Tuesday, May 19, 2009

Fundoplication Results

Surgery went fine. The only complications were half expected, and totally prepared for. The intent was to go in laparoscopically, so they inflate the abdomen with CO2. This pushes on the diaphragm, and puts some pretty decent pressure on Eli's lungs, and they didn't take that very well. Think of the lungs like a sponge... they were squeezed pretty hard, and couldn't do their job. So they had to deflate the abdomen and perform the surgery classically, with an incision. Otherwise, everything was as expected. One fundoplication, one G-tube.

The squeezing of the lungs caused a little trauma, so they're using the respirator to restretch those lungs back out. Eli will probably be intubated for a couple days so this can happen. As we left late last night, his numbers and bloodwork showed the lungs to be performing their job better than immediately after surgery, so he appears to be on the right track. This is good, as they'd obviously like him sedated for as short a period as possible.

Eli's next step is still a few weeks out, when they take him to the cath lab to measure blood pressures inside his lungs. This is how they'll be able to tell if he'll be ready for the Glenn procedure, where they route the superior vena cava (upper body return flow) directly into his lungs instead of to his heart. Here's just a quick recap:

Your typical cardio system has a flow pattern of: Heart>lungs>heart>body, repeat. The heart pumps blue blood to the lungs, it comes back to the heart red, then gets pumped out to the body red, and comes back blue. Repeat. Eli only has one pumping chamber, not two, so his blood flow will be altered to: Heart>body>lungs, repeat. Red blood will go from the heart into the whole body. On the blood's return path, it will make a passive journey through the lungs, turn red, and come back into his heart. Repeat. His blood's flow through the lungs will only be passive, not pumped like yours and mine, so the lungs have to be in good shape in order to still flow blood even though the blood pressure is now much lower.

And there's your anatomy lesson for the day! Thank you for continued prayer, continued support, and a continued outpouring of love on us. Today, we're headed to the zoo with Paige, then lunch with Nana, and the afternoon with our sedated little boy.


Kimberly said...

You guys are in my heart, thoughts, and prayers every day.

Heidi Short said...

Continuing to pray for your family. And thanks for the lesson of the day :)

Anonymous said...

Couldn't make it sunday, but prayed just the same. What a trooper that Eli is! Hope your day at teh zoo was great and hope your strength is holding up. We're still praying! The Ayers

T&B said...

Much love to all of you.

Rebecca Parker said...

Good job making cardiac blood flow anatomy and physiology simple! One of the things I always thought when I was in nursing school was that they made things harder to understand than they really needed to be!

Continuing to pray for Eli and your family. May the Lord give you joy today.