Payton Rocked the Surgery

She looks a bit puffy but that's not her fault since she was given a lot of fluids in the surgery.  They will let her de-puff a little on her own then tomorrow they'll consider a diruetic if she still needs it.

Her surgery didn't go fully to plan.  She didn't get the tubes placed laparoscopically as hoped but in the end it may be a bit of a good thing.

Her incision is a bit smaller (about 2 inches) and follows her old one so that is good.  Also, it should still be a bit numb so her pain level should stay minimal.

The reason they couldn't do it laparoscopically was because she had too much scar tissue which apparently inhibits vision with the scope.  So they had to open her up. 

It worked out because her stomach was a bit twisted and they were able to untwist it a bit so that will help her manage her feeds in the future.

There was a small (but unconcerning) complication or two.

The first being they were trying to manually follow her bowels for tube placement and when her bowel tracked to the back of her abdomen it became more difficult.  After a small puncture to her bowel (which was sewn up) they decided to insert the tube blindly.

The second complication was the blind tube insertion into her bowels.  They placed it as far as they know it 'should' be but they aren't sure it actually travelled through her bowel as far as it should be (or if it coil in one place).   They will do an x-ray tomorrow to confirm.

If it tracked where it should have then great, all systems are a go.

If it didn't they hope that after a couple of days, the direction of traffic in the bowel will pull it down and stretch it out.

Worst case scenerio is if it is coiled and it doesn't straighten out then Radiology will be able to straighten it with a wire - problem is they won't do it for 2 weeks (they don't want to work on freshly operated patients so they delay it for minimum 2 weeks).

Payton's drainage tube into her stomach went in with no problems.

The above picture shows how Payton will be fed for possibly the next 2-6 months. Its not pretty but I wanted to include it for any possible CDH parents to see what they may or may not be facing in the future. 

We have seen so many CDH babies prior to our time in the NICU that we've been very well prepared on what to expect.  What I didn't do was much research into CDH babies and feeding issues.  So to be honest, this has been the most 'unexpected' thing Payton has undergone.  It really has made me realize how very important sharing information has been, no matter how difficult.

Its also made me realize what a beautiful gift it has been when parents have shared photos of their little ones going through this process.  So for all you parents who have watched their child go through a difficult proceedure and have posted it on the internet for other parents to see (and be prepared for what is in store for them) THANK YOU.  Thank you for the very difficult and selfless gesture of sharing such a difficult moment with those of us who will follow.

In closing, I just called the NICU.  Payton is still 'out' from her surgery but is doing well, though still vented.  They will wait till she's fully awake to determine how much morphine she needs.  If she needs a lot they'll keep her vented (since morphine slows her breathing).  If she's handling the pain well they will extubater her (hopefully for the last time ever!!)