James' Surgery (#9)

James has surgery yesterday and is doing good. He was scheduled for 9:40 am, but as we all know these things never run on time. They took him back to the OR at 11.

The pulmonologist went first. They did a scope of his upper and lower airways. They found that the majority of James' airways are swollen and some are even flattened as opposed to being round. His vocal chords are swollen too. There was also some really thick mucus blocking a few smaller airways that they were able to get cleaned out (he hasn't sounded so clear in weeks). At this point it's hard to tell the cause and it's possible that there are multiple things going on. They took a culture from the inside of his lungs and this should confirm that his reflux has been causing him to aspirate food into his lungs, but we won't know for a few days. Finally the pulmonologist did a pulmonary function test to test his lung strength. We should have the results of this test today. This all took about an hour or so.

Next the surgeon was up. They have a lot of technical terms for what they did and why. I will take a stab at an explanation. At the base of everyone's stomach is the pyloric valve that opens and closes to allow food to pass from your stomach to your intestines. Because of James' gastric pull-up to connect his esophagus to his stomach, his pyloric valve is higher than normal and in an unusual orientation. This abnormal anatomy sometimes requires the pyloric valve to be disabled (about 20% of kids that have gastric pull-ups). They put a small scope though his belly button and another one down his esophagus to see what they were doing. They were then able to then do the procedure with only 4 small incisions (as opposed to cutting open his belly) which reduces recovery time and the chance of infection post-op. This will hopefully allow his stomach to empty more efficiently and prevent him from refluxing food into his airway, but only time will tell. The surgeons feel that this will help, but don't necessarily expect it to totally fix the problem because he will always have an unusual anatomy. This procedure took a little over 2 hours.

James made it back to recovery around 3 and we were able to see him at 4. He is on pain meds for now to keep him comfortable. They are going to put a PIC line in today so they can get him some calories via IV. The poor kid has gotten so skinny in the last couple weeks. He won't be allowed to eat until later in the week and it will be slow process getting him back to full feeds. We are hoping that we will get to go home by Monday. The doctors are confident that we will be home by Christmas.

My mother-in-law is town this week helping out with the baby. My dad and brother are planning to help out next week. Dave is hoping that once James comes home from the hospital, he will be able to work from home until the New Year. God, our family and your prayers have kept us going and continue to give us strength. Please keep praying for James' healing and our sanity!