Alexandra: Post-Op / Mid-Week Update

Hi everyone, and welcome back! Sorry I am a day late... In case you hadn't figured it out, I write these things mostly at the bedside over a period of several days... so sorry if sometimes the text doesn't flow right and/or the subject-verb agreement isn't the way we learned it in 6th grade...

Post-Op Update

Alexandra's surgery was done first thing Monday morning; she was back in her room by 10 or 10:30. The surgery was relatively simple and straightforward, and initial indications are that it went as planned.

The result of the surgery should be to allow the stomach's contents to pass normally into the intestine. This will hopefully put an end to most of her vomiting and some of her spit up. She has been spitting up a little today, but we were warned to give it a few days and try not to be nervous parents. I have to admit I feel like a nervous Chihuahua on speed and caffeine pills washed down with a double espresso as I wait out these few days.

After her surgery, Monday was a little rough on her as you might imagine. She had some discomfort and some anxiety. The nurses (and respiratory therapists) did their best to keep her cozy. She was intubated (breathing tube down her mouth) and she knew it; it freaked her out every time she woke up. Also, she has a pretty sensitive gag reflex (she got that from Dad), so she kept gagging herself, which of course, made her freak out even more. As the afternoon transitioned to night, she started to get a little more settled. Suhey spent the night with her to give a little extra comfort that only a mom can.

Tuesday started off just the same as Monday - trying to keep Alexandra comfortable. By mid-day it was time to try to take the breathing tube out (mostly because she kept gagging herself on it). She handled being off of it like a champ! She was put back on CPAP, but at a higher setting (she was 5 for a few days pre-op, and is now 7 post-op). She rewarded us with her best blood gas EVER (PCO2 = 42, pH = 7.431). In the evening she was moved back into an open crib from a clear plastic incubator.

Wednesday she continued to thrive. Her blood gases kept looking great. For the first time EVER (that we can think of), she was not requiring supplemental oxygen... She is making due with the same ole 21% the rest of us live off of. She had been as high as 35%, so this is a great sign... especially when coupled with very reassuring vital signs. Her heart rate used to be in the 170's, whereas now it's 110's. Some of the nurses who know her from weeks gone by have commented how her expressions are much more relaxed now (she often had a look of concern and a wrinkled brow before).

Today she was out of her bed and sitting in a swing. She absolutely loved it. She was a smiling factory today for several people. Maybe she was also happy because her longtime neighor got to go home; he was here 7 or 8 weeks already before she was born...

Her Progress in General

So by now you may sense my enthusiasm for Alexandra's progress. I have to admit it's a great feeling, but please keep in mind she still has a while to go before discharge. The way I figure it, she probably has another 1-2 weeks on CPAP. After she's off CPAP, then we will need to see if she can learn to take a bottle. Previously we were told that could take 1-2 weeks. The bottom line is that you shouldn't think it's a setback if she is still here in a few weeks. If this surgery was the push she needed, she still has another few weeks here... But Alexandra may just be closer to the end than the beginning!!!