropped to the lower 80s, but no one's sure why yet. We're not panicking quite yet. Low 80s are still good, just not the best numbers yet.
Tyson is on bloodthinners (heparin) and epinepherine (heart med) and they've stopped morphine for now in an effort to get him to wake up more. If he needs more morphine later, they can give him some directly into an arterial line, and it will take effect within about 30 seconds. For those of you who know Tyson well, you know that he'll certainly let us know when he's in pain :)
That's it for now. More later tonight, once the breathing tube it out!

9:25 pm

Ok last update for the day: Tyson is extubated and doing well! Saying "owie" a LOT, and asking for something to drink. But he's not allowed anything to drink for another few hours until they are sure he won't need to be re-intubated. Now that he is awake and agitated, it's time to give more morphine, so he will hopefully calm down and be more peaceful. We didn't actually get to witness the extubation, even though we wanted to experience this milestone with him. During shift change, (7-8pm when no parents are allowed in the room) he woke up with a vengeance, and couldn't reach the breathing tube because his hands were restrained. So he started sliding his bum down the bed and bending his head down lower as he slid so that he could grab at the tube. The nurses and respiratory therapist had to act fast and get the tube out quickly before he self-extubated and damaged something in the process! So when we came in to see him at 8 pm, he was breathing on his own and saying "owie owie." Poor guy. The first night will be the roughest. It should be clear sailing from here, provided that he continues to make upward climbs :)

God is good, God is good, God is good, God is good!

G'night!

Mel:)