Tuesday, March 27, 2012

BROVIAC Surgery Tomorrow

Today didn't go like we'd anticipated.

Jude's BROVIAC catheter placement didn't happen today; it's been postponed until tomorrow, although we don't know exactly when the surgery is scheduled. The case is being delayed because another procedure is being added onto the BROVIAC placement: With radiology's assistance, the medical staff will attempt to advance a tube into the upper part of Jude's bowel so that he can receive transpyloric (TP) feeds (see post from yesterday for more info). It may be difficult, if not impossible, to place the tube in the desired spot; nevertheless, it's worth a shot so that Jude can have a chance to get good nutrition from his mommy's milk. (The TP tube is being placed while Jude's in the OR because he'll be under general anesthesia and will be much more agreeable to having a tube threaded through his nose, throat, and stomach.) When Jude is anesthetized for surgery, he'll need to be intubated and put on a conventional ventilator. We're hoping that he can be extubated and put back on nasal cannulas before returning to the NICU, but that call will be made in the OR.

After talking more extensively with Dr. Hebra, the NICU team of neonatologists are now on board with his plan for Jude, which means that hernia repair surgery probably won't happen right away; rather, it could be a few weeks from now. As we understand things, the logic for waiting may be multifaceted, but it largely hinges on nutrition. Apparently, there is a greater chance for a favorable surgical outcome if Jude can receive good nutrition from breast milk in the interim period before surgery. If the placement of the TP tube fails in tomorrow's surgery, then Jude will remain on IV nutrition.

Please pray with us that Jude's surgery tomorrow goes well and that his TP tube might be successfully placed. We'll let you all know when his surgery is scheduled as soon as we find out.

Also, please pray that Jude's respiratory status remains stable and that he won't lose ground amidst all of the changes that he's having to endure right now.

Thank you so much for all of your prayers and support. Good night!


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