Bilateral Hernia Surgery Completed

Henry had his hernia surgery today. We started off the day with Janice as his day nurse. At 6AM, he was only allowed to have pedialyte. Of course, Henry was hungry when Janice came on duty, and there was no pedialyte in the NICU. Janice eventually was able to get some around 8:30AM, which calmed him down a little.

I arrived around 9:30AM. My dad was in Henry's room, talking to Joyce, who came into the NICU at 8:30AM (during her vacation) to make sure that Henry (and me) was alright. I have to say (again) that Joyce and Holly are amazing nurses. I am so touched that they care about Henry so much to come into work during their vacations. My dad went to work after I got there. The surgery was scheduled for noon.

Holly came some time between 10-11AM. Jeff had work to do in the morning but managed to get there around 11:15AM. Around 11:30AM, someone from downstairs arrived to take our baby to the operating room. Holly said a prayer with me and Jeff before we headed down there.








Once downstairs, we spent about 45-60 minutes in a prep room. Jeff and I met the surgeon for the first time, a doctor named Catherine Cosentino. We didn't talk with Dr. Cosentino long. But she put me at ease almost immediately. She carried herself in a self-assured manner (not cocky but confident). There are a few people in this world who possess a natural leadership style. They don't have to list out their accomplishments or drop names to gain respect from others. Competence and command emanate from their behaviors seamlessly. My mentor in graduate school (KHJ) is such a person. And, Dr. Cosentino exhibited these traits as well. She explained what would happen in the OR. She checked out Henry's hernias while we watched. Unfortunately, he had one on both sides (bilateral). She explained the risks of the surgery but said matter of factly that they wouldn't happen under her hand. She wasn't braggadocios as she said it. She just stated it as fact. Unfortunately, just because he has had this surgery doesn't preclude the hernias from breaking through again, since the tissue on preemies is very delicate. But we'll hope for now that no holes appear and that Henry can enjoy some semblance of digestive normality once the surgery has been completed.

After talking with Dr. Cosentino, we talked with the anesthesiologist, Dr. Loeb (I think). Holly came down to the prep room with us. Between her and Janice, they covered Henry's prior history for Dr. Loeb.

Henry got wheeled away around 12:20PM. My mom (who arrived while we were in prep), Holly, Jeff and I then went to the cafeteria for lunch. The cafeteria today seemed particularly unappetizing. As far as cafeterias go, it isn't bad given how inexpensive the food is. But as a vegetarian, there are only a couple things I can eat. And having been at the hospital 106 days, I couldn't stomach those options. So I had a chai javalanche and a brownie (not exactly nutritious). We got back us to the NICU around 1PM. The doctors called from downstairs to say that the first part of the procedure had gone well. We sat around Henry's room for a while. Joyce joined us. She didn't go downstairs as she didn't want too many cooks in the kitchen. I was pleased that she was there when Henry came back upstairs.

Henry emerged with an entourage of doctors around 1:30PM. Dr. Cosentio reported that everything had gone well. We are to have a follow-up with her in two weeks. Henry was still ventilated when he came back upstairs. They had him on a slightly different ventilator than the ones he had had during his first two weeks in the NICU. This one was a Galileo ventilator. I gather that the NICU nurses weren't exactly impressed with the intubation that they had done in the OR. They had put the ventilator tube down Henry and taped it down over the cannula tube, rather than removing the cannula, which at least two NICU nurses independently described as "lazy."

Rather than putting Henry back in the isolation room, Dr. Erenberg had Henry placed in Pod Three, slot 22, which as you look at the room toward the windows is the slot second from the back on the right hand side. Pod Three just has a few babies at the moment, so Henry didn't have podmates near him. My mom counted eleven people in Henry's entourage. My mom, Jeff, and I hung back as the entourage got Henry settled.

Once Henry began to stir, Janice took a blood gas. The results looked quite good. Jeff headed home once Henry was settled in. We decided to try to split sleeping shifts. Jeff came home to take a nap. He's at the NICU now. I'm home, obviously writing this blog entry, and plan to take a nap and then relieve Jeff in a few hours.



A little while after Jeff left, once Henry showed signs of really wanting to wake up, the doctors and nurses decided that he was ready to be extubated (off ventilator, tube removed from throat). By this time (around 3PM), Janice was going off duty and nurse Henry was taking over Henry's case. The Galileo ventilator was different from the Servo that Henry had been on before, in that it had a computer screen that allowed the machine to be set in a CPAP (continuous positive airway pressure) mode. This version of CPAP was a little different than the CPAP that Henry had been on for 29 days in that it was run out of the tube down his throat, rather than through his nasal passages. The CPAP provides pressure for the baby to breath but the baby has to do the work taking the breath in. By running through the mouth, it creates a situation that Melita said is kind of like breathing through a cocktail straw. Henry's test for being ready to be extubated was that he had to keep his sats elevated for 10 minutes while on CPAP mode. Not only did he managed to keep his sats elevated, but his oxygen saturation levels actually increased to 99%. Nurse Henry counted down the minutes. And then switched Henry over to cannula. The cannula tube got kind of messy with the tape that had been placed over it. Therefore, nurse Henry showed me how to get rid of all the old tape and put down fresh duoderm and tape to hold the cannula in place. While replacing the tape, the cannula was off Henry's face for several minutes. I kept an eye on his sats, and they stayed around 100%. I think that he'll be ready for being off oxygen soon. He just needs to get a little bigger (more lung tissue) and to raise his hematocrit up a little bit (it was 30 on Sunday).

Nadine called into the NICU to check up on Henry. Aren't these nurses sweet? Holly took the call and gave Nadine the update. Henry's primaries rock!

Holly headed home around 5PM, having once again going beyond the call of duty (she is after all on vacation and not getting paid for her visit, although she helped out with a lot of things). Henry was very awake and hungry by this time. Nurse Henry got me a bottle of 45 mls to feed my son. Henry took 15 mls, but then didn't seem to want anymore. Nurse Henry said that I was being too gentle with him and showed me how to get him to eat more. He kept Henry alert by twisting the bottle a quarter turn every time Henry tried to drift off to sleep. My son ended up eating 45 mls. Nurse Henry had to go to Pod Two to attend to another baby. My son was still rooting. I tried giving him the pacifier. But after sucking on it vigorously for 10 minutes, I decided that he needed more. So Kathy Lucas got me another 20 mls, of which Henry drank 10 mls. Not bad for a post surgery feast. Nurse Henry removed Henry's IV once it became clear that Henry was eating.

Henry's sutures are quite small. Two little lines held together by steri-strips right above the groin about an inch below the belly button. The biggest obstacle for recovery is probably getting the anesthesia out of Henry's system. My mom overheard one of the doctors say that Henry's vitals were rock solid during the entire surgery. They are prescribing Tylenol for his pain. And, since he had several apnea spells after his eye "treatment," they decided to give Henry one shot of caffeine.

While I was feeding Henry, Aunt Erin stopped by to check on him. Erin, my mom, and I chatted for awhile. Around 6:45PM, we got kicked out for shift change.

It was an eventful day. Things are looking fine. And, hopefully, on Thursday, we will be able to bring Henry home.