Thursday, July 23, 2009
This morning Michelle, Kevin, and Nana went to the hospital and found the surgeon within the vicinity. We were able to get a quick meeting with him and someone from the NICU that had an idea of what Karsie's situation entailed. We will probably have these about once a week, though since all three of us are constantly asking questions, we think much of it will be old news. However, today's was not.
Update from Surgeon: Dr. Losasso started by saying there is good news and bad news. The good news is that she is responding well to treatment. She is being weaned off of the ventilator at a decent rate. Following that, her bowels are doing a little better. We are close to being able to check that off of the prayer list as "answered". The bad news (which we found out we already knew...relief) was that her abdominal cavity is so teeny tiny and her organs are not. Organs growing inside the abdomen both keep the organs smaller and stretch out the cavity. Because there was no restriction, her organs grew bigger than her cavity and her cavity didn't grow, so it's a double whammy. All of which to say, he doesn't think he will be able to get everything in. Normally, they want to start putting it all back in immediately and have it all in within 7-10 days. We are on day 6, so the clock is ticking.
What this means: The surgeons will start on Saturday, when they can, squeezing (like a tube of toothpaste) the intestines slowly back into the cavity. This will help the liver, currently vertical, sit more horizontal on top of the bowel, which is where it should be. The more "stuff" that goes in, the harder time Karsie will have breathing. Since she has been without restriction on her lungs so far, she has had no obstacles to her breathing. After Saturday, that changes. This "squeezing" procedure will go on a daily basis until they have to "bite the bullet" and just finish. Meaning until it is not safe anymore for the organs to be in the siloh. Once that is finished, assuming some miracle doesn't happen and they are able to close her up, they will get a Gore-Tex patch and sew it around the opening, over the exposed liver, and wait for the skin to grow around it. This will most likely take at least a couple of years to complete. Fortunately, we will be able to take her home well before that growing process is complete. I'm sure you can pick out the parts in that situation to pray for.
NICU - As far as Karsie is doing as a whole, the nurse practitioner explained their timeline to us. First of all, they will work with the surgeon explaining to them how the baby is responding to treatment and how or if she is ready for more "squeezing" to be done. Their biggest goal at this point is weaning. Karsie needs to be getting adequate oxygen (which she seems to be doing very nicely), she needs to be stabilizing her blood pressure (needs some work on that), she needs to have a nice heart rate (at times a little fast, but okay), and her blood gases need to be showing good signs (decent but not great. Her CO2 levels tend to be a bit high and her PH levels fall slightly lower than normal, but not horrible). Basically, once the patch is on and everything is inside the body, they want to see Karsie breathing on her own, eating on her own (through the mouth) and off of the meds helping her stabilize her vitals.
As far as a timeline for taking her home goes, no medical worker wanted to comment on that as they only have one week worth of data to give any kind of trend, and it all is shot soon anyway when the organs start to go inside. However, the social worker, based on other situations that have come in like this said that we're looking at anywhere from 4-8 months being in the NICU. She may surprise us and start really improving much more quickly, but she said that is about average. So we are hoping for at least a nice little Christmas present and maybe a little Thanksgiving present if we're lucky. The good news about that is we will be able to hold her and play with her much earlier than that, but until those important things like eating and breathing are being done without any help, Karsie will stay put.
On a completely new direction, Karsie was moved in the NICU to a much more quiet spot. The nurses thought that her high traffic spot was stressing her out a bit. We are also going to be able to give her voice recordings of us for the nurses to play while we are not around.
We're doing better than we were yesterday, but we're still very sad about all of this. The meeting was mixed with hope, sadness, thankfulness, worrying, and a whole bunch of other emotions that go with trials like this. We know Karsie's situation has been turned into a far reaching story, and we thank all of you that continue to keep her in your prayers.