The Post Op Dance

Anyone who's had a child go through open-heart surgery before will tell you the first 24-48 hours post op are a bit of a roller coaster, even more so when hemodynamics have been changed significantly. 

And even more so when you're talking a transplant where everything has changed. 

But honestly? Bodie looks really good.

I just can't get over his nailbeds - they're the same color as mine for the first time in his life!!!

His native heartrate is nice and strong, but only in the mid-80's, so they have temporarily paced him at 100 for now, just to help him out during the recovery period (this is common post-op, as higher cardiac output can help the healing process as everything settles in, and I think all kiddos come back from the OR with temporary pacing wires in for this (and other) reason). And his blood pressures have been up and down. But all things they expect post transplant and things they've very good at dealing with.

I noticed earlier today that his left leg was cool and clammy to the touch, and his foot in particular was cold (both of which were fine yesterday). The concern in this situation is always that a clot formed, perhaps when they pulled a line today or earlier and is just now appearing. So they did an ultrasound of the leg, during which time the leg warmed back up and seems fine now. We don't have the results back of the ultrasound yet, but are hopeful that it was just his body adjusting to lines being pulled (rather than a clot that perhaps travelled somewhere else). 

They pulled out his Arterial line and one other line today, which is great progress forward.

They also took out his Foley catheter, which, for reasons Bodie probably doesn't want me to get into here, was larger than typical and painful. They had planned to take it out and then replace it with a smaller catheter later today. The general consensus was that because he has so many sedatives in his system, it would be highly unlikely that he would pee enough on his own to be without a catheter. But that we'd give it some time to see how he did.

To which Bodie responded by promptly peeing all over the bed. Requiring them to change all the sheets.

Twice.

Suffice is to say, Bodie understood the assignment. 

From a sedation standpoint, the muscle relaxant has been removed and he's responding appropriately to stimulation now. (Which is to say, he wriggles when they mess with him, not that he has intentional gross motor movements yet.) We are hoping that they might be able to extubate him tomorrow, but it will depend on how he responds overnight and whether he starts breathing over the ventilator. He's been sedated an on muscle relaxants for quite a while now, so we don't want to extubate before he's ready and risk reintubation. So that will happen in Bodie's time. But we can't wait to see him fully awake and be able to tell him of the miracles that have transpired while he was sleeping.

Please continue to pray for Bodie as he navigates this critical post-op period:

1. Pray that Bodie's body continues to like the new heart and shows no signs of rejection.

2. Pray that we're able to extubate Bodie tomorrow and talk with him again (what an amazing Father's Day gift that would be for Dusk!)

3. Pray that his profusion continues to be good, with no clots anywhere in his body. 

4. As he wakes up, pray that we're able to keep him calm - and that his brain is just as smart and ornery as when he last talked to us over 8 days ago!