Here We Go Again...

After our last post, Rose and I went to rounds together to learn more about Jude's condition and the tentative plan for his care. Many thanks to Dossie and Benji James for graciously agreeing at the last minute to watch our little Annabelle so we could go to the hospital together!

So while Rose and I didn't get answers to all of our questions this morning (as Jude's surgeon will need to answer some of them), we nevertheless got a clearer picture of what's going on with Jude and what we can possibly expect over the next few weeks.

First, the doctors confirmed that some loops of Jude's bowel are now up in his chest cavity on the latest x-ray from last night, which suggests that either the patch that was used to close the hole in his diaphragm has come loose or that it's otherwise degenerated. In either case, it means that Jude has reherniated and that he'll need another surgery to repair the hole.

For now, the plan is for Dr. Hebra, the surgeon who conducted Jude's original hernia repair, to do this subsequent surgery. However, he is out of town for another week, so it looks like the earliest date for Jude's reherniation repair would be next Monday the 26th. Provided Jude remains stable, as he is now, then there hopefully won't be any need to do the surgery in the intervening time. As long as Jude doesn't go into respiratory distress or have serious intestinal issues over the next week, then he should be OK to wait until the 26th or shortly thereafter to have his surgery.

Although nothing is certain yet, it sounds like it might take a few weeks for Jude to recover from his reherniation repair. He'll need to be re-intubated, sedated, and possibly paralyzed for a while both during and after his surgery. Then, of course, he'll need to have his pain managed through medication, just like after his first hernia repair. His overall recovery and weaning from his respiratory support and pain management shouldn't take nearly as long as it did the first time around, but it will nevertheless take some time, which means that Rose and I are expecting Jude to be at MUSC for another month, at least.

While Jude is doing very well in light of the fact that some of his intestines are in his chest, unfortunately he's not able to eat right now. As we said in our last post, yesterday evening it became clear that Jude's stomach and/or bowel wasn't working properly when his nurse, Kayte, suctioned a lot of milk, mucus, and bile out of his stomach. It's OK or even normal for Jude to have small amounts of food and other substances in his stomach at any given time (particularly after a meal), but the amount that came out last night was much bigger than anything that we had been seen before. Because he apparently can't tolerate feeds in his digestive system right now, he's been switched to IV nutrition via a new PICC line that was put in this afternoon. The poor little guy was not happy about getting the PICC -- it took 3 nurses to hold him down while the catheter was being inserted and he needed doses of Ativan and morphine to calm down. :(

Will you please pray with us about these things?

• Because Jude's bowel has moved, it could become twisted or obstructed. We're also concerned that he could experience some intestinal ischemia, which is damage to his bowel resulting from poor blood flow to it. Jude's intestinal anatomy (i.e. the fact that his intestines are fused together from adhesions) already puts him at risk for obstruction and other issues, so please pray with us that Jude won't experience any of these additional complications that are now possible.

• Jude could very well have some pain or discomfort because of his reherniation. So far he seems to be OK, but please pray with us that he'll remain as comfortable as possible until he gets his surgery.

• So far, Jude's reherniation doesn't appear to have affected his breathing. Please pray with us that Jude won't experience any respiratory distress while we're waiting to have the hernia repaired.

• We're fairly sure that Jude's occupational and physical therapy will be hindered or put on hold because of his impending surgery and recovery. Please pray with us that his development won't suffer greatly as a result of any hiatus in his therapy.

As always, thank you so much for your thoughts and prayers! We know that God loves our little man more than we possibly can and that His plans for Jude will be accomplished. We'll keep you posted!



Hear my cry, O God,
listen to my prayer;
from the end of the earth I call to you
when my heart is faint.
Lead me to the rock
that is higher than I,
for you have been my refuge,
a strong tower against the enemy.
(Psalm 61:1-3 ESV)