Thursday, May 17, 2012

Pre-Op: Done!

With a bit more anticipation than usual, we got all ready for today's prep for the Fontan.  It was really pie.  The blood draw was dreaded but they got it over and done in one stick (thank you nurses!)  Olivia was hysterical for the duration, but I guess as sad as it is, I'm becoming hardened to her hysterics with all things medical.  Our Nurse Practitioner is actually a friend of a friend so that made it even better.

Chest x-ray was a snap and the four hour appointment that they had us all prepped for was over in two hours.  That's about the only experience we've ever had where we got out faster than expected.  Who knew?

The Pediatric Surgical Heart Unit (PSHU) has been below census in their ten beds for months.  This week? They are booked solid and have four sweet little babies on ECMO all at once.  It comes as no big shock given that there were four Norwoods done the week Liv was born and when she was in for the Glenn they were so over-booked that we got kicked to the PICU to spend that dreaded "Black Friday" on August 5th, 2010.  Ideally she goes to the PSHU but the PICU is a little more lax so there's trade-offs for both; whatever is best for her care is paramount.  Goal is she comes out extubated, stays nicely sedated all of Monday and most of Tuesday.  By Wednesday morning we should be able to start giving her minimal fluids and food.  She will be on fluid restriction until they've deemed her chest drainage to an acceptable level and we confirm that she didn't develop a chylothorax.

Chylothorax: A sort of pleural effusion (build up of fluid in the tissue within the lungs), in this particular instance she would be dripping fat into her chest cavity and have to go on a fat-free diet until the milky white fatty liquid stops draining

Post-Fontan is a little different than I had envisioned.  They're going to want to see her pretty regularly again for cardiac clinic to make sure she's not retaining fluid, adjusting lasix as needed and she'll need to go to her peds or the local lab near us to make sure her Coumadin is at a therapeutic level.  After the first 90 days on Coumadin, it sounds like we will be dispensed a meter similar to a glucometer for diabetics that will measure her clotting levels and make adjustments as needed based on the readings I get from her.  I dislike this but prefer it to constantly taking her in to get the levels read so it's all about the trade-off.

Still waiting on the exact time for the surgery on Monday but the hospital has already called to tell me that her bloodwork came back great and they found the results to her holter test which was perfectly normal.  I do love getting good news!

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