- The surgery is scheduled to start at 1 pm. We don't know how long the surgery will be, as that will be largely dependent on exactly what Jude's surgeon finds after he's begun. The plan is to move our little man's organs back into their proper places, close the defect (i.e. the hole in Jude's diaphragm) with a patch, do an anti-reflux procedure called a Nissen fundoplication, and place a gastrostomy feeding tube (G-tube).
- The defect is believed to be smaller than the past two hernias. Today, Rose had a conversation with Jude's surgeon, Dr. Hebra. After he reminded her that Jude has very little natural diaphragmatic tissue, he went on to say that, in this case, he believes the hole that has allowed Jude's stomach to move into his chest is actually somewhat small. Generally speaking, this is good news.
The belief is that part of the GORE-TEX patch, which was used to close the hole in Jude's diaphragm during his last hernia repair operation, has partially pulled away from the posterior side of Jude's chest / thoracic cavity. X-rays taken over the past two weeks appear to show increasing amounts of Jude's stomach in his chest. First, part of the stomach was up. Then, a majority of it was up. And now, all of it appears to be in the chest. But while Jude's stomach is up, all of his other abdominal organs are clearly still down -- that is, except for one.
- We're not exactly sure where Jude's spleen is located. This might seem a strange thing to say, but all it means is that his spleen hasn't been clearly visualized on the imaging tests that have been done recently. This fact could ultimately be insignificant, but Dr. Hebra expressed a possible concern about it when talking to Rose today.
There are some blood vessels that run between the stomach and the spleen, and it would reportedly be very hard to stop the bleeding from these vessels if they were damaged. If Jude's spleen is still below his diaphragm, then it could potentially present a challenge to move Jude's stomach back down through his defect without damaging the vessels connected to the two organs. If Dr. Hebra can't move the stomach down without damaging these vessels, or if he thinks that it would be too risky to try, then it's probable he would try moving the stomach via incisions in both the abdomen and the chest. (The present game plan involves surgery through the abdomen only.)
If the worst were to happen and Jude started bleeding profusely from the vessels in question, then Dr. Hebra may be forced to remove Jude's spleen completely. Pray with us that this won't be necessary!
- Jude may recover from his surgery in a little more than a week. Rose and I were a little surprised at this, particularly since Jude took so long to recover after his previous hernia repair surgeries. However, we were reminded that his recovery period is expected to be shorter because he's bigger and stronger than he was before. We know that anything can happen (and with Jude, it usually does), but the prospect of a quick recovery and subsequent discharge? Yeah, we're cool with that. :)
Thank you for following the story of Jude and our family. It's been a tough year since we learned about his diagnosis and a tough 8 months since his birth -- time fraught with fear and anxiety, but also many blessings and great joy.
If you feel led to do so tonight or tomorrow, please pray with us that Jude's surgery will be successful and that the Lord would show favor to him and everyone who has a part to play in his healing. Please feel free to share Jude's story and/or our request for prayer if you are inclined to do so.