Day 3: Post-Op in the ICU

Day 3: Post-Op in the ICU: Morning Update

Nov. 20, 2020, written by Mama

I stepped away overnight and a lot seems to have changed. In ICU, there are four "sleeping rooms" that a parent can request so they can sleep better and take a shower. Chris stayed in the room while I went to the room down the hall to shower and sleep for 4 hours straight. I feel so much strengthened and now it seems like I might need it.

Thomas's liver and kidneys are not doing well. His labs are getting distinctly worse. At this point we are told it will now be "several days" before they even consider extubating him from the ventilator and the surgeon told me "to expect to be here a while." I think we're now moving well beyond the estimate of staying five days.

Thomas is getting a central venous catheter in his femoral artery in mere minutes.

Thomas might be getting a line in his neck artery in order to receive anticipated dialysis. 

They are going to be giving him special medications to try to protect his kidneys in advance of doing a CT scan with contrast dye (the dye strains the kidneys). After CT scan, Thomas might be having surgery.

Diuretics are contraindicated with pancreatitis, so Thomas is going to get more swollen than he is now (5 liters+). Overnight he developed sclerodema (swelling of the sclera on the eyeballs).

A lot of things are going to be happening quickly this morning and we appreciate all prayers. I don't know how to describe our parental emotions right now.

Day 3: Post-Op in the ICU: Evening Update

November 20, 2020, written by Mama

 

This day I felt like a bit of seaweed being crashed against by wave after wave after relentless wave of specialists coming into the room and giving information to us.

Thomas is being given excellent care. They are so professional, so kind, and so quickly responsive!

Thomas is very difficult to see in this condition and I'm glad I brought pictures of him with our family that are posted on the wall so all the staff can see him as he really is. Thomas is now retaining at least 3,500 cc of fluid (15 cups) and his skin is taut like an overfilled beachball. Thomas weighs 11 pounds more than when he arrived at the hospital: all retained fluid. Even the sclera of his eyes have edema.

He is attached to 15 things supporting him.  Where can I even touch my baby? For my mother's memory, I list them:

• port access
• IV in left arm
• arterial in right arm
• catheter in femoral vein (with three lumen, which are connections for IV tubes)
• vascular catheter in neck for purpose of dialysis (with two lumen)
• ventilator tube down throat
• NG tube in his nose
• stickers in 3 places to measure blood flow
• stickers on chest to measure electrical stuff
• temperature sticker on his ear
• blood oxygen sticker that that gets rotated around his body
• urinary catheter
• surgical drain in his abdomen

 

Thomas's CT scan does not show a cause for surgical intervention at this time. His kidneys and liver are struggling, but not so bad that they need the surgeon to go back in; those organs have good blood flow. Thomas's spleen appears to have lost blood flow, so he might lose that, but I was assured repeatedly by two surgeons that that is seriously the least of our concerns and we can talk about immune system implications later. The big problem is Thomas's pancreatitis. (By the way, stay off Dr. Google, as much written about pancreatitis is not about this type.) Pancreatitis needs time and time means Thomas's body needs all these machines to support his various organs until they are ready to do their jobs again.

So many times today, every time one specialist has talked about decisions needed to be made about one organ or system, I'm told that there are factors X, Y, and Z that require consulting with the various other specialist teams. All the teams are talking together all day long. It is daunting to consider, but I'm so grateful.

Thomas is more heavily sedated now so he is not reacting or rousing: the good side is that he is no longer distressed and crying every time he is jostled. It is anticipated that Thomas will develop fluid on the lungs, so we were told he definitely needs to stay intubated to ride out that situation.

Our head surgeon feels much better at the end of the day than at the beginning. Our impression and understanding is that Thomas has a hard row to hoe, but he will overcome each problem one by one. I begged the surgeon to "throw me a bone" by giving me a ballpark estimate or how long Thomas would be in the hospital: He told me two weeks and I promised not to hold him to that. Our surgeon did ask specifically and twice to please have our friends keep praying "because I think it is working."

In the evening, Thomas was started on dialysis (continuous = 24/7), which should very, very slowly draw off a tiny bit of fluid each hour. Since he cannot have diuretics, this is a way to start to reduce fluids without causing his blood pressure to be unstable.

Unfortunately, Thomas did exactly that and I spent a solid 30 minutes watching Thomas become significantly unstable while I prayed nonstop Memorares and the rosary. His BP dropped to about 60/30, his oxygen to 83, and a dozen medical professionals came into the room to help. Everyone was moving very fast. An x ray taken in the room during it all shows that Thomas does now have fluid on one lung. In addition to Thomas's reaction, then there were seeming serious mechanical problems with the vascular catheter just placed. I won't even share more details because it was pretty scary and I'm shaken.

I'm leaving out hundreds of details from throughout the day. There is so much information and I know I can't keep it all straight.

It is now two hours since dialysis was attempted and Thomas is stable, his numbers good. His temp dropped to 94 degrees Fahrenheit--normal reaction to dialysis--so he is under a cozy warming blanket. Doctors are working on the vascular catheter and I'm told they will attempt dialysis again later tonight.

I am scared and I am tired, but I am so grateful to sit here in a place of worry and hope today because some mothers sit by gravesides. I am now praying for the intercession of a little boy who recently died whose name is Vincent and whom I believe is enjoying the Beatific Vision of God so I beg of him to intercede for our Thomas Vincent.