livingwithevan.com

Author: William

  • Days 3 and 4

    Days 3 and 4

     

    We have had a couple pretty good days. Erica was our nurse on Thursday, she was our favorite nurse from our previous stay. Evan continued to rest and recover. Erica sat him up hunched over some bundled blankets and he really loved it. He spent most of the day sleeping sitting up or sitting there looking at everything going on around him. Everyone was so enamored with our little man and how cute he was when he was sleeping but how serious he looked when he was awake. Sitting up helped some more fluids drain off of his chest and put us in great position to remove the chest tube on Friday. We found a burn and blister under Evan’s neck, this can happen if the Betadine solution they use prior to surgery for disinfecting the area is not all wiped up. We have some burn cream that we need to apply 3 times a day. I’m sure this doesn’t feel good and being under his neck there it’s never allowed to get any air because of Evan’s little neck rolls. Evan continues to be on constant pain meds, Tylenol, Motrin, Oxycodone are scheduled so that he’s never without something and the occasional small dose of morphine if he seems to be in pain.  

    We knew that Thursday would be our last day in the ICU, it was just a matter of when a bed would open up. We were not in any hurry to be honest. We like the 1 on 1 attention in the PCTU much better than that of the care you get on the general floor. I’m not saying the care is bad, it’s just that things don’t get attended to nearly as quickly because a nurse has 2 other kids to tend to in addition to yours. Alarms and cries go much longer before they are attended to, so I feel really guilty when I am not here. I don’t want Evan to lay crying for who knows how long before a nurse comes in to see what’s going on. Finally at about 7pm on Thursday a room opened up and we were transferred to the general floor. Oh and FYI… when I say general floor, it’s more like general cardiac floor. All of the kids around us are heart kids. All of the 11th floor is cardiac and much of the 10th is as well including the 31 bed (currently only enough staff for 17) PCTU. The picture on the right is of the television screen on the wall in our room. This TV is our portal to many movies, hospital videos, internet, and we’re even able to order food.

    Thursday night was an interesting one… full of gas and runny stool. TMI? Evan had the worst diaper we have seen so far, it was like a lake in his pants. We had to change his bedding and a couple of his bandages because it was everywhere. All over his chest tube, g-tube, femoral IV, it was really bad. I have a picture but I’ll save you from that, LOL. Drainage from his chest tube had slowed to less than 10mL per shift so it was decided to take the chest tube out. This was done on Friday morning and Evan seems to be much happier without it. Additionally, Evan had an echocardiogram and EKG done and the results from them were normal. They did see slightly reduced function of his heart than what they saw pre-op but I would expect that since they hadn’t restarted all of his heart meds.  They have since restarted his meds and his feeds have continued to go up. We’re doing continuous feeds with a pump at the recommendation of the gastroenterologists, who we’ve consulted about all of the puking that Evan as been doing.

    We’ve made some friends during our stay here. Brian and Kim Sidlauskas have a son Ethan who also has a CHD and is here for another surgery. Kim and Sarah actually went to high school together. They have spent much more time at the hospital than we have, little Ethan was here for a solid 6 months the first time and Ethan had to go home with a trach and ventilator. All of that is gone now and Ethan is recovering from his next surgery and is doing pretty well. Please keep this family in your thoughts and prayers as well. We met another family while we were here as well, the daughter’s name is Avery and at their 2 month checkup the pediatrician heard a murmur, they had heard this before but didn’t give it much merit because the whole family has murmurs the pediatrician continued to look into it and it turned out that Avery had to be rushed to Ann Arbor and scheduled for immediate surgery to repair her heart. I’ll have to find out the name of her condition again, but in general, many of the arteries and veins around the heart were in the wrong place and connected to the wrong things, additionally there was an extra artery going up her neck that needed to be tied off. She had surgery Tuesday morning (this was the case that bumped us from 1st case of the day to 2nd) and is doing well. The family is now on the general floor a couple beds down from us. Mia Wilson continues to fight allusive infections, and now osteopenia which is low bone mineral density, this was found out after it was realized that poor Mia had a broken bone in her leg.

    Friends from Lansing came to visit today, Tony and Jennifer Knapp. We visited with Evan for a while, went and had some dinner, and visited with Evan some more. I see that look in Jennifer’s eye, like she wants to steal my baby. 😉 We saw our first smiles since before the surgery today, thanks to Jennifer. Thanks for coming you guys, it was great seeing you.

     

     

     

     

    Our hurdles before going home, in my eyes are:

    1. Getting him off of oxygen, so far they have attempted to wean him and each time they do his SATs drop and he needs to go back on the oxygen. We want to know what’s going on with that.
    2. Consult with GI… we met with them and a GI study was mentioned but I don’t think it was scheduled because Evan was on Morphine at the time. Are we going to get the study before we go? Are we going to leave and come back in a week or two once he’s settled and not full of pain meds? Or are we going to skip it since they can get copies of the studies done at Bronson? Do the Bronson ones show enough of what they need to see?
    3. We need to know what to do with his feedings. GI said that we should continue doing continuous feeds on the pump for a few days and then start progressing towards bolus feeds (bolus means all at once) but we don’t have a scheduled or know exactly how to do that. Nor do we have a feeding pump or know how to use one.

    These things could be figured out pretty quick so we could go home yet this weekend or on Monday.. Less than 1 week in the hospital?! Evan, you are amazing.

    Here are some pictures from the last couple days.

  • Hemi-Fontan Update #3 :-)

    Hemi-Fontan Update #3 🙂

    The nurse came out again at around 5:30pm and told us that Evan is off bypass and everything went great. They are waiting for some of the normal bleeding to stop so they can close his chest. Once he’s closed they will take him to the PCTU (pediatric cardio-thoracic unit) and we’ll get to see him about an hour after that. So, maybe at about 7:30pm. The nurse indicated that Dr. Hirsch is very happy with the outcome and she’ll be out to talk to us soon.

    We took this image a couple days ago… you can see that his feet are fairly blue in comparison to Sarah’s hands. This is why we’re here. The oxygen level in his blood is getting lower and lower as his body grows out of his shunt. With this surgery, the shunt is being removed and the top half of his body will provide blood to the lungs. As his body grows, this operation will continue to grow with him.

    Look at how much Evan has grown in the last 5 months! Click on the image to see it bigger. That’s Dr. Hirsch holding him.

    While I was writing this post Dr. Hirsch came to talk to us and reiterate how well the surgery went. She did have problems getting into his chest because of the scar tissue that is there and she put a piece of GoreTex between his abdominal wall and chest cavity so that getting into the chest next time will not be such a problem. She used the word “scraping” which made me cringe. He may have some extra drainage because of all the work that it took for her to get in. Evan’s pacemaker was turned off and an external pacemaker was installed temporarily due to the cauterization tools used during surgery. The pacemaker will be interrogated tomorrow to make sure there was no impact. She was not happy with where the surgeon in Kalamazoo put the G-tube (in the middle of his chest just below his sternum), which made us laugh because he was complaining about where they put the pacemaker. Apparently if they know the child is going to need a g-tube they put the pacemaker on the right side so the tube can go on the left. They put Evan’s pacemaker on the left… Why? Just assume that these kids might need a g-tube and put the pacemaker on the right all the time. In any case, because of the placement of the g-tube and pacemaker there is very little ‘real estate’ for pacer wires, chest tubes, etc.

    Here are some pictures of the day so far for you to enjoy.

     

  • In waiting…

    The first case is running late do we’re waiting in pre-op.

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    Always with that foot in the air. 🙂

  • Today’s Heart Cath went splendid!

    Today’s Heart Cath went splendid!

    The title says it all. Evan was amazing today and his heart cath went really well. It was an exhausting day for everyone.

    We were supposed to be there at 7AM but we were running late as usual. We got up at 5 AM and were out the door at about 5:45. We arrived about 30 minutes late but it didn’t seem to make much difference. First we went to radiology where Evan got a chest X-ray that he was not too happy about. We’ve never had a chest x-ray like this one…. all strapped up.

    We met with Shannon, a nurse practitioner, and went over general stuff like height, weight, meds, etc. Evan had an EKG and his pacemaker was checked out. At about 10AM we were moved to the pre-op area and started getting Evan ready. They took him at about 11 and we went to see Mia Wilson and grab a bite to eat.

     

     

    Ha… I spit on your silly sedatives.

    Just after 1PM our pager went off to let us know he was done. The cardiologist performing the cath, Dr. Aiyagari came out and gave us the good news. Everything went really well and his heart looks great for surgery next week. The only bump they ran into (which the anesthesiologist had already came out and told us) was that the sedation they wanted to use did not work on Evan, it actually had the opposite effect and they had to intubate (breathing tube/ventilator) him and put him completely under. Apparently Versed is like candy to Evan and it just amps him up. This is something we’ll need to remember for the future as this isn’t the first time he’s reacted this way to Versed.

    Evan's Heart Cath pictures

    If you click on the image on the left you can see some of the images that they captured of Evan’s heart and arteries. In the top left you can clearly see Evan’s pulmonary arteries, these are the ones that provide blood to the lungs. In next weeks surgery the superior vena cava (the large vein that empties the blood from the top half of the body to the heart) will be removed from the heart and attached to this artery to provide blood to the lungs instead of the shunt that was placed during the Norwood procedure. You can read more about all three operations here. Dr. Hirsch (the surgeon that performed the Norwood and will be performing next weeks surgery) came and talked to us and was extremely pleased with the size of his pulmonary arteries. Yay Evan!

     

    EKG, and Pacemaker Check… all while Evan eats his drumstick.

    We got back to see Evan at about 2:45 pm and he was very awake but clearly still sedated and in need of some sleep. He fought off sleep until 4:30 when we got him unhooked from everything and headed over to see the Wilson family and  then head home. They hold patients for 4+ hours after a heart cath to make sure that there is no bleeding at the catheter site (Evan’s right leg, femoral artery and vein). During this time we had a few visitors including Nurse Bethany and Nurse Practitioner Staci. Bethany took care of Evan quite a bit when he was there  for the first surgery. Staci checked out his pacemaker again and another EKG was done both with the pacemaker turned on and off. The doctor’s need to determine if they are going to replace Evan’s pacemaker next week or wait until surgery #3, the Fontan, which will occur  at about 2 years old. If you recall, Evan’s current pacemaker controls his ventricle only and at a  set pace, it does not increase/decrease like ours would when we get excited. This one was installed because it’s much smaller and all that an infant needs. The intention was always to replace it with one that senses the atrial beat and tells the ventricle to beat just like yours or mine, it’s just a matter of when.

    Momma tells Evan how proud she is of him and all that he's gone through.

    Right now we are scheduled for first case on Tuesday, which means we need to be at the hospital at about 6:15AM. Yuck. Typical stay for surgery #2 is 5-10 days, and we’re told this is the surgery that kids recover the quickest from. I’m interested in hearing from other heart families how their hemi-Fontan went and if their kid had the ‘hemi-headaches.’ How long did they last? How bad was it? Did you just give tylenol regularly, did it help?

    Here are some pictures from the day. Everyone have a safe and happy new year!

  • Surgery moved up.

    Just wanted to leave a quick note to let everyone know that Evan’s heart surgery has been rescheduled. We will go in for the heart cath tomorrow morning and the surgery will be on Tues. January 3.

    Here’s my understanding of what is going to happen tomorrow:

    Arrive at Mott @ 7AM
    Meet with a nurse practitioner where we’ll go over some pre-procedure testing including:

    • anesthesia (he needs to be sedated for this echo to make sure they get perfectly clear pictures)
    • echocardiogram
    • chest x-ray
    • EKG

    We’ll go to the cath lab at about 10AM and this will take 2-3 hours. Heart catheterization, if you don’t know, is a procedure in which a catheter is placed into an artery and moved into the heart to look (it has a camera on the end) at the chambers, valves, etc of the heart. Pressures and flows can be measured and if necessary samples can be taken of blood or heart tissue. If you would like to know more you can read about it here. After the cath lab Evan will be moved to recovery. Recovery takes about 4 hours, after which we will come home.

    Please continue to keep Evan in your thoughts and prayers as he goes in for another procedure tomorrow and surgery next week.

  • Merry Christmas!

    Merry Christmas!

    Have a safe and happy holiday!

     

     

     

     

     

     

     

     

  • Open Heart Surgery #2 Scheduled 🙁

    It’s been a few weeks since we’ve made a post… sorry about that.

    Here’s what has gone on the last few weeks…

    Since the G-tube surgery Evan has continued to gain weight very steadily. In the last two weeks he’s gained a pound. His current weight is about 14 lbs 12 ounces. Feeding orally has unfortunately gotten worse. We think it’s from the constant puking that he’s decided that food in mouth = puking and he doesn’t want any part of it. We’ve stopped trying to feed him orally all-together as to not reinforce whatever it is that has made him hate it so much. On Wednesday we had our first visit with occupational therapy. The therapist evaluated Evan by watching his reactions when she touched his face and mouth with her gloved hands. He was not having a very good day, worse than most and when she put her finger in the front of his mouth he started retching and puked. It was at that time that she told us that Evan was the most oral averse child she’s seen. That wasn’t very comforting to hear but at least it allows us to put in perspective how hard we’re going to need to work to fix this. We’ve temporarily switched to straight formula wondering if something Sarah eats is upsetting his stomach. So she’s going to give up dairy in the meantime and if the change in formula works we’ll try the ‘dairy free’ breast milk. If the formula change helps and the same is true of the dairy free breast milk that would be great. If Sarah’s diet change doesn’t help and the formula does then I guess we’ll switch to formula but that would be a real disappointment. Sarah works very hard for that milk… pumping 5+ times a day, the endless pump parts to wash, lugging it around with her wherever she goes, always having to schedule things around pumping. It would be a shame to see the 2+ months worth of milk in the freezer go to waste. Spending $235 per month on formula vs the zero we spend now is another negative.

     

    We had a follow up appointment in Ann Arbor with Neurology for the stroke/seizures that Evan had back in August. Dr. Lieber was very happy with his progress, he didn’t see anything out of the ordinary. So far Evan has developed very well, and we’re not seeing any negative impact of the brain injury. We’ll follow up with them again in 6 months.

     

     

     

     

    It’s Christmas time and what is a must for kids at Christmas? Sitting on Santa’s lap of course! Our friend’s brother dresses up as Santa at Christmastime for events – and since he had the costume laying around he thought he would offer to be our personal Santa so that we don’t have to lug everyone to the mall.  It was very kind of him to drive from Grand Rapids (yes in costume) to walk into an ambush of babies.  Getting 5 kids ranging in ages of 4-13 months in a picture with Santa is no small task. Shear chaos, but it was fun.

     

     

    We’ve been seeing the cardiologist every two weeks and so far everything has looked great. Our appointment two weeks ago was no exception, Evan’s oxygen saturation (sats) were in the low 80’s which is great given his heart condition. After leaving last time and not having an appointment for another 2 weeks we really thought things were looking good. If you would have asked me yesterday I would have told you that I thought Evan’s surgery would not be until early February.  Today’s appointment didn’t go as well. His sats were in the mid 60’s today. What gives? Well, he’s a growing boy… His shunt, only 3 millimeters wide can no longer supply enough blood to his lungs to keep up the level of oxygen in his blood. As he grows it’s only going to get worse. The cardiologist performed another echocardiongram to look at his heart function and the shunt, both of which were good. Then she told us that she was going to call the surgeon at U of M and let her know that it was time for the next surgery. We were taken back to say the least. We left the appointment with heavy hearts and lots of dread. I went back to work and attempted to get some things done but all I could think about was my beautiful little boy and what he’s going to have to go through… again. A short while later we got a call. Evan goes in for  a heart catheterization  on Jan 5th and the surgery is scheduled for Jan 6th. Less than 2 weeks away. 🙁

     

  • Happy Thanksgiving!!

    Happy Thanksgiving!!

     

    This year we are thankful for all of the wonderful doctors and nurses at Mott Children’s Hospital and Bronson Methodist Hospital. Their dedication to helping children and families is amazing and we’ll be forever in their debt for what they have done for Evan.

    Have a wonderful and safe Thanksgiving!

    Thanks Erica for the beautiful hat.  🙂

  • Home!

    Just a quick note to let everyone know that we were discharged from the hospital this evening and are now enjoying being back at home with Evan. Evan was pretty fussy this morning but that has passed and he is nearly back to his normal happy self aside from a nasty cough from being intubated. We have a follow up appointment tomorrow with the cardiologist and with the surgeons office to talk about all of the do’s and don’ts of the g-tube. Here are some pictures from today. TUBE FREE! 🙂

  • Recovering in the ICU

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    We’re hanging out in the ICU. Evan seems comfortable now and is getting some sleep. We’ve started feeding him through the new tube and so far he’s tolerating it.