This blog, originally thought of as Ethan's 'baby book', has morphed into an Ebenezer of sorts. It's where I go when I need to be reminded of God's faithfulness. It's five years worth of stories and answers to prayers. If you find yourself with extra time on your hands, I would encourage you to go read the posts from April and May of 2009. Taste and see that the Lord is good!
I want to share the details of last week so that we'll have yet another reference point to which we can come back and say, "See what God did there?!" It's also super helpful for me to document the medical details of Ethan's care, as they serve as puzzle pieces to the ever-growing picture of our son. From the smallest to the biggest, we know that every moment I'm about to share was ordained by a gracious and loving God!
If the details interest you in the least, read on and celebrate with us! I'll break them up into a couple different posts, starting with his surgery day.
Wednesday, July 30th: Ethan was taken back to the operating room around 8:45 a.m. He was happy and calm the entire morning and, with a fast-acting dose of Versed in his IV, he was wheeled down the hall with no issues whatsoever. Me? I sobbed into Jeramie's chest for a solid three minutes before joining our family and friends in the waiting room.
We received updates every hour, beginning with the first incision at 10:30. We had a slew of people waiting with us, for which I was incredibly grateful. I would not want to go through something like this without the Lord and our family and friends!
It took quite a bit of time to get through the scar tissue, but by 12:30 p.m. Ethan was on bypass and Dr. J had begun the actual procedure. Replacing the conduit (which could be thought of as a 'reconstruction', but was technically considered a replacement) and replacing the pacemaker battery took considerably longer than we anticipated. We prayed that Ethan wouldn't have any adverse effects from the prolonged bypass time and the Lord faithfully protected him! By 4:30, Ethan was off of bypass and Dr. J worked on closing his chest for the next hour or so (and did a fantastically, beautiful job, might I add!).
Ethan came out of the O.R. extubated (!!), with one (!!) chest tube, and with a JP drain to keep fluid from collecting in his old pacemaker site. I caught a glimpse of his tube-free, pink face as the team wheeled him through the doors of the PCICU and, yes, I cried again. We met with Dr. J around 5:30 in the PCICU and learned that everything went as planned. He was able to put an adult-sized 23 mm valve into the newly reconstructed conduit, which is now pre-stented and will set Ethan up for future interventions in the cath lab rather than the operating room. He was also able to place Ethan's new pacemaker behind the abdominal muscles -- praise the Lord! In other words: best case scenario all around.
Dr. J left and we all gathered in the conference room for a sweet time of prayer. Within minutes, we were called back to see our boy.
Unfortunately, Ethan had declined quite a bit after settling into the PCICU. By the time Jeramie and I got to him (literally 20 minutes from him leaving the O.R.), he had desatted significantly (low 60s) and had to be bagged in order to increase his oxygen levels. He was so heavily sedated and evidently felt no need to breathe on his own.
Even with the bag ventilation, Ethan's oxygen saturations were only getting up into the mid-70s. He was quickly placed on BiPAP, which greatly increased his saturations, but there remained lots of talk about reintubating him. I made it clear that I didn't think that needed to happen, based on issues we were having with the BiPAP mask not fitting correctly, and the Lord sent us an advocate by way of a respiratory therapist. He convinced the NP to give Ethan a few more minutes on BiPAP before drawing another blood gas, then make a decision about retintubating. Within 10 minutes, between the first blood draw and the second, Ethan's carbon dioxide levels dropped from the eighties to the fifties (their goal for him at that point was forty)!
Managing his pain throughout the night was difficult. Too much morphine and Ethan refused to breathe; not enough and he thrashed around in his bed. Jeramie and I were so weary from such a long day, and seeing Ethan in so much pain was more than we could bear. Around 9:00, I had stepped out to eat something and was called back into the room by my sister shortly after. Ethan was still wearing the mask at that point and crying hysterically underneath it. He wanted me something fierce, and when I could finally make out his words, "I want you to come closer.", I flung down the side of the bed and draped my body over his. In that moment, the only words I could pray were, "Lord, please." Despite my attempts to fight it, the sobs overtook my body, but my convulsing shoulders calmed him into a peaceful sleep.
Ethan stayed on BiPAP until around midnight, once he was mad enough to rip it off and could prove to us that he didn't need it anymore. From that point forward, his team found the sweet spot of pain management and Ethan steadily improved. Jeramie and I took turns sleeping, each logging three hours of "rest", and I woke up Thursday morning to a much happier boy, thanking God for the day's new mercies.
...to be continued...