All Put Back Together

Truman's surgery went well this evening, and there were no complications other than a delay in the start time of the operation. Our anesthesiologist was called away on an emergency procedure for another patient which pushed our start time from 4:30 to 5:00, to 7:00, and eventually to 8:00pm. While it was frustrating to wait, it helped us to think that this time Truman wasn't the critical patient, and that he was healthy enough to wait for a while. That's progress.

Once the operation began around 8:00pm, it took about 90 minutes, of which about 60 minutes were actual surgery and the remainder was prep and clean-up. So now, Truman is no longer attached to an ostomy bag and there is no longer a large hernia in his abdomen, so he looks much better. Truman was intubated at the start of the operation because while he was under anesthesia he needed to have breathing support. He will likely be on the ventilator at least through tomorrow, and possibly for two or three days.

Shockingly, by the time we got to his bedside Truman was already waking up, even though the anesthesiologist expected him to be sleeping through the night. By the time we left his bedside, Truman was quite awake, opening his eyes completely, responding to our voices, wriggling his legs and torso, and squeezing our fingers if we offered them to him. He cannot make any sounds right now because the breathing tube keeps his vocal cords immobilized. Kara also thinks that he looks considerably larger than he ever has before. While this probably simply related to the fact that half of his abdomen isn't covered up with wax and ostomy bags anymore (as it had been for the past 11 weeks), it's still nice to see. Because of this, Kara was able to look at Truman tonight for the first time as her newborn, and not as her preemie.

The nurses seemed encouraged by his level of alertness and think that it might mean that he'll be ready to come off of the ventilator tomorrow. We'll just have to wait and see. Also, sometime in the last day Truman's tear ducts have started to work, and his eyes formed several tears while we were at his bedside after the operation. We wiped them away gently, but we were assured by the nurses that it was doubtful that the tears were a sign of pain because he did not have any of the other corresponding pain indicators like elevated blood pressure or excessive wriggling. In all likelihood the tears were simply a reaction to the heated air coming out of his new bed.

We've been told a variety of things regarding the time frame for expecting Truman to resume his feedings. The lowest estimate we've heard was from one of the nurses who said it might be 3 to 4 days, but the surgeon told us to expect 5 to 7 days. It's going to be a really unpleasant week if Truman has to go hungry for nearly 7 days, but we have to do what will allow his gut to heal in the best possible way. In the meantime, Truman will receive fluids through an IV and nutrition through a TPN line. We've also been moved back to the Level 3 critical care hall of the NICU, but we're still surrounded by many nurses and doctors we've come to know over the past 15 weeks, and this is much more of a leap forward than it is a step back.

Assuming there are no more complications (such as picking up another infection or something), Truman's challenges will now consist of healing up and recovering from this surgery, building up his energy reserve, and being able to take all of his feeds by breast or bottle. Once all of these criteria are met, he'll be homeward bound.

It seems that there is light at the end of the tunnel, and it's beginning to come into view.

--Ben