Meeting with the sugeon

Today Caleb was feeling: Grumpy. We're not surprised! LOL He is still having a bit of tummy trouble, and when he gets angry, his sats drop. Which isn't good... he had to have the O2 blow a few things today. That's basically just a big tube that shoots O2 at him. But when he's calm, his sats are in the 80s, which is great. They're supposed to sit at 60+.

One of his doctors brought by the pack of students that were learning today. I'm afraid I don't remember any of their names... I just remember Dr. Mazer, and I'm still not sure if that's the pregnant doctor or the dark haired one. ANYHOW~ The pack of doctors entered. There is one who has been leading on his case... Caleb just happened to be hollaring his little head off, and then the O2 monitors started beeping. The doctor turned to the pack, "That's how it works... first he goes off and then his alarms go off. He gets pretty pissed." Yes, the doctor said "pissed." :)

Oooh, and he's now taking ALL his food from the bottle. He hasn't used the food tube in nearly 24 hours. Finally he's got the family trait of loving food. He drinks it down quickly and is (go figure) cranky when his meals don't come fast enough.

Today the surgeon came by to talk to me. He was a nice guy--kind eyes and a gentle way of explaining things. He went over what the diagnosis was again, and what the treatment is. Also he talked about the risks and what would happen.

The surgery will take place on Monday. We should be there by 7am. The baby will go in at 7:30... after that they will give him anesthesia and then put something down his throat so they can make a echo real-time from the back side of his heart. This part will be about 1-1.5 hours. After that they will do the surgery.

First they will open the chest in the center, and then they will remove a gland in the front of his heart. It's a gland that is needed during their time in the womb, but by the time they're teenagers the gland just kinda shrivels up and goes away. It will probably be in the way, so out it goes! They will put the baby on the heart/lung machine and give the heart some medication that will allow it to live without blood (the drugs allow it to live for about 8 hours, this operation takes about 4). Then they will open the sack around the heart, then begin the arteral switch portion of the operation.

After the switch, they will reattach the coronary arteries... they are small little ones that pretty much have to be attached perfectly to the heart. It's the hardest part of the operation, as there is no wiggle room, and the arteries are so teeny. The good news is that out of all the configurations of arteries, Caleb has just about the easiest. This gives them a little extra "wiggle room."

Once this is done, the heart should return to normal function. The only long-term concerns they have specific to the baby (other than the normal complications that could pop up, such as narrowing, etc) is that one of his valves is only 2-sided instead of 3-sided. This may/may not fix itself as it gets older. It also may/may not be an issue when he gets older if it doesn't fix itself. It may/may not mean anything!! You get the idea... they don't know. They don't know how many people are running around out there with 2-sided valves, and sometimes there are issues and sometimes not.

Going back to now... the baby will have to have blood transfusions. Once to start the heart/lung machine, and then one at the end because the heart/lung machine removes the platelets (spelled right??) from the blood, and he needs those.

Once things are finished with the switch and they watch the heart function without the heart/lung machine, then there will be another 30-40 minutes of getting him ready to go back to the PICU. He'll be on the vent and sedated. His chest will probably not be closed.

What?? Not closed? You read that right. They will probably just cover it with a membrane for the first few days. The reason is that there is swelling after surgery and they want to make sure that the heart has room. They may/may not close it after the surgery right away if there is room. In a few days they will close up his chest properly. Then we wait until the swelling goes down.

When it goes down (the baby has to pee this out! Go baby!) they will be able to take him off the vent. Then, they need to teach him to eat again. We're looking at 2-3 more weeks in the hospital from Monday. He could be out by Friday of that week, but it could also be another month or longer. It all depends on him.

A-ha... aren't we glad that he's so cranky and stubborn now??

The surgeon was happy to see his spunk, and commented on the strong lungs he has. He is expecting things to go well, and I advised him to have a good Monday. He will be doing the operation with the other surgeon (who is on vacation this week). Together they will work on making the baby better! We can get a DVD of the operation after. I can't watch it, but I think the baby might like to have it when he grows up. Boys like that kind of thing!! LOL

As a note... some time tonight the baby will be moved from the IICU to the PICU... I guess that they have 19 beds in the NICU and they're full now. Caleb will go to the cardiac side as that is where he would be going after the surgery any how.