She is back

Our poor little girl.  We have talked with the surgeons.    Poor baby.  I will try to explain this since I don’t understand it that well.  In her fundoplication they took the stomach and wrapped it around the esophagus.  The fundus of the stomach is sutured (stitched) to hold it in place.  This makes it tight and hard (or almost impossible) to burp or vomit.  When they opened her up, they saw that where the fundus was sutured was necrotic.  That means the tissue had died.  And there was an abscess.  There was a perforation and lots of fluid.   They had to remove the dead tissue.  They removed the puss and cleaned everything up.  They re-did the fundo.  She has a drain. 

She looks wonderful!  Her skin was all marbled, even though she was stating well.  Now she has beautiful skin again.  Our fellow says we have earned a few more days stay here in the PICU.

To explain some of the tubes and wires.  She has a drain in her mouth.  It is draining the contents of her tummy.  Then there is the trach.  She has her leads to measure her heart rate.  She has a g-tube.  A drain.  A foley to collect urine.  Her blood pressure cuff.  Her pulse ox to measure her oxygen saturation levels.  While in surgery we was given a new double lumen central line.

Implications:  She now has a partial fundo.  Will it be able to perform the job that we need it to do?  We’ll have to wait and see.  But the fact that the tissue was dead explains why she was able to vomit this morning.  Her nurse and I looked at each other – shocked!  She should not have been able to do that.  Now we know why.

Her vent settings have been turned up.  She cannot have any meds in her tummy.  Most of her meds can be given by IV, but her pulmonary hypertension meds cannot.  So we are going back on Nitric.    They have re-started her sedation drips.  After she recovers, she’ll have to re-do all of her weaning.