This morning started out very early....especially for someone used to sleeping till at least 7:00 or so! :) Drew and I arrived at the hospital a little after 5:30 to spend a little more time with Rebekah before surgery. Since we had gotten to hold Rebekah for most of the weekend, I didn't really anticipate the chance to hold her again, but the nurses let us hold her for about an hour and a half.
Daddy and Rebekah before surgery
The nurses change shifts between 7:00 and 8:30, and no one is allowed in the PCICU during that time. So, we said goodbye to Rebekah at 7:00 and laid her back in her crib. The OR team came to get her around 7:45 and the surgery actually began between 8:30 and 8:45. Dr. Hsia told us afterward that he was able to place the band fairly quickly, but he spent a great deal of time evaluating whether or not he had the band tight enough or too tight. By the time he completed the surgery, Dr. Hsia came right back to where he had the band in the first place! The goal was to tighten the band enough to restrict some of the blood flow to Rebekah's left lung, yet leave it loose enough to grow with her for the next few months. It is a fine line to balance between the two, and I am glad it was not up to me to get it right!
Dr. Hsia is very pleased with the outcome of the surgery at this point. Rebekah came back to the PCICU around 11:00 this morning on the ventilator (but on a lower setting than when she went to surgery). She was on the ventilator the remainder of the day and will probably be on the vent through the night and possibly tomorrow. As long as she is making improvements, the doctors will continue to wean the ventilator settings down through the night. Before Rebekah went to surgery, her vent setting was at 36; when she came back from surgery, the vent was set at 26, and by the time we left around 6:30 this evening, she was down to 18. She did have a slight setback due to a leak around the vent tube in her trachea and she had to have the tube replaced around 5:30 this afternoon. We were hoping to make it work through the night and be able to take it out altogether, but she really needed the more gradual decrease from the ventilator.
Rebekah about six hours after surgery
The plan for now is to let Rebekah rest through the night and work down on the ventilator settings as she is able to. The next step will be removing the tubes and leads from her heart and chest, which will happen in two or three days. She is already off the blood pressure medication that she had while in the OR, which is a good step. The final test of the success of this surgery is if Rebekah's blood pressure (especially the diastolic pressure), oxygen saturation and heart rate all stay within the levels that Dr. Hsia is targeting for Rebekah. Especially before her complete Truncus repair, Rebekah will not have "normal" blood pressure, oxygen saturation or heart rate levels for a baby of her age. But Dr. Hsia is looking for what should be normal for Rebekah in this stage of her repairs. When Rebekah is completely weaned from the ventilator, Dr. Hsia will be able to determine if this stage of surgery was successful for Rebekah.
The plan for Mommy and Daddy tonight is to get some sleep! After such an early morning, we are ready for some rest. Add to that the rain hitting the window, and it's a perfect recipe for sleeping. Good night, all! :)
Nancy
