Surgery for Samuel

Well, lots has happened since I last posted on Wednesday. It is late at night and I am sleep deprived, so I'll try to make this concise and coherent. I am typing this post from a computer at the nurses' station in the ICU where I am staying with Samuel. Here's why.....

Samuel was in the hospital on Thursday for his scheduled biopsy. While he was in the recovery room, it was decided that his remaining native kidney should come out sooner rather than later. We have known for a while that this would be a possibility. I'll try to explain why in another post sometime. Samuel's left kidney was removed back in September. At that time, the tentative plan was to take the remaining right kidney out when he had his transplant. The surgeons later decided that doing the nephrectomy (kidney removal) during the transplant surgery would mean Samuel would be on the operating table for too long. Given what happened during the transplant at the end of October, this was a very good decision....but that is another story.

So....on Thursday evening while Samuel was recovering from the biopsy, the surgeon made arrangements for him to have his right kidney removed the very next day on Friday. Samuel was moved from post-op to the pediatric floor late Thursday to spend the night. At 6:00 a.m. he was dialyzed and at 1:30 p.m. he went into surgery. At 4:00 p.m. the surgeon met with me to say that he would not be able to remove the kidney laparoscopically as planned. It seems Samuel had significant bleeding after the biopsy (one of the risks). The blood in his peritoneal cavity was obstructing their camera's view and had irritated his bowels, making them distended. This swelling restricted the space in which they had to work. To complete the surgery safely, they needed to abandon the laparoscopy and make a large incision in the center of his abdomen. It was slow and tedious work as they had to "unstick" the many adhesions caused by his 2 previous surgeries. They had to place a stitch here and there on his intestines where they were bleeding after being unstuck. Samuel was in surgery for 6 hours and received 3 transfusions that day. We met up with him again at 8:30 p.m. in the ICU. That was Friday night.

It is now Saturday night and if I don't finish this soon, it will be Sunday morning. Samuel is one hurtin' pup. Some things are happening with him that the doctors don't quite understand yet. This evening's bad news is that Samuel has some clots in a vein in his neck where his dialysis catheter is. This creates some very real dangers for him. They will begin dosing him with heparin to keep the clots from growing larger. Unfortunately, they cannot heparinize someone who has an epidural, so Samuel's was removed. This will make managing his incision pain a bigger challenge. Please pray that he would be comfortable enough to sleep and heal.

This is the short version of what has been happening in the last 3 days. There is so much more I could write about, but I haven't the brain for it and you would surely be bored with all the medical details. I would like to finish by sharing with you some very good news...

Because Samuel ended up having an open nephrectomy, the surgeons were able to take a good look at the new kidney. They say it looks great! They are feeling confident that it will eventually work enough for Samuel to discontinue dialysis. They don't know how long it will take to reach that point, but they feel sure that Samuel's dialysis days are numbered. The new kidney is actually making urine (hallelujah!!) and Samuel's blood pressure is being managed with only one drug instead of 3.

At this point, we have no idea how long Samuel will need to be in the hospital. There are many hurtles to overcome in the days ahead. We covet your prayers.