After surgery

Eliza's surgery on Thursday went as well as we could have possibly hoped. They took her down to the O.R. right on schedule, and called out to the surgical waiting area at 2:15 to let us know that they'd started - right on time. By 3:45 the surgeon was able to come out and tell us (including Eliza's cheering section of Nana, Granny, and Grandma and Grandpa, all of whom were able to be in town for the surgery) the good news. They'd inspected the full length of her intestine and not found any remaining perforations, and had flushed liquid through it easily with no sign of strictures or obstructions. She only lost about 2-3 cm of intestine during the reconnection process, and after stitching her ends back together they were able to confirm that the connection was watertight. All in all a very successful surgery.

When we were able to go back in to the ICN to see our recovering surgical patient, we were struck by how much bigger she looks without a giant ostomy bag stuck to her stomach and stomas protruding into it. It's a more dramatic change in her appearance than we were expecting.

Now, of course, it was time for her to rest and recuperate from her major surgery. That's been difficult so far for her and for us - it's been a real balancing act between giving her enough morphine frequently enough to keep her pain under control, and on the other hand not giving her so much that it depresses her breathing and requires additional respiratory support. (She was put on the ventilator for surgery and stayed on it for about 24 hours afterward, then graduated to the nasal cannula where she remains for now.)

Heather was at the hospital from 8 AM to 11 PM yesterday, watching and caring for Eliza with assistance from her mother and grandmother (during the day) and me (during the evening). Eliza was having a rough time of it all day, causing Heather a lot of stress and exhaustion. She was having bradys and desats every five to ten minutes - she would flinch or wince, causing her pain, and then drop her heart rate or hold her breath. Sometimes she would be OK for a while, letting us think that she was starting to do better, then surprise us with a sudden big brady. She had several events where she would brady continuously or repeatedly for several minutes, and she had at least one desat where her oxygen level dropped to 20% (!) and took a seeming eternity to come back up to healthy levels. It was seriously scary and stressful.

To add to our stress, the nurse practitioner in charge of Eliza during the day was tending to err on the side of not allowing her enough morphine. We had to really fight to stop cutting back further on her dosage and instead give her as much as she needs. Shortly after we left for the night at around 11, they finally managed to give her enough morphine and she was able to sleep well from midnight to 6 AM or so.

We're back at the hospital together today. Eliza has already had a few bradys and desats this morning, but we're hoping for a better day than yesterday. The care team today is okay with keeping her at her current morphine dosage if she needs it (they were even discussing increasing it a bit!), not trying too aggressively to wean her off the nasal cannula, and just in general leaving her alone to rest and heal. Hopefully that's exactly what she needs right now. Heather is holding her for the first time since the surgery as I write this, and they both look less stressed and more content then they ever did over the previous day and a half.