Braden's Surgery Day 4 & 5

Hello all...Well the adventures of Recovery have been interesting to say the least. Sorry I am behind on the posts but Braden has been wanting ALOT of Mommy and Daddy time and of course he can have as much as he needs! So since the last post alot has occurred. Throughout the night on Thursday night Braden had many things challenge his body. To start off he started have bowel movements which at first we thought was "Oh good, things are working" However, after a night of them along with the presence of a mild fever and tachycardia(fast heartrate) they did a few things including blood, urine and stool cultures. He also was decreasing the amount of oxygen in his blood and required a small amount of oxygen via nasal cannula while asleep. So the results of things were interesting...Braden has what is called C.Diff. The doctors are pretty sure due to the fact that we are only 2 days out of surgery that this could potentially be a result of when Braden was hospitalized and on the antibiotics from his peritonsillor abscess in late may/early june and when he was in surgery and given antibiotics his gut just didnt like that. His blood and urine cultures up to this point have shown no growth(which is good). Braden also had a chest xray to rule out the presence of pneumonia due to his inability to keep his oxygen levels up. What was found was atelectasis(lack of gas exchange of the alveoli in the lungs due to fluid consolidation) and a mild pleural effusion(excess fluid that accumulates in the fluid filled space around the lung. excessive amounts of fluid can impair breathing by limiting the expansion of the lungs when taking a breath in). So the biggest thing is working with Braden to cough/deep breath and clear his lungs. We are attempting to do this by blowing bubbles and using what is called an incentive spirometer. He was also starting on the Nicardipine drip which throughout the night on Thursday he was weaned off of because his blood pressures were at a "boring" level as the Dr stated. All I can say is I will take boring :) So Friday morning started off farely descently and again the Dr's rounded on Braden and we were involved in these rounds to help develop his plan of care. Throughout the day, Braden was more awake and alert and began moving around in bed on his own. He did such a good job with his deep breathing/ Coughing and blowing bubbles that the oxygen was able to be weaned as well. One of our bigger obstacles and concerns is with the swelling Braden has in his lower extremeties. He is SOOOO puffy it is hard for him to even move his legs, but as determined as he is, he does it and without complaints. We had the vascular doctors come and evaluate his legs as well because they were cool to touch and we wanted to make sure their was no obstruction. After evaluation by the vascular team, they are reassuring us that the swelling will go down and it is from the amount of fluid he has been given for surgery and since then. Braden's blood pressures remained labile throughout the afternoon and evening on Friday as well and also his oxygen levels were Great. Friday night was uneventful and Braden was able to get a great deal of rest and relaxation. He even woke up at 3am and wanted to watch cartoons, so that is what we did for about 3 hours! At 600 this morning Braden wanted to get out of bed and that is just what he did. He was able to sit on the side of the bed and dangle his feet and stand. Standing was a big challenge because the amount of swelling in his legs have caused them to be very tight and uncomfortable so he could not bear weight for a great deal of time....but I was so proud of him. He then was able to sit in the chair and we reclined and cuddled for almost 4 hours this morning. He watched cartoons for some of the time and also slept. This was a very surreal moment for me as I had distinct memories to the day I was able to hold him for the first time when he was in the NICU and 17 days old. Finally, I was able to feel not so helpless and like his mommy, comforting him and telling him how proud daddy and I are of him. We thoroughly enjoyed our cuddle time and at about 10am we got back in bed. At this point Mommy headed back to the hotel to shower and do some laundry and Daddy was on Braden duty! While at the hotel, the dr's did rounds and some changes have been made to Braden's plan of care. They are going to take out the IV he has in his neck(it is called and IJ) this is a central line which is VERY useful as labs can be drawn off of it, mutiple medications can be administered at the same time. However, it is a BIG infection risk. So unfortunately this will be removed but 2 more peripheral IV's will be placed. Also, they had to advance Braden's nasogastric(NG) tube because it was not far enough in and was causing irritation. So needless to say this also wasn't so pleasant for Braden because it can make you gag(and Braden has a very sensitive gag reflex) Also, it was reported to us that the C.Diff has drastically reduced and his White blood cell count dropped drastically too from 18.4 to 12.7. They also reduced the rate of his pain control medication to attempt to wean him off of that and progress to IV pain meds. All of this information Ian relayed to me while I was at the hotel. So I went back to the hospital to allow Ian to return to the hotel to shower etc and upon returning Braden's BP's are a tad bit higher than they were and the doctors are deciding if they want to restart the Nicardipine drip again to decrease them...the were running 100-110/40-60's and now they are 130's/70's. So we will see what they decide. Right now Braden is napping and I just continue to look at him with utter amazement. It is amazing to see your 6 year old grow up so quickly and most things he is having to endure, we as adults would not come anywhere close to tolerating what he is!

Again, Ian and I would like to thank our family, friends and coworkers for your amazing support, encouragement, generosity, and prayers. We definately feel your love and will forever be grateful.