Thursday, October 12, 2006

10/12/06 - NICU Day #10

  • PDA ligation successful and uneventful.
  • We visited at 7 AM and then again at 9 AM. He looked great both times but his blood pressure was 51/19. The very wide pulse pressure belied his stability.
  • He passed a lot of dark stool (probably meconium) at around 9:30 and then again just prior to the start of the surgery.
  • The anesthesiologists started at around 10:45 AM. We waited in the Family Room. The surgeon sent a message in that the start had been delayed because the endotracheal tube needed to be replaced again. Better that it require replacement before the procedure than in the middle. At around 12:15, the surgeon came to the Family Room to inform us that the PDA ligation had gone smoothly. The recurrent laryngeal had been visualized and moved and was identified after the placement of the hemoclips so any potential damage should be minor.
  • We went to see Daniel immediately after the procedure was over. His blood pressure had already improved to 55/31. He was still limp from the anesthesia but it was such a relief just to see him.
  • The post-procedure CXR demonstrated the hemoclips by the aortic arch and a minimal left apical pneumothorax. Also, his lungs already looked clearer than the prior mornings film. Of course, that is likely due to fluid restrictions and the lasix from the prior 24 hours but it was still terrific to see. The images of the abdomen looked unremarkable.
  • Now, we just wait for him to wake up and start moving around again -- that could take 24 to 48 hours. The chest tube will most likely come out in 24 hours. His tube feeds probably won't restart until after the weekend.
  • A few hours after surgery Daniel's blood pressure was down to 44/18. Repeat checks with various cuffs measured pressures as low as 40/15, MAP 23. We discussed this with the attending and the fellow and they assured us that the pressure will normalize over the next 24-48 hours. The earlier higher pressures may have been due to mucking around near the baroreceptors in the arch of the aorta. If the pulse pressure stays wide, they'll re-echo him.

11 comments:

noah.lichtman said...

We have been thinking about Daniel Louis and everyone all morning. I've been refreshing this blog today more often than when I'd watch the Reds score on-line when they were still in the pennant race (Sara can vouch that is a lot). Thank you for the update. Daniel is staying in my thoughts.

anythingbutlaw said...

We have been waiting for the surgery update and are delighted that things went so smoothly for Daniel. Thank you for keeping us updated on his progress. He is always in our thoughts and prayers. We send our love to all of you.
Tony, Phyllis and Caroline

Joseph said...

Thank you for updating us on this so quickly. While I definitely love to hear that Danny-boy is doing well, I also appreciate updates on stool color and frequency.

Ross said...

Dr. Stein - we wait in rapt attention in the reading room for the latest news of your progeny.
Dr. Wolf says "rock!"

MF

Michael said...

Just wanted you to know that we thought about you, Jenny and Daniel all day. I am glad the sugery went well.

We love you!!!
Rebecca, Michael, Jessie and Lizzie

GBerg said...

Evan< Jan and Daniel, We are still praying with you and for you all. Love, the Bergs

Hercules said...

Great News E&J -- thanks for the quick update. Make sure he has an extra blanket tonight -- his first taste of that wind blowing off the East River is on its way!

Kendra said...

Jen and Evan, I'm so happy to hear your updates and details. Thank you so much for keeping us updated daily! You're in our thoughts and prayers. Best wishes, Kendra

Kavita said...

Hi Evan,

Just wanted to let you know that I've been reading your blog and that we were all thinking about you today.

Kavita

bahar said...

Hi Jen, Evan, and Daniel,
I am so happy to hear all went smoothly with the mini-procedure! A big smile, hugs, and prayers coming your way. Little Danny is a fighter :) I am still waiting to hear from my friend (think she's been on call) but as soon as I do, I will send along that phone number. All my love, Bahar

Kimberly said...

Fantastic news. We are all down here sending up good strong energy and a big hug for Daniel. So glad to hear the surgery went well.

We'll check in later--love the new tummy photo.