Saturday, March 13, 2010

Holy oxygenation, batman! Look at those sats!! (aka, “holy Speedy Gonzalez, batman! We’re already home!”)

Sorry for the two titles, folks. I (and others) preferred the oxygenation title, but Asher preferred the speedy Gonzalez one. His words: "i love that one, mommy." Sigh. I suppose i should humour him... it is his blog, after all. Anyhoo...

So, we're home!! J
Here's the low-down:

We were discharged from sick kids on Tuesday. The only reason we were in as long as we were (discharge papers word it this way: "Discharge was delayed due to persistent, non-chylous chest tube drainage.") was that pesky tube, but the drainage had slowed enough that they pulled the last drain and sent us home on Tuesday.

Meanwhile, however... wow! Was he ever cranky!! Mind you, i'd be a little ticked, too, if all my ribs were broken and someone had carved me up like a Christmas turkey, so i can't really blame him. But still! I'm not used to this! He's the happiest kid i know! So this was hard to see, but we managed. We stayed overnight in Hamilton with my family. We both wanted to see the other kidley-winks before heading home. So the plan was to come home on Wednesday. But... and yes, there's always a "but" in asherland... he threw a fit and demanded we stay one more night with "blivey and bramby." So i humoured him, and we stayed one more night. But we had post-op clininc at London cardio on Thursday morning, so we absolutely had to leave then. Which we did.

And here's how post-op clinic went:

Registered at 11 and went right in for our echo. I warned the tech (Jamie. Love her. And for those London heart moms out there... check out her ink next time you're there. It's really cool. But i digress...) about the quirk with Asher's fontan. And now, writing that sentence, i realize that i may not have posted about that here. So here you go: Asher had a "fenestrated fontan" which means that they put holes in the new wall which directs bloodflow straight to the lungs. These holes are intended to ease the transition to this new circulation and new pressures. Well! They know they put holes in there... but they can't find them now. Asher has had 3 echos since then, including and trans-esophogeal echo done in the OR, and they cannot find any flow into the right atrium from the IVC. They've looked, and there just isn't any. So i like to refer to this as an "unfenestrated fenestrated fontan"... the one complication from Asher's surgery. Haha so anyway, Jamie looked and looked but couldn't find the fontan. But otherwise, an uneventful echo.

Next up, bloodwork. Which was closed for lunch by the time we hiked all the way up there. Sigh. So, down to the first floor for a chest x-ray. With which our hero was not impressed. But he did well and got some fun stickers out of the deal, so no major complaints.

After that, hike back to clinic, because it's not nearly time for the lab to be open again. But, of course, no one was around in cardio, so we headed back to the PMDU for bloodwork.

Which was awful. They couldn't get in the vein in his one arm, so they switched to the other. Two pokes, plus lots of fiddling around in there to get it into his very scarred vein, and Asher left with a bit less blood, two band-aids, and a great new hot wheels car with a hood and trunk that open. So he was (relatively) happy... and hasn't let go of that car since, by the way.

Back to cardio. ECG went well. Uneventful, in fact. (wow, i love that word!!). his blood pressure is still high (114/65... mine is 110/70. Anyone see a problem there? That's right. My 3-year-old has higher blood pressure than me. Nice). BUT!!!! And make sure you pay attention to this... Asher's sats were... get this...


Ok, i just realized that not everyone knows what that means or why we care. "sats" show the amount of oxygen that is in the blood. Most of us reading this post have sats in the 98 to 100% range. That's normal. Before surgery, Asher's sats were 78 to 84%. And now they're almost normal!!! Can you believe this?!?! Never thought i'd see the day, but here we are!!!!!

There is another issue remaining, however. Apparently, Asher wasn't done draining. So there is now a pocket of fluid on his right lung. They saw it on the echo and the x-ray. So they're keeping his diurrectic (HCT) at twice daily for now (it was once daily pre-op) and we're going back to clinic for another chest x-ray on Monday. Oh, joy.

So Asher is now on quite the old man cocktail of meds. Three meds for blood pressure (carvedilol, which also helps with rhythm; ramipril, which also helps with function; and HCT, which also helps his kidneys), and one blood thinner (warfarin, which my grandfather was on for years). And he doesn't like any of them. He used to be so good with his meds. Now he not only complains, he turns away with a "hmph!" and says all-too-emphatically, "i don't like you, mommy. I don't want medicine. I don't like you, mommy." Gosh, isn't it swell that he can talk now? (why, oh why can't you hear the sarcasm?!)

But being home has definitely helped his mood. He is now usually happy and chipper and playful, although he still gets cranky and has a wicked short temper, but it's getting better... slowly. But again, i completely understand. In his mind, i didn't protect him from the doctors, i didn't stop them from hurting him, so he's angry. I understand. It doesn't make it any easier to hear/see, but i understand. And the fact that i can't pick him up properly the way he wants me to doesn't help, either. But he likes to cuddle with me and wants me to carry him a lot and chats my ear off, which is nice and makes those cranky moments a little easier to handle.
But there you go. Probably not my best writing, nor my wittiest post, but i'm tired. Maybe when i'm not quite this tired i'll edit/repost. Maybe. But don't count on it. ;)


Pam said...

Don't change a thing in your post. Sometimes the way you say things tells a great deal of the story. 96 !! Wow. And he will forgive you eventually . . .LOL . . . but I bet it will be a LONG COLD DAY before he forgives those mean old doctors . . . LOL . . .

Pete, Alison and Charlie said...

96%? WOW!! As a mum of a pre-Fontan HLHS son, I dream of seeing sats like that!
My son, Charlie, goes in for his Fontan surgery on March 22, so we're hoping to be in and out as fast as Asher!
So glad all went so smoothly for you - hope Asher is back to his normal cheery self very soon! x