Friday, May 7, 2010
When they say it's by the book...
Something always goes wrong. So we were scheduled for take down at 1230. I got a call around 0830 saying they were ready for him. Great! We'll get the take down done, into recovery, and up to the floor and he'd be up and talking around dinner time!
Um, No. So they take him into Pre-Op around 0930 and I make my way up to the Peds floor to pack Isaiah's stuff. He's moving to the PICU due to having surgery - no big deal, same routine.
However, as I walked down to the PICU at almost 1000 I found three of the main surgeons for the Team outside of the PICU - one of which is scheduled (and so I thought was already there) to be in surgery with Ike. I get a phone call update about 10 or so minutes later stating the Surgeon is getting ready to start the take down and the central line is done.
Ok - fine. Moving on to about 1230 get a call stating we're all done and Isaiah is moving to recovery. Normally we wait till they call again because Isaiah isn't really awake and they're just monitoring him coming off anesthesia. I get another call around 130p saying he is up and calling for me, so I wander back to the PACU and find the boy wanting me and mommy and pain meds - all normal since this is the 6th major surgery we've had with Isaiah, as sad as it may sound this is all routine. We know what meds he's going to be given and for how long, which ones work best and give him the most comfort.
So, I find out during this time that the initial placement for his central line was going to be on his left side, but because he's had so many lines and developed scar tissue, it had to be placed on the right. Ok, so why am I being told this? Because - they punctured Isaiah's left lung with the first placement and now he has developed a pneumothorax - or an air pocket from the top of his lung partially collapsing. And we're just getting warmed up.
So for the next 30-45 minutes I get to witness Isaiah have to go back under anesthesia, get his left rib "opened" so they can insert a chest tube to relieve the air pocket. You can google pneumothorax and see the treatments/issues with this type of procedures - but I can tell you it was interesting. Four x-rays later, and we think we have it in the right spot.
So we finally get him through all of this and he wakes up around 330p. Up to the PICU to monitor recovery. So around 430p, the team feels like the chest tube needs to be flushed and checked again. Ok - so what do we find?
The chest tube from the top-down looks like it is in the perfect position. However, from the lateral view we find the tube has not even entered the chest and has found it's way to his back. I don't even know how to describe the whole thing. What I do know, is Isaiah is put back under sedation, the correct hole is made and the tube is placed again.
I'll stop now. Let's hope this is not a sign of how this recovery is going to go.
I admire Isaiah's strength. This boy has had a liver biopsy, a tube down each nostril, a chest tube placed (twice), a central line placed (twice), his intestine sutured and placed back in his body, and a catheter just for good measure all within the last 24hrs.
God be with him and his recovery.