July 31, 2009

Sorry this is so late.....

Just wanted to write and let everyone know how Jenna is doing. We had a minor set back when closing her, she kept oozing blood from where he manipulated and recontructed her arteries in her lungs, which caused her to bleed. So, they had to give additional blood and keep suturing the area. They did not want her to bleed out later tonight, so they were trying to stop it as much as possible. The surgeon finally came in to see us around 5:45pm to discuss her case. He said that she went through the surgery well, but had a little issue with her rhythm of her heart went he was going to close her. He said that he was able to reconstruct a couple arteries on each side of her heart, making them about 4mm wide, normal being 8 or 9. So it does not seem like much of a difference but it is. He said that he placed a larger conduit in so that he would not have to replace it in the near future, this was she can grow in to it. During our conversation he received a page from the OR nurse stating that her heart was having trouble with her rhythm on the EKG so he would need to check her and return to discuss her case further. About an hour later, the nurse came out and stated that they had to place her on a temporary pace wires to help regulate her pressures in her heart which had gone higher than normal. They surgeon was trying to decide what to do at this point. He was not sure if he would have to take her to the cath lab to review her pressures in her heart closer or if he would need to go back to the OR and place a hole in the patch he just placed. After 12 1/2 hours of surgery- the surgeon came back out at 7:45pm to let us know her status. He said that she was doing well, and he had been watching her over time to see if she would stabilize more. He said that the pace wires helped her pressures, and he wanted to monitor her overnight at this point because he wanted to just let her rest. He said that he spoke with his colleagues about the situation and no one had a clear answer on what would be the best option for her, so they are going to watch her closely at this point. They do not want to have to take her back into the OR and place her back on bypass, but this could be an option if needed. So, he said that she is not out of the woods quite yet. He said that they may attempt to wean her ventilator tomorrow if she is doing well, but will probably not be until the next day. It just depends on how well she does. He said that he does not feel that she will need the pacemaker continuously, because he feels that her conductivity or electricity in her heart was not damaged to cause heart block which requires pacing, but that it could be related to her pressure levels, or the surgery, or from the hole being closed. It just depends. So, he said that in the am they will re-evaluate and see where she stands and decide the next step at that point. He said that at this point, her pressure levels are not adding up, which means that he is not sure if her right side is having too much strain on it. He said that previously her left and right were the same, which they do not want, but he is also not sure if her levels are higher which is dangerous or if they are lower. He says that he is not able to tell until after her heart relaxes a little, and he is better able to assess her. They are going to perform additional tests at this point. He said at this time, she could go either way with her status, better or worse, she is "on the fence." He said that he wished he had a more clear answer, but it just depends on how Jenna reacts. So, around 9:40p we finally were able to go see her. She had a slight fever upon arrival of the floor-101 but quickly went back to normal. She was off of the pacer wires, which was good because he rhythm was normal again. She was first on about 14 drips/various medicines for post surgery, but was weaned down to about 7-8. She is on the ventilator which is primarily breathing for her because she is so sedated. She is on nitric oxide to relax her lungs to breathe easier. They have her on a Fentnyl drip for sedation and pain, Epinephrine, Vasopressin to help pump blood in her heart and to help keep blood to center of her body so plenty is being purfused through her body. She has many tubes, chest tubes, pace wires, foley catheter, arterial lines, central line, 3 iv's, an aorta line, oxygen, and a oxygen level which monitors the level going to her brain. She is somewhat stable at this point, she is not what he called "crashing and burning" to go back to the OR, but is still not through with flying colors. So, we took pics and gave kisses and let her rest for the evening. We will be back bright and early in the am for rounds to see what her next step is. We will keep everyone posted as we can. Thanks for the support, love and prayers. Talk soon.



Love,

Jenny, Justin and Jenna




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