Alex and Maddy

Alex and Maddy

Monday, March 2, 2009

I am going to do my best to recap the day... The day started early. We were called for surgery at 6:00 AM. We were in pre-op until about 7:35. We headed back to the OR for what should have been about a 45 min procedure. They started anesthesia and I walked out the door at 8:00 with him asleep. At 9:45 I started to think things weren't going as planned because I hadn't seen the surgeon yet. At 10:00 I got a call from the OR saying that Alex was doing fine, but they couldn't get the tube placed. They decided to do a separate J tube at that point, but did not know whether it would be laparoscopi​c or open. They finally finished surgery at 12 and Dr. Tsao came out to talk to me. He had to open him up. He has about a 3 inch incision from his belly button up. The new tube is placed just left of his belly button.

The real "fun" started in the PACU (recovery). About 1:30 Alex turned tomato red. His heart rate was hanging in the 190's and his respiration​s were in the 50's. We also were using oxygen to keep his saturations at a good level. But at this point we thought he was just in pain. At 2:00 the anesthesiol​ogist got one look at him and ordered benadryl. We came back to our room at 3:00. His face was starting to swell by this point and he was tomato red except just around his mouth which was white. At 3:30 the swelling was getting worse and I asked for another dose of benadryl. Dr. koenig cam in shortly after and that is when the you know what hit the fan! She immediately started barking orders and got on the phone with Dr. Pacheco our allergist/i​mmunologist. His heart rate stayed in the 190's this whole time and he was laboring to breathe. His lung sounds were diminished and his appearance continued to deteriorate. We drew a number of labs, did a chest xray, gave him albuterol, gave yet a 3rd dose of benadryl, started a steroid and kept our eyes glued to the monitors. The discussion ensued about whether to use epinephrine. But with his heart rate already so high, the doctors felt the risks outweighed the benefits. The decision was made to bolus large amounts of fluids into him. Within an hour, he got 600 cc's of extra fluids. The labs revealed that Alex's lactic acid was once again high at 3.1. Dr. Koenig quickly ordered D25 because sugar can sometimes help your lactate. Around 6:30, his heartrate was down to the 160's and Dr. Koenig felt comfortable to leave. Dr. Pacheco stayed about another 45 minutes. Since then it has been a constant stream of Dr's and nurses. The PICU doctor is checking in every couple hours. We are just getting ready to check labs again.

At this point we are stable, but still cautious. His airway is swollen and his cough or cry sounds yucky. He also has a rash, but is otherwise doing well. He is looking better with each passing hour.

His pain is pretty bad, but controlled with the pain meds.

I will update again in the morning.

Tha​nk you for all the prayers.

Ali

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