Care4Conway: Post Op Day #2 - Plan for the Day

Friday, August 10, 2012

Post Op Day #2 - Plan for the Day

Good news and bad news. Good news is that he is technically floor status. While there are no floor beds available and he has to stay in his ICU room, he will be allowed a bit more freedom. The great part about this is he doesn't have to share his nurse! The team is pleased with his progress, and planned to pull all his chest tubes today, but felt that since he didn't walk around enough yesterday they want to make really sure that there are no pockets of fluid hiding in there that need to still drain. That's the bummer part. It's harder and less comfortable to move around with the tubes, but you need to move around in order to get the fluid out. This morning's chest xray was still showing a diminished left lung. We're hoping he'll prove that he can walk a lap or two around on the 10th floor. If he can do that, his nurse has been given permission to take him upstairs to the 11th floor playroom. Part of me wants to tell his this is the deal to motivate him, but I also feel like it's not fair to even mention the "promised land" to him if he just isn't ready to move that much. What's the sense in taking him there if he can't do anything yet? After he wakes up more, we'll try to get some breakfast in him and get him up and around some. Then tomorrow they will withhold food and pull all three chest tubes and his IJ line in his neck. That's his only IV access right now and it is bothering him quite a bit. As his nurse put it, he itched away his other two lines yesterday in the backs of his hands. Since it's his IV line right now and he's on IV meds they won't take it just yet. He may have to get another poke tomorrow, but hopefully he can just be switched to some oral lasix. It's less effective, but considering he's outputting more than he's inputting, it's okay. Specific prayer requests for today include pain management and mobility. We ask God to keep his pain tolerable so that he will be motivated to move around and get rid of any fluid accumulating around his heart. We also ask that his spirits be lifted by being able to move around more and have some fun instead of laying in bed today. Please ask God to heal his lungs completely.

2 comments:

H. James said...: Thanks for the update. Hope today continues with progress and no set backs. Much love from us.; August 10, 2012 at 9:33 AM
Anonymous said...: It has to be awfully hard to watch your little guy go through all this. Our prayers and thoughts are with you both and Conway. Bill and Wilma; August 10, 2012 at 1:03 PM

Conway's Heart Story

Conway's Heart Story

Conway David Beckemeier was born on March 3, 2007. His heart defects went undetected during pregnancy and he was diagnosed at two days of age with L-TGA, a large VSD, sub pulmonic stenosis and Ebstein’s Anomaly. Just before turning six months of age, he underwent open heart surgery to reroute the bloodflow in his heart. Called the "double switch", this procedure is the most technically challenging for pediatric cardio-thoracic surgeons to perform. The version of the double switch that Conway received on 8/28/07 was called the Rastelli-Senning with VSD closure and sub pulmonic resection. He suffered a grand mal seizure following the surgery that lasted over an hour and had several other post-op setbacks including surgical heart block, which required another operation on 9/18/07 to insert a pacemaker. Following surgery and such a long hospital stay, Conway developed an oral aversion (he would not eat) and he was 100% NG tube fed for eight months. He also lost muscle tone and required both physical and occupational therapies. In April 2008, he had a cardiac cath and attempted balloon angioplasty on his pulmonary arteries that did not work. Although his recovery was very long, he had a solid year or so of being a "normal" kid . Then in May of 2009, it was discovered that Conway was having rhythm disturbances, specifically atrial flutter. His pacemaker allowed it to go undetected for several weeks until he showed signs of heart failure and was admitted to the ICU for a week to be placed on IV heart meds and undergo cardioversion on 5/6/09. He went home and his heart function started recovering when he had another episode of flutter (6/16/09). This time, he was again hospitalized and put on IV milrinone, but he converted back to normal sinus rhythm by himself. At that time he was placed on the anti-arrhythmia drug, amiodarone. On 7/22/09 he had to be cardioverted again for yet another episode of flutter. The following week, he got worse instead of better. His cardiologist did a full work up and it was determined that his aortic, mitral and tricuspid valves were all leaking worse and were felt to be the cause of his heart failure. On 8/24/09 he had a cardiac cath and attempted ablation. The electrophysiologist was unable to induce a single arrhythmia. Then, just two days later, he went into atrial flutter on his own. He was placed back in the cath lab where he underwent mapping and a total of 17 burns were made to try to knock out his arrhythmias for good. The next day, 8/27/09, he had his second open heart surgery to repair his mitral valve called ring annuloplasty. He also had a partial Maze procedure done. His surgeries are performed at C.S. Mott Children’s Hospital at the University of Michigan (Ann Arbor). This time he was discharged just six days later! His Left Ventricular function improved drastically. In December 2010 we noticed he began getting more winded during physical activity. A January 2011 cath showed that he is outgrowing his RV-PA gortex conduit, but he was not symptomatic enough to warrant intervention. In April 2012 Conway’s fatigue increased and an echo at the end of May revealed that the ratio between the right and left sided pressures has gotten too high and it is time to replace the homograft that was placed when he was five months old. He had a cardiac cath on 5/25/12 which confirmed the echo findings. He had surgery on 8/8/12 to replace his pulmonary valve and RV-PA conduit, add an additional pacing wire to his left ventricle, and change his generator to a bi-ventricular model which is shown to preserve function and help the heart muscle pump more efficiently/effectively.