Day #60....Surgery Report

Sorry to leave you hanging for a couple days. I just needed a break. Now to get you caught up….

Samuel’s surgery on Thursday night went well. He was in the operating room for just over 2 hours. Despite his elevated white blood cell count and what the CT scan showed, the surgeons did not find an abscess in Samuel’s right renal fossa. That is good news! A bit confusing, but good! There were plenty of adhesions and some inflammation in his abdomen, but no obvious pockets of “traditional infection” (meaning pus). The surgeons had to separate some of the adhesions to be able to work, but some adhesions they left alone, including the bit of bowel that is now attached to Samuel’s new kidney. They used more than two liters of a saline/antibiotic solution to wash out his peritoneal cavity. Doing this disrupted the existing pockets of fluid that he had near his spleen and kidney. These collections of fluid are normal after an abdominal surgery and are, over time, reabsorbed by the body, but since the surgeons had the opportunity, they cleaned these pockets out also.

While they had Samuel open and could see what was what, the surgeons took a biopsy of the new kidney. This also allowed them to watch to be sure there was no bleeding after taking the sample. If you remember, Samuel’s last biopsy on December 6th bled significantly and created a whole set of problems. I’ve been told that the initial biopsy report looks good…no sign of rejection! More detailed information will come later. The surgeons also took out one of Samuel’s lymph nodes for testing. They don’t anticipate that there is anything wrong with it; they are just being overly cautious.

Samuel spent Thursday night through Saturday afternoon in the ICU. His blood pressure was incredibly stable and LOW!! Later on Saturday, he was moved up to the pediatric floor and, would you believe, he is back in his old room…Baird 587!

Sunday was a quiet day of rest. We watched a fascinating program about the history of some foods….chocolate, pizza, hamburgers and fried chicken. Very interesting! We also had a nice visit with Grandpa Hoot and Elizabeth. Tom came to visit earlier than usual so he could leave in time to watch the Super Bowl at home. Inspired by the television program we had watched, Samuel and I decided to order a pizza for dinner. Shortly before I went down to the hospital lobby to meet up with the delivery person, Samuel had an episode of muscle spasms, headache, and intense nausea. He was medicated and eventually fell asleep leaving me to eat cold pizza alone. I’m hoping he’ll be up for eating some leftovers later.

So, here’s where we are right now…..

Samuel has a large, nasty-looking incision down the center of his abdomen and his belly is extremely tender to the touch. Yesterday, he told me that he feels like he has been “cut up and put back together wrong”. His pain is being managed with a scheduled oral dose of Dilaudid, as well as a PCA (patient-controlled analgesia) pump that administers an IV dose of Dilaudid whenever he pushes his “pain button”. It will not allow him to have more than a programmed number of doses each hour. It locks him out if he pushes the button too often. He has had this set-up before so it is pretty routine for him.

Samuel’s blood pressure was ideal (systolic 110-125) on Friday, Saturday, and Sunday. It seemed that the surgeons had unwittingly adjusted some unknown BP thermostat while they were operating, but since this morning, his pressure has been a bit higher (135-149). He continues to be on four different blood pressure medications. We’ll have to wait and see where things go. It is a mystery why his blood pressure was suddenly so low and stable after the surgery.

Today Dr. Di Carlo told me that they have wanted to take Samuel back into the operating room for awhile. But without a clear reason to do it, they were hesitant to take such an invasive step. The combination of the elevated white count and the suspicious CT scan on Wednesday, gave them the excuse they were looking for. So even though they didn’t find the abscess that they “saw” on the CT scan, it seems to be what the Lord used to trigger the surgery. Dr. Di Carlo explained that sometimes a person, like Samuel, with a compromised immune system, isn’t able to mount an appropriate response to an infection. In these cases, it is possible to have an infection without rallying white blood cells (pus) or even having a fever. At this point, the assumption is that Samuel did have an infection somewhere in his abdomen. The washing out procedure has really made a difference. Samuel’s overall condition is greatly improved! His white blood cell count is now lower than it has been in a very, very long time! Today, his creatinine level took a BIG jump down from yesterday’s 2.50 to an all-time low of 2.15!! More of his labs are falling within normal ranges. Anemia is still a problem but, hopefully, that too will begin to turn around.

So today, on day #60 of this adventure, Samuel appears to be making great progress. He is chatting, reading, and eating (a little)….all good signs. We are grateful to the Lord for His goodness! Please rejoice with us and continue to pray for Samuel’s complete recovery.