Like Old Times

Tonight one of James's primary nurses from the NICU came by James's room for a quick visit, and so did one of the residents who took care of him and Matthew when they were in the NICU. It was so nice to see them again! Mattie was there visiting, and James was awake but fairly sedated from his meds.

And one of the nurses on the floor was Matthew and James's first babysitter. Mike had gotten to see her last night (she was helping out with taking care of James), but I had a chance to say hello to her and catch up a little bit this evening, which was great. We had taken Matthew down to the NICU to visit some of their primary nurses the other day, too -- seeing them is always a highlight of our hospital trips. (They manage to make even stressful days good ones for us!)

So, basically, we've been having a big hospital reunion -- a silver lining of James having to be back there!

James had a good day (pretty mellow, some good naps), but apparently an even better evening. After Matthew and I left, Mike said that James threw up right after he got a dose of one of his medicines -- but after that, it was like he was back to his old self again. He was rolling over, getting up on all fours in a crawling position, playing with his toys, and clapping. Wow! The only bad part about all that is that he he still has a drain coming from his incision and still has a catheter, so we worry about him pulling something with all this movement. (He wanted to chew on the little plastic container at the end of the incision drain, for instance.) Everything is taped down, but still, it's not really designed for a baby in motion. Hopefully both of those will be removed tomorrow morning, and then he'll just have the monitors.

Return to Milky

James is back to drinking formula! He didn't really want to drink overnight, so we were a little worried because one of the options on the table was to put an IV back in. (If they couldn't do it when he was well-hydrated, I don't know what kind of magic it would have taken to do it when he was dehydrated!) But then he had a good bottle of apple juice and water for Mike this morning, and when the doctors did their rounds, they said he could have formula -- yay! He's had a couple of bottles so far, and I bet he feels better now that he's getting some nutrition again.

James versus the IV

The dressing for the IV in James's hand got wet, so his nurse had to change it. (She wisely decided to do this just after giving his morphine dose.) She tried her best to keep the IV in, and we thought we had it, but then at the last minute it slipped out. The pediatric IV team doesn't work on weekends, so she called the regular IV team. They came and couldn't find a good spot to put one in. So she called the PICU (pediatric intensive care) and they sent someone up -- he tried and failed.

Fortunately, though, the docs decided that James could get his meds through his g-tube (directly into his stomach) instead of intravenously. So, he's been switched from morphine to oxycodone.

Of course, one issue is that he's not getting IV fluids any more, so he'll probably be hungry and thirsty soon. We'd been offering him bottles of pedialyte and pedialyte mixed with apple juice since early this afternoon, but he didn't want any of it. Finally this evening he drank about an ounce of apple juice mixed with water for me. If he can drink some more clear fluids and handles them okay, then they can start giving him formula again.

Once the IV drama was over, he's been pretty chilled out all afternoon and evening (no doubt helped by the meds!)

Code Brown

Great news!! James had a big poop this evening -- so it looks like his bowels are "waking up" and the systems are working as they should. We are very excited!! (Mike said that James seemed a lot more comfortable after that, too.) So, maybe some food or at least some clear liquids are on the horizon for him.

(The other good news of the evening is that they took the IV out of his neck. All of us are happy about that; it did not look too comfortable.)

This is James the morning after the big moment:

Popular

Our surgeon is on vacation next week, so a different surgeon is taking over to follow James's recovery. That's fine; the other surgeon was actually in the OR for part of the procedure, so he's familiar with his case. After explaining this, our surgeon remarked to Mike, "Everyone knows James." While this is reassuring in some ways, I'm also a little sad that my baby has such a wide circle of acquaintances among pediatric surgeons!

Yummy

Since James is too little to read the blog right now, I can post this picture of Mattie enjoying his lunch/facial of sweet potatoes and apple yogurt. (We are trying not to mention food or milky around James because he's not allowed to eat yet!)

We took Matthew to the nephrologist yesterday. When we first arrived, he was a bit out of sorts (probably because I had to wake him up from a nap to bring him to the appointment) -- so the initial blood pressure was on the high side. (And probably half the hospital could hear him yelling when we tried to weigh him.) We were disappointed, but when his doctor took it manually once he'd calmed down, it was right in the normal range. So, she said that we could finish out the bottle of meds that we had (which will only take another couple of days), and then have his blood pressure rechecked in a week or so. If it's normal, then he's all done with the meds (and the nephrology followups). Hooray!! Our nephrologist is awesome, but we'll be delighted to "graduate" from her practice. (And I would be thrilled to have one less reason to have to go to the hospital pharmacy.) So, keep your fingers crossed for good pressures!

Mike hadn't left the hospital since Tuesday night, so today I sent him out for lunch with Uncle Isaac, Auntie Erin, and Matthew. Mike claims he did not let Mattie try the espresso part of this dessert!

Friday night James slept well, and so did dad. The surgeon stopped by this morning and said James looked good and was on course. He took out the NG tube and peeled some tape away from one of the incisions. James will be given some antibiotics to ward off any incipient infection that may or may not be present in the old ostomy location. Right now James is sleeping comfortably following his morning meds.

(Photo is from Wednesday morning before surgery).

Good night

James is sleeping more comfortably tonight than he was last night. So far, anyway.
The red light on his hand measures his pulse and blood oxygen levels. The tape on his face is holding the NG tube in place.

Very Relaxed

This is a very relaxed baby! This is around 8:30 PM, shortly after he had received a dose of morphine. They've adjusted his dosage tonight (around 2 am) because he was having periods of breakthrough pain, which means peaks of pain that occur as the morphine wears off. But at this moment (2:15 am) he is resting comfortably once again. A few hours ago we removed the wraps around his arms (the thing that looks like a cast). They are supposed to prevent him from grabbing and pulling at his tubes, but they mainly succeeded in making him very uncomfortable and squirmy.

All is Well

We're (finally) back up in the room -- everything went well with the surgery. No more ostomy -- hooray!!

We were in the recovery room for a long time and James is mostly settled, but he seems to still be in a little bit of discomfort -- he'll probably be getting another dose of morphine soon. He's surprisingly active for a kid just out of surgery. He's mostly had his eyes closed, but opened them to say hello to us. He rolled over onto his tummy, which seems like it would be very painful given all the incisions there, but the nurse said that if that's where wants to be, then it isn't hurting him. He's got arm restraints on him ("no no"s) to keep him from pulling out the many tubes he has attached, but they're probably also making it hard for him to get comfortable.

So, long day but a successful outcome.

Meanwhile, Back at the Ranch

We hear that Matthew is living the life of Riley, quite pleased to have three adults (Auntie Erin, Uncle Isaac, and babysitter Nicole) and three dogs attending to him. Hopefully he won't get too used to this level of staffing!

Still Waiting

Our nurse just called down to the recovery room (at about 5 PM), and they had James on their list (for being out of the OR) for around 6:30 PM. So, we have more of this stressful waiting, but it's at least a little reassuring to know that it's not unexpected that he's still down there.

Cleared for Take-down

[Ostomy closure surgery is also sometimes called a take-down. To me that always brings to mind some kind of drug bust, as if James has joined the SWAT team.]

James had a pretty good night, and was in fairly good spirits this morning, given that he hadn't had anything to eat. They took him down to the OR a bit before noon. At one point someone mentioned that this would be a 2-3 hour surgery (I think not counting the anesthesia prep time which may also approach an hour), so I'm expecting more like five hours -- the surgical time estimates we've been given in the past have always been significant underestimates.

James was starting to get a little fussy in the pre-op room, and the anesthesiologist gave him the first calming-down drug through his IV. He went from screaming to smiles in the course of about five seconds. His head was sort of lolling around like he was a happy drunk, and then his eyes started to drift closed. It was very cute. (I asked if we could get some of that stuff for his brother's naptime, but no dice.)

Checked In

James is all settled in at the hospital. (We ran into one of Matthew's former primary nurses when we were registering, which was a nice start to the evening!)

He's on the 7th floor, which is good because it's the pediatric surgery floor. (I liked it better than the 6th floor from the start because they have very insistent signs about using the prominently-displayed hand sanitizer before entering the unit, as opposed to the 6th which had some vague suggestions about handwashing but nary a public sink in sight.)

Apparently James is on the schedule for 1 PM tomorrow, which is a bummer because they stopped feeding him at 9 PM tonight. We expect a cranky morning tomorrow. The one silver lining is that I don't have to head back to the hospital before dawn, so I can be here for the morning routine with Matthew. Mike is spending the night with James.

James was very unhappy about getting the IV, but he finally dropped off to sleep.

Happy Birthday, Grandpa!

James and Matthew Alden (and the rest of us) say Happy Birthday to Grandpa G! We love you and hope you're having a wonderful day!

Mike, James, and I are off to the hospital to check James in. Wish us luck!