LADD Procedure

Dallas's surgery was yesterday and things went fairly smoothly. Although, prior to him going in, I did stress that he is a tough kid to intubate and also and impossible IV start. The anesthesia DR looked at me with those skeptical eyes and pegged me as another mother who thinks their kid needs special treatment. He had a far different tone after the procedure. It took 8, yes EIGHT, attempts to get the IV going (he has all the bruises and pokes to prove it). He also noted to intubation was in fact a challenge and that perhaps if he has another surgery, they will have an ENT surgeon come to place the tube. The only change surgically, was that they were not able to do the laparoscopic approach and they had to open him up. His incision looks really good and is about 1.5 inches long. His intestines were pretty well coiled and the surgeon said he got everything straightened out, literally! They took his appendix out too.

Most of yesterday was just trying to keep Dallas comfortable. He was on a fairly high dose of morphine which eventually caused such significant desaturations in his oxygen levels that they put a nasal cannula on him to get him some oxygen. After this, they discontinued his morphine. They tried a couple of other drugs, which did not do the trick and he was restless and uncomfortable all evening. Because he only has one kidney, the pain killers that he can take are limited and usually are not the ones doctors would generally use. He usually ends up just getting Tylenol. :(

He slept fairly well throughout the night, but did not wake up a happy camper. I sat in his crib with him from about 7am until 11:30am. Every time I tried to get out, he screamed. He cried steady for the first two hours and finally the surgeon was paged in and felt his stomach. It was bloated. Sometime overnight, the nurses had closed his vent (there was a tube open/vented from his stomach to help drain stomach bile). The surgeon re-opened the vent and sure enough, tons of bile started streaming out and Dallas finally quit crying. He still whimpered on and off until 11:30, when he finally fell asleep. Because this bile isn't being absorbed by his stomach, this tells them that Dallas is not ready to eat.

He will remain vented to rest of the afternoon, and then they will try again to close it off for 4 hours. If when they open it back up, there is no bile, then the will consider starting to feed him again. This is definitely going to be a process, and we were informed that today will be or should be the "worst" day. Child Life folks did bring by a bottle of bubbles and that cheered Dallas up for a little bit. He was even kicking his legs, his signature move!

Watch him sign on YouTube: http://youtu.be/7tx3aOKUfyQ