Long Night, surgery complete

Tuesday, April 05, 2011

1:17 AM. – Garrett called and told us that he and Kaydi had just received a call to return to the hospital,  Gibson had taken a drastic turn for the worse.  His heart rate had accelerated; his oxygen saturation level had dropped into the 50’s; his carbon dioxide levels were elevated.  All bad signs. 

1:34 AM – Text from Garrett told us the situation and suggested that we come to the hospital. 

1:46  AM– We were informed that there was blood in Gibson’s lung and that is was making it difficult for him to breath effectively.  By 2:05 all the grandparents were in the family waiting room right outside Gibson’s room. 

Nurses were working on Gibson to get his oxygen content elevated.  They turned up the ventilator as far as they could – gradually so as not to inflate the lungs too fast.  They also extracted as much blood from the lung as possible. 

Kaydi was allowed to watch as Garrett, Kurt, Darrell, Chez and I went into Gibson’s room and Garrett gave Gibson another blessing.  Garrett again blessed Gibson with an understanding of what was happening and blessed his lungs that they might clear, and also blessed him with strength.  He told Gibson that he hoped to spend more time with him and encouraged Gibson to do what he could to hang on. 

Gibson received some medication to help moisten and lubricate his lung.  Many medical personnel are meeting to determine whether to perform surgery now or wait.  Gibson needed to have his oxygen levels at 70% before surgery would be possible.  By 3:00 he reached that level. 

We held a family prayer offered by Darrell.  He acknowledged the hand of the Lord in all things and asked that Gibson be blessed with health and that Garrett and Kaydi would be blessed as well. The prayer added great relief to a very tense morning in the waiting room.  I think we were all reminded that ultimately it will be the will of God that determines how this story unfolds.

4:10  AM – Garrett and Kaydi left Gibson’s room as the surgery was about to begin. The room was filled with doctors – at least 3.  Dr. Barnhart would perform the surgery.  Dr. Null was also in attendance as well as Dr.  Lang, who had done a nice job of keeping the family informed about the situation.   She informed us that Gibson was struggling for survival, but that they had used up all resources to assist him, except surgery.  It wasn’t the perfect time to do surgery due to the low oxygen concentration, but if Gibson took another turn downward they had no way to help him. 

Surgery actually started at 4:20.  By 4:45, they had removed the bowel from the chest cavity and revealed a very small and ineffective left lung.  That was disappointing news as everyone was hoping for some assistance from the left lung.  Gibson now has to make it happen with one.  He can not afford any more setbacks.  The liver needs to be moved into the abdominal cavity and then the diaphragm needs to be repaired.  The doctors will leave the incision open for a time to alleviate pressure on the abdominal wall. 



5:37 AM – The surgery is going well and rapidly.  All organs have been removed from the thoracic cavity and returned to their proper place.  The liver was not attached or wrapped over the diaphragm in any way and so it was easily returned to its proper place.  The opening in diaphragm can be patched with a muscle flap – by far the best solution as it allows for growth as Gibson grows older and larger.  Oxygen content is a little low, but that is expected.  The left lung is very small but may be able to serve some function depending on much pressure has been on it and the length of time it has been under that pressure.  So far, so good.

6:15am - Garrett's brother Tyler drove down and got here just in time to hear the results of the surgery.

6:30AM  – The surgery is over.  Each of the doctors and the anesthesiologist came and talked to the family and everyone was impressed with the surgery and Gibson’s response to the surgery.  For now, we will wait and watch.  The abdomen is not closed yet and will remain open for a week or so.  There is a mesh covering over the opening and a ‘silo’ as well.  As near as I can tell the silo is a plastic bubble that houses some of the intestines.  Gibson’s abdomen is not stretched enough to hold all the new contents and if they sealed it off, it would push against the diaphragm and undo all the good that they accomplished with the surgery.  Now the NICU nurses and Gibson take control.

7:15AM  – Kaydi and Garrett were able to sit with Gibson for a while and have since been ordered to go home and sleep, lest they get over-fatigued and get ill.  They need to be strong physically and mentally.  There are tough times ahead.  Gibson is resting peacefully.  The nurse said she hasn’t seen him this good since last night at 11:00 PM.  His oxygen content is 70% and rising. 

5:13 PM – Gibson had a restful day as well.  He is doing “really really good”.  His oxygen level is doing well; his CO₂ levels are a little high but dropping.  The nurses are gradually decreasing the amount of assistance he is receiving from the ventilator.  We got to see x-rays of the lung area and his right lung looks good even to the untrained eye; it is fully inflated.  His left lung is teeny, but can grow for a couple of years if he has adequate alveoli.  There is not room inside his abdomen for his intestine without putting pressure on his lungs, so his intestine is setting on top of his belly.  That sounds bad, but it is covered and many precautions are being taken to protect his bowels from infection. Gibson has a room with a view and if he is anyting like any of his parents and grandparents, this is good.