After talking to the doctor at the completion of surgery I went in to be with Malia. Having been sedated and on pain meds she was still way out of it but the ventilator was working like a charm keeping her very stable. In the first hour after surgery she did have a few instances where her heart rate and oxygen level dropped sharply so they were watching her closely and adjusting the ventilator as necessary. Still after about 2 hours she was just barely showing signs of waking up and then would return to sedation. Despite Malia still being very much out of it she was starting to take breaths on her own. Over another 90 minutes they weened her off of the ventilator to the point that she was taking almost all the necessary breaths on her own. Eventually they got to the point of changing the ventilator into "CPAP" mode, more or less making the air available for her to breathe it as opposed to pushing the breaths in and out for her. After about 20-30 minutes of solid breathing on her own she just all the sudden stopped breathing and didn't rebound. Standing there with the nurse as she tried to stimulate her into taking breaths again it was evident that she wasn't bouncing back like previously. Everything was a blur from that point, all happening so quick. The nurse called in another nurse to assist her and within a minute they pressed a magic button on the wall which brought approximately 15 nurses, specialists, and a doctor within seconds. Pulling out all the stops it seemed to be somewhere between 2 to 3 minutes when she was given a drug (Narcan) to reverse the sedation and pain medication helping to wake her up. Once awake they gave her some breaths using the "bag" and pretty quickly extubated her removing all of the parts used in surgery. From that point forward she was able to breathe fine on her own with little more assistance than what she was receiving prior to the surgery. After being stable for almost 2 hours I called it a night and headed home. For the next 5 hours, up to about 2AM when I called to check in on her, she would have a handful of apneic episodes where the nurses had to intervene using the bag 3 times to get her back to breathing again. Later the next day we heard that after my call she remained stable with no issues the rest of the night. Blocked from feeding prior, during, and for hours after this procedure she has just recently returned to bottle feeding where she continues to have limited strength and stamina drinking only small amounts.
Friday, June 11, 2010
Speaking of her eye surgery... The need for surgery was identified after the Tuesday (6/8) eye examination revealed that her left eye had gotten worse and now showed Stage 3 Retinopathy of prematurity (ROP). The right eye remained at Stage 2 with no significant change. When Stage 3 is identified they schedule the patient for surgery within 72 hours, and that they did. Malia wasscheduled for Thursday (6/10) 2PM laser eye to treat both eyes. Even though the right eye was not yet to the point of needing surgery they recommended to take care of it while they were performing surgery. In hindsight, that would be a very good thing. I was there for the surgery and loved being able to hold her for a good 30-45 minutes prior to things getting started. One of the main concerns we had about the surgery was the fact that they had to intubate her. Given the issues with her airway/vocal chords combined with the issues encountered in the previous procedure we were not too excited. Thankfully the experts consulted each other and determined they would use a type of intubation that did not enter the airway but remains at the top (at a loss for the proper term). So the surgery began and I waited outside for the estimated 30 minutes per eye. Upon completion the Opthamologist came out and explained to me that the surgery went very well and as expected. There were about 450 laser zaps in her left eye and 150 in the right. Apparently these are relatively low numbers, as it's not uncommon to see more than 1000 per eye. However, the success of the surgery will not be know for up to 2 weeks. We're praying the retinopathy will be resolved, and her eyes will develop giving her the ability to see with no blindness.
Posted by Harley at 10:00 PM