Monday, December 22, 2014

Deja Vu

When we got ready for Owen's procedure to fix his hernia, we were told the recovery would be 3-5 days. Based on our past experiences, we went ahead and assumed it would be at least 5 days. The operation was on Thursday and we figured the middle of the following week would be our discharge goal and we would be home and moving forward. As the case has been throughtout this entire journey, it was way more complicated than we thought.

Owen was progressing post surgery and everything looked good the weekend after the operation. We started to test his feeding tolerance, which was the ultimate hurdle to going home. He had to be able to handle 24 hour continuous feeds before we could get out of the hospital. Once he reached this goal, we could work on compressing his feeds at home. All his feeding would be done through the G tube, which was on his side and went directly into his stomach. We had to wait for Owen's gut to wake up before we could begin the feeding process and we were told that during an operation on the stomach/intestines, they sort of go into shock and take a few days to wake up and begin working.

On Sunday, we changed the way his G tube was draining to see if Owen would tolerate his own secretions. All of his feeding tests were over 8 hour periods. If he did well with each step after 8 hours, we would move on to the next step. He seemed to do pretty well with the first step of tolerating his secretions. He was coughing up some stuff that mostly looked like mucus/spit, but he didn't seem to have much trouble with it. The next step was to feed him Pedialite at a rate of 10 MLs per hour. The Pedialite would absorb in his system very easily. After 2 hours on the Pedialite, Owen threw it back up. This wasn't unexpected since it was the first time he was eating and the doctors said his gut was not fully awake. We continued to try the Pedialite and he continued to vomit. Then overnight Monday, Owen tolerated the Pedialite for 8 hours. He spit up at the end of the 8 hour period, but it was determined that we could move to start feeding formula.

We began to introduce formula, which is a little heavier and tougher to digest, at the same 10 ML/ hour rate. He was vomitting pretty much every 2 hours. His bowel sounds were still not completely active, so we just kept trying to see if he would improve and tolerate the feeds better. He continued to vomit fairly regularly. I think they had to call in extra laundry staff to deal with all the sheets and towels that we were going through.

Overnight Tuesday, he actually tolerated his feed for 8 hours. He promptly vomited at 8 hours, but this was seen as progress and it was decided to push him a little bit more with 15 MLs an hour. He began to vomit regularly with the increase. It just seemed like the feeding wasn't quite working for whatever reason. Being almost a week removed from the surgery, we were expecting to see a little more progression.

Around 11pm Wednesday night, while Owen was sleeping, his heart rate started jumping all over the place. It started to jump up close to 300. He had slipped back into the arrythmia that he encountered after his first heart surgery in July. We were quickly shipped back to the CICU. Owen was stabilized and was given some medicine to slow down his heart. He finally came out of the tachycardia early Thursday morning. It was a scary moment to see Owen going through this again. It was also deflating to realize this was not going anywhere near according to plan. One week after surgery, when we thought we would be home 3-5 days later, we were now back in the CICU no closer to going home than when we started.

Owen spent the next two days pretty much sleeping. Owen is such a happy baby after all he has been through and to see him sleepy and lethargic for 2 days straight was very difficult. They tried feeding again at an even lower rate of 5 MLs and he still wasn't tolerating so on Friday afternoon, we were ordered for an upper GI series. They were going to put some dye in through his G tube and see where it went. They took X-rays after the dye was put in and it was quickly evident that nothing was draining from his stomach. Everything was sitting and collecting until he threw it back up. Because of this, all medicine and feeding through his stomach were stopped. Over the weekend, Owen's surgeon stopped by to talk to us and was very apologetic about how everything had gone. He told us that in his 20 + years of operating, Owen's anatomy is the most complicated he has ever seen. Unfortunately, there are no awards for that. He told us that they are working to figure out what is going on. The next step was to get a scope of his upper GI and to place an NJ tube through his nose which bypasses his stomach and empties into his small intestine so he can begin feeding. Unfortunately, they don't do those procedures over the weekend and the earliest we can get in was Tuesday. The procedure is fairly quick but it still requires Owen to go under general anesthsia and have a breathing tube placed.

Owen has not had anymore arrythmia issues since the scare on Wednesday night. He has slowly gotten his personality back, but is still frequently in pain and not happy. It has been pretty frustrating to go through this again, especially when Owen was doing great before the surgery. This procedure has just seemed to make things worse and to add to the mounting frustration, we were not able to attend Owen's Grandma Juju's birthday party and will be spending his first Christmas in the hospital. We are hopeful that the scope on Tuesday will provide us some clearer answers and help us get Owen back to the happy, growing boy he was before this operation.

We would like to thank everyone for the support we have received in this difficult time. We would especially like to thank Chas Allworth and Ashley Spataro, Ed and Cheryl Polaski, and The Levin's for sending some thoughtful gifts for us and Owen. Owen is truly lucky to have so much love and support through these tough times.

We will keep everyone updated as we learn more. Thanks again for all the thoughts and prayers.

Friday, December 12, 2014

Surgery and Recovery

Owen's hiatal hernia surgery day arriving was bittersweet. We had been enjoying our time at home being a faimly and doing fun family things and the realization of going back to the hospital for another operation did not sit well. However, we knew that this was a necessary operation to help Owen start moving towards a more normal feeding regiment and continuing to stay healthy and grow.

The night before surgery, the three of us were laughing and having fun. We took some pictures of Owen in his superhero cape to show he was ready to take this next operation on.

We sent the pictures to our family and discussed how this operation would result in the removal of his NG tube from his nose. We were fortunate that during our time at home, Owen had not pulled his NG tube out of his nose and made us put it back in. It is not a fun process putting the tube back in and Owen especially does not like it. No more than 5 minutes after the discussion, Owen felt the need to show us his rebellious side and pulled the tube out of his nose. He was very happy with what he had done. We were not quite as happy. 12 hours before he had to stop feeding and have the tube removed for good and we had to put the NG tube back in. Owen obviously got his Mother's patience and figured he had had enough of the tube and would help us all out by removing it. He definitely knows how to make us laugh and keep us on our toes. 


We arrived at Children's Hospital around 10 am to check in for the operation scheduled to begin at 11:45. Our mood was considerably more upbeat and positive than before his previous opeations. After going through 2 open heart surgeries, this seemed like a walk in the park. We were taken to a waiting room where information was gathered on Owen and all the logistics were reviewed. We were told that surgery was running about a half hour behind, so 12:15 was our new time. Thye soon after updated us and said that surgery was now running an hour behind, so 12:45 was the new projected time. Owen was in such a great mood throughout it all. He had not eaten since 7 am and yet was still laughing, smiling, and talking to us.  


Around 1, they told us that the surgery team was ready, but they had to wait for a bed to open in the CICU for Owen to recover and it might be another hour. Owen somehow was still in a great mood. Finally, around 2:30, they were ready for Owen.

We walked Owen back to the operating room and we met some of the team who assured us that he was in good hands. We gave Owen some last hugs and kisses and handed him over to the surgical team. Owen remained calm throughout as we walked away and he showed us how brave he is.

We met our parents in the waiting room and prepared to wait for what was scheduled to be about a 3 hour operation. We got an update at 3 that Owen was doing well and the operation had started. About 15 minutes lates, we got another call for an update. We were not expecting to hear from them so soon. They informed us that the surgeon had quickly decided that this would no longer be a laproscopic procedure and they would have to perform an open procedure. We knew that this was a possibility, but it meant that Owen would be in a little more pain in his recovery. Owen's surgery was completed around 6 and he also got an echo while he was under sedation.

We spoke with the surgeon after the procedure, and as we had come to expect, the operation was not as straight forward as they thought it would be. Owen had a laundry list of procedures to be performed including, pulling his stomach down into his abdomen, patching the hole in his diaphragm, performing an anti reflux procedure wrapping the stomach around the esophagus, placing a G tube into his stomach, performing what's called a Ladds procedure to prevent his intestines from twisting due to the malrotation that he was born with, removing his appendix, and while he was under, they performed his circumcision. When the surgeon began the procedure laproscopically, he looked on the left side for Owen's stomach, and couldn't see it. Then he looked on the right side and couldn't see it. At that point, the deciosion was quickly made to perform an open procedure. They found his stomach directly behind his liver. Once this was located, they were able to do everything but the anti reflux procedure. Owen's esophagus wasn't quite long enough for this procedure to be properly executed. This means that Owen could have some bad reflux problems when he begins feeding and potentially would have to be fed into his small intestine to prevent that from happening. This would also mean that he would have to be on pump feeds continuously. These are things that will play out over the next couple of days.

The echo revealed that Owen's heart was still in good shape, but they did see some narrowing in his pulmonary veins that were repaired in his first operation. The doctors said this is something that they will have to follow to determine if it continues to get worse and there is any blockage that may need an intervention. They aren't overly concerned at this point, but it is something that is just part of the game when you are dealing with such a complicated heart.

Owen was taken to the CICU for recovery. We were able to get into our room and see him around 7pm. He was pretty out of it, but luckily, he had his favorite monkey to make him feel safe and comfortable waiting for him as soon as surgery ended.

Owen had some pretty intense pain over night and also had a fever, which we were told was pretty standard post operation. Other than dealing with the pain, he was doing very well. The next morning we found out that they were ready to move him to the step down unit, which was welcomed news by all. In a cruel twist of fate, we ended up back in the same exact room that we had spent 2 months in the fall between his two heart surgeries. We had a couple nurses, doctors, and even cleaning ladies jokingly welcome us home.

The next couple of days will involve Owen coping with the pain and waiting for his bowel functions to return. Once that happens, we can begin feeding and hopefully get back home soon. We will keep everyone updated on the progress of our little warrior in the coming days. Thank you all for the continued prayers and support.




Sunday, December 7, 2014

Enjoying Home


It has been an amazing month since Owen was discharged from the hospital. Owen has done wonderful in the weeks since coming home and had so many fun experiences. It has been a true blessing to finally be home after such a long stay in the hospital.

Owen quickly adjusted to being home. He has been smiling non stop and making up for lost time at the hospital. He sleeps without being interrupted. He has been able play with all his toys and continues to develop new skills. He gets to wear new outfits and not just pajamas that button up. Owen met all his cousins and had a number of visitors stop by to meet him.Here are a few things that he has been able to do:

He enjoys his baths and his warm towel.

He got to see his first snow .


He discovered Mom's "Owen Strong" bracelet and fell asleep holding it. 


He gets to hang out on the couch and read books. 

 

He gets to talk, hold hands, and play with his cousin Max.







Owen has a had a couple of doctors visits including his first peditrician appointment, a follow up with cardiology, a meeting with the surgery team for his hiatal hernia operation, and a meeting with Hematology to discuss his high platelet count due to his asplenia.

Cardiology was very pleased with how Owen's heart was performing. The valve ia holding up and his heart function actually improved a little from the last time he was evaluated. We scheduled his Hiatal Hernia operation for December 11. The procedure is laproscopic and minimally invasive. It will bring his entire stomach below the diaphragm and help him feed in a more normal fashion. Even though the procedure is minimally invasive and normally would be an outpatient procedure, Owen will have to spend a couple days in the hospital due to his heart condition. The doctors want to monitor is heart for a little bit post surgery. As part of the operation, Owen will have a G tube placed in his stomach which will be accessible through a port on his side. owen will need to be able to tolerate his feeds in this new way before leaving the hospital. This will also allow Owen to have the NG tube removed from his nose and face. Once he fully tolerates feeding orally, the G tube will be removed. We are very excited to have the NG tube removed from his face and be able tos see his huge cheeks and adorable face more without tubes and tape.



The Saturday after Owen came home, his Great Grandma passed away after 96 years. He only got to meet her through Facetime, but she loved Owen and his smile. My Grandma lived a full life and her last wish was that she could offer a trade with God, she would go to heaven if Owen could come home. The fact that she held on long enough to see Owen come home was a truly special moment and showed what a wonderful woman my Grandma was.





Owen was fortunate enough to experience his first Thanksgiving with his family. We were so lucky to be home to be able to experience the holiday with everyone. It was extra special to spend the time with out family after all that we have to be thankful for this year.






Owen is such a lucky boy to have so many people praying and caring about him. He continues to be spoiled and receive some extemely thoughtful gifts. We would like to thank Brendan Hosty, Alison Kropf, Emily Kaniecki, The Mirtes, Great Grandma Fagel, Debbie and Jim Murphy, The Brown's, Katie Lowstuter, The Thelen's, The Bolger's Steph Miles, Holly Piddock, and The Thompson's for sending Owen toys, books, and clothes and also food and wine for Mom and Dad. We can't thank you all enough and let you know how much it has meant to us to have your support. We wouldn't have been able to get through this without all the prayers and support of so many wonderful people.Owen also got a pair of custom Nike's from The Frericks that he looks awesome in. Thanks again to everyone for everything.


Owen quickly got in the Christmas spirit and loved looking at his first Christmas tree. He even helped decorate with his very first ornament thanks to Ali Stigler.







Owen is ready to take on this next operation and move forward. The hope is that after a quick recovery, Owen will work on eating, growing, having fun, and being a kid. We look forward to more great experiences ahead for our Little Warrior. 


















The Frericks, Holly Piddock, Steph Miles, Brendan Hosty

Wednesday, November 5, 2014

Home

After almost 4 months, 17 weeks, 119 days, 2 open heart surgeries, and countless tests, pricking, prodding, beeping machines, and an overwhelming outpouring of support and prayer; Owen is home.

We moved to the step down unit Tuesday, October 28th. It was great to get out of the CICU and take the next step towards going home. Because nothing has come easy, Owen did not have a good first night. He experienced some more of the desats while he slept that were an issue prior to surgery. This was obviously not a good development. The doctors decided that Owen would have to undergo another sleep study to try and determine what was going on. Owen did much better Wednesday and Thursday and the sleep study was performed Thursday night. Owen had to go through being covered with sensors and watched all the night.The preliminary results from the sleep study were encouraging, but we wouldn't get final results until Monday morning.

Owen celebrated his first Halloween on Friday. We were thinking about what to dress him up as, but Grandma Lulu surprised us with the perfect costume "Owen with a Bee on his nose".



Owen continued to do well and on Saturday morning, we were told that the goal had been set for a Tuesday discharge. This was the third time we got a discharge goal, so we tried to not get our hopes up, but we just couldn't. We knew, this time, we would be going home. We decided not to tell anyone in case it didn't happen, so we kept it a secret from our family all weekend.


Monday morning we got the results from the sleep study that showed Owen still has some sleep apnea. While sleeping, he stops breathing for a short period of time and his brain does not trigger him to breathe right away. Because of this, the doctors decided it would be safer to keep Owen on a small amount of Oxygen while he sleeps. Fortunately, this didn't delay our discharge, it just meant we would be getting Oxygen for him at home.

Tuesday morning arrived and it was all systems go. Our room was packed and ready to go bright and early. We had picked up all of his medicines, arranged for Oxygen delivery, and spoke to the doctors about his care and follow up appointments. Finally, Owen got in his fancy clothes and was ready to see the world.

We said our goodbyes to many of the nurses and doctors that we had developed relationships with over the last coupe of months and headed for the door. It was truly surreal to put him in the car and drive away from the hospital. Mommy sat in the back seat and talked to Owen as he took in all these new experiences.

We arrived at our house and brought Owen in for the first time. It was such a special moment after all the things that he has gone through in the last 4 months. We quickly took him up to his room and set him in his crib and took a short video to send to our family to surprise them with the news that we were home. They were all shocked and elated to see Owen at home and in his crib.

I don't know if Owen knew he was home or if he just reacted to our faces, but he literally did not stop smiling all day. He got to meet his Cousin Max for the first time and they like each other already.

We went on our first walk outside to get some fresh air.

He got to meet his cousins Josie and Leo for the first time.

And most importantly he got to sleep at home for the first time and not deal with people checking on him every couple of hours and taking temperatures and blood pressures. Owen finally got to feel like a baby.

We would again like to thank everyone who has supported and prayed for us. We recieved a very thoughtful note and gift from Maria Schmitt and we countiue to be overwhelmed by all the thoughts and prayers. This was an ubelievable milestone in our lives and it was such an incredibly happy and sepcial day. This isn't the end of the journey for Owen. He will be undergoing a quick operation to fix his hiatal hernia in the next 4-6 weeks and after that fix we can begin to work on a more normal feed and eventually getting rid of the nasal gastric tube. We have to see the Cardiologists every two weeks to check on how things are progressing. He will have a follow up exam in the next couple of months to see if his sleep apnea has improved and can come off the Oxygen anytime soon. He still has to take a number of medicines. We know our Little Warrior is up for any challenge that will come his way.
Even with all that lies ahead, Tuesday, November, 4th felt like we had won the lottery. We finally got some normalcy in our new life as a family of three.



















Friday, October 24, 2014

Recovery

The recovery process for open heart surgery is complicated and intense. There are wires and tubes everywhere giving fluids, medicines, and oxygen and draining and clearing out fluid. It is a slow, meticulous process to start removing and weening things. Each removal of a tube or wire is a small victory and a sign of progress.

Owen did very well overnight after his surgery. He was heavily sedated, but his numbers were looking good and the doctors were very pleased. There had been talk of removing the breathing tube Saturday, but since he arrived late on Friday, they decided to let him rest all day. Owen remained sedated and on pain mediction while the breathing tube was in. He would stir every once in awhile, but the best thing for Owen was to keep a low heart rate and blood pressure and to sleep.

Sunday morning the breathing tube came out. In order to take the breathing tube out, Owen had to come out of his sedated sleep so he could breath on his own. He did wonderful and quickly started breathing well, but he was still pretty out of it and dealing with some pain. There were a couple of major sources of pain for Owen that he had to deal with. The first and most obvious was from the surgery. The second source was from the chest drainage tubes that were clearing fluid out of his lungs and chest. These were up in his chest and against the nerves in his lungs. Those would come out as soon as the drainage subsided. The third source of pain was coming from intense, migraine like headaches. The Glenn procedure takes the Superior Vena Cava, which in a normal heart connects to the right atrium, and connects it to the the pulmonary artery. The Superior Vena Cava brings blood from the head to heart and then is pumped into the lungs. Because Owen has a single ventricle physiology, the blood flowing from his head is now flowing to the pulmonary arteries and into the lungs. This new path of blood flow causes some pressure to build up in the head before the body gets used to it, causing severe headaches. Owen has been a warrior dealing with all these sources of pain. We were lucky enough to get to hold Owen on Sunday. It was alot of work to get him out of bed with the tubes, but we were encouraged to hold him because it soothes him, helps clear out his lungs, and it helps with the headaches to have his head up.

Owen got one of his chest tubes out Monday morning, but the other two were left in to continue to drain. He was very puffy from the surgery and had retained alot of fluid that needed to be drain. He started to wake up a little bit more and he opened his eyes and looked at us for the first time since his surgery.

On Tuesday, Owen had an EP study to determine if an arrythymia could be triggered and if he needed to go back on his heart meds. We got great news that they were unable to trigger any abnormal beats and that they would not be putting him back on the heart meds at this time. It does not mean that he would not have the arrythmyia anymore, but it was a good sign.


Owen had a little more pain on Wednesday and had trouble sleeping. The exhaustion was evident on his face, but he just could not sleep. He finally slept well Wednesday night, thankfully, because he had a big day Thursday. He had the remaining two chest tubes removed, which immediately eased the pain. Owen also had a line in his jugular from surgery that was being used to give some meds and fluids that needed to be removed. Unfortunately, they still needed access for emergency meds or fluids, so instead of another IV, which have not been the greatest with Owen, they decided to place another PICC line. Owen had a new PICC line placed in his right arm which goes all the way through his vein and sits in his Superior Vena Cava. Owen did great with the procedure and with having his jugular line removed.



From this point on, the main focus is getting Owen to tolerate his feeds and weening him off of oxygen. He continues to progress and do well and everyone is pleased with how he is doing. As of Friday morning, the hope was that we would be moved to the step down unit on Monday.

We would like to thank all of you for your thoughts and prayers. The support has once again been overwhelming. We would also like to thank The Browns, The Mix's, and Amy Celesti for sending very thoughtful gifts for Owen. We were also lucky to have Aunt Carol and Uncle Randy send up a homemade dinner and a gift and the Hambleton's also sent a homemade dinner, which all really hit the spot. We can't thank you all enough for continuing to support us and Owen.

This has been a tough week for Owen but he continues to fight and we can't wait to see that smiling face again sometime soon. He is getting close to flashing it, but not quite all the way there.