Wednesday, April 20, 2016

April 20, 2016

Yesterday morning we were informed that Zeke was going to need surgery. They weren't sure what the issue was, but that he had an accumulation of air in his abdominal cavity. The surgeon believed that he had a perforation in his bowels that was allowing air into his abdomen. They wanted to perform a colostomy where they remove the damaged portion of intestine and sew the end of the healthy intestine to the abdominal wall so that any stool empties outside the body into a colostomy bag.
Ezekiel was taken down around pre-op around 1145 and we met with the surgeon and anesthesiologists that would be working on him. The length of the surgery was dependent the amount and severity of the issues they found, so we were expecting multiple hours for it to be completed.
They started the procedure at 1230 and we got to hang out in the waiting room for them to call with updates. At 1330, the surgeon came and found us, and we were concerned that it had not gone well. We didn't expect it to go that fast.
The surgery went extremely well and was fairly straightforward. Once they started the procedure, they found that he had a perforation in the colon wall just above his rectum. That perforation had allowed a large amount of stool to pool in his abdominal cavity, which is why he hadn't pooped since he was born. They flushed all of the stool out and performed the colostomy, suturing the lower part of his intestines to the abdominal wall.
The surgeon explained that there were two possible causes of the perforation. First possibility is that he has Hirschsprung's disease, which is where portions of the intestines develop without the nerves that cause the bowels to contract and move stool through the intestines. The other possible cause is that since he was premature and had other developmental issues, there may have been a section of bowel that did not receive adequate blood flow and didn't develop properly. They removed a section of his bowel and sent it to the labs for a biopsy to determine if it was Hirschsprung's or not.
During the surgery, they also found that his bowels were malrotated, meaning that during their development they had twisted. The surgeon corrected the twists in the bowel and stapled it into place to keep it from reoccurring. The condition can be fatal in newborns, so it was a blessing that they had to conduct the surgery and found the malrotation.
They also found that his bladder was full of urine. The catheter that was initially placed had come out and was not draining. He's continued to produce small amounts of urine overnight. This is very encouraging as it gives us the hope that he may have some remaining kidney function. We still don't know yet what the quality of the urine is which will determine the actual function of his kidney's.
It's now 24 hours later and Zeke is doing extremely well. He was very unstable yesterday prior to the surgery with Brady's (heart rate drops) every couple minutes and as low as 60 bpm (normal is from 120-160 for him). He hasn't had a single Brady since we came in this morning. Last night he was on 70% O2 and 60 rate on the ventilator. Overnight he's weaned down to 27% O2 and 50 rate. He's back on dialysis with no issue. His poor belly is finally back to a more normal size and the swelling throughout his body has gone down. He does have some sweet scars now though.

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