So what will tomorrow look like?
Although we understand that it's possible to perform surgical repair for a diaphragmatic hernia laparoscopically (i.e. via small incision(s) that are minimally invasive), Jude's surgeon has determined that instead he will open him through a large incision on his torso and manually move the abdominal organs in his chest down into the areas where they should be. He may or may not have tubes or drains inserted to relieve his body of excess fluid. Jude will be on a ventilator for the duration of the surgery, and he'll be given both anesthesia and a paralytic drug, which will render him motionless for the procedure. After surgery is over, he'll be brought back up to the NICU to recover.
Post-surgery, here are some issues that Jude and the medical staff may or may not have to contend with, so Rose and I ask for your prayer for them:
- Jude will be given a lot of fluid during surgery, and he'll probably take fluid on board as his body reacts to the surgical trauma, so fluid management will be a big issue that the medical staff will need to deal with in the days and/or weeks to come. If you've been following this blog for a while, then you probably know how fluid can put pressure on various organs and thus hinder their functioning. We're praying that any extra fluid he retains won't put inordinate pressure on the surrounding tissues or organs, and that it won't restrict his blood flow to any parts of his body.
- Although Jude has already weathered a lot of pain as a result of medical problems or procedures, his surgical repair will probably be the most painful thing that he'll have to endure while he's in the hospital; consequently, the medical staff caring for him will have to be very vigilant and careful as they manage his pain post-surgery. Jude has already been on morphine (narcotic for pain relief) and Versed (sedative) drips for about a month, and he has received boluses of both of those drugs plus lorazepam (anti-anxiety drug) periodically as needed. Because he's been on morphine and Versed for so long and his dosages have been steadily increased, he has developed a tolerance to those medications, which may make using them for pain relief/sedation more difficult. Jude has yet to really receive much fentanyl, a powerful synthetic narcotic that's much more potent than morphine, so that may come into play as needed. We're praying that the Lord would minimize his pain as much as possible, that he would give wisdom to the medical staff as they determine which drugs to use for pain, and that the drugs would be effective in regulating his pain levels.
- Although recent echocardiograms have revealed very little evidence of pulmonary hypertension, we know that it can present again post-surgery. If it does reappear, then it could pose another obstacle to Jude's recovery. We're hopeful, however, that the scant evidence of pulmonary hypertension in recent tests portend good things for Jude, and we're praying that it won't reappear or, if it does, that it is manageable.
- Because Jude's bowel (or much of it) is in his chest and will need to be moved back to it's rightful place there is potential for trauma to his bowel which could result in gastrointestinal issues in the future. We are praying the Jude's bowel will endure the surgery and placement with no issues and that if there are issues they will be minimal.
- As with any surgical procedure, there are risks to Jude and his life. We are praying that the Lord will carry Jude through his surgery with no problems and that his vital signs will remain healthy and strong.
- After Jude's organs are moved to the appropriate places we are hopeful that his lungs will spread out and open up to be used at their full potential. We are praying that Jude's lungs will be larger and healthier than expected. We are praying that his lungs will be just the right size for sustaining Jude.
Now on to the snuggling! (from Rose)
A few days ago we were told that if Jude was able to get onto the conventional ventilator then I might have the opportunity to hold him. When Jude surprised us with the switch yesterday I was hopeful that I might have the opportunity to hold Jude, but I wasn't quite sure if the doctors would allow it. This morning in rounds the docs gave the "ok" for me to hold him for a few minutes as long as he handled it well and as long as his stats remained steady.
So, this afternoon I sat on a big comfy chair and held my sweet son for the first time. What an amazing moment! Jude was so snuggly and so comfy on my chest that he had the best of his best CO2 levels for the day! It made me so happy to know that he was so peaceful laying on my chest. He was doing so well, in fact, that I was able to hold him for three hours! I would have held him even longer if I could have!
I am so thankful that the Lord provided a way for me to hold Jude before his big surgery tomorrow. My heart is so full this evening! We took MANY pictures and videos of our snuggling session and we hope to post a few tomorrow afternoon as we sit in the waiting room during Jude's surgery.
Thank you for your prayers for Jude. Tomorrow is such a big day but I feel more confident knowing that the Lord is with Jude and that so many of you are praying. We will update you on how he is doing as often as we can.
Therefore do not be anxious about tomorrow, for tomorrow will be anxious for itself. Sufficient for the day is its own trouble.