Rewind: 24 Hours Post-Op

I promised more details about Sheridan's surgery, so here's the first installment - the first 24 hours after the surgery.

Rockin' the green toe nails on the day of the surgery - I had to represent with Sheridan's color!

The monitor in the waiting room showed each child's status (each child had a code that only the family knew). Sheridan is highlighted there (#2864) and next to his code it said "Surgery Start" - that meant that they had begun the actual procedure (incision was made). It was nice to have something where we could see some basic updates - but nurses and physicians assistants called to give us updates frequently, and a couple times even came out to tell us how everything was going.

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Here he is, about 90 minutes after surgery...

...sometimes eyes closed, sometimes eyes open but pretty vacant (he was pretty out of it coming off the anesthesia, etc.), but he would make eye contact briefly, and even gave my dad and step-mom a smile when they went in to see him. I was expecting more of a "puff" factor - so many babies (and adults for that matter) can be pretty bloated after surgery, but Sheridan wasn't at all. 

The only thing we didn't see was his breathing tube - they extubated him (took the breathing tube out) only ONE HOUR AFTER SURGERY. In fact, it took us longer to see him because they extubated him and he started rolling around in the crib, etc. - the nurse said he started doing "whirlies" - not sure what that means, but she was Australian so maybe somebody can translate :)  They had lifted the sedation (you can't take the breathing tube out until people are "aware" enough to breathe on their own) - and when they did he just woke up and went gang busters on them. It took almost 90 minutes for them to get all his IVs, tubes, etc. transferred over to the ICU poles, devices, and monitors, and to get him settled in. Then we finally got to see him.

After Gary and I visited we let the grandparents and my aunt rotate in so they could visit Sheridan. You can see the surgical team attached his poster to his crib so the ICU staff would see it...

What they didn't know is that I had a different sign for the ICU nurses with a slightly different message :)

Lots of IV meds (e.g., calcium because "hearts love calcium" as his nurse said; milrinone to help blood flow through the body - keeps capillaries and small vessels dilated so blood flow is good and easy; saline). Lots of tubes and wires. And equipment to measure each chest drainage tube and urine output (top right pic below).  

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Sheridan had seven (yes, 7!) IVs: one in his neck (his central line), one in his left hand, two in his right hand (one was a regular IV, one was an arterial line in his wrist so they could draw blood, etc.), one in his left foot, two in his right foot. And see that glowing red big toe (bottom right)? That's how they monitored his blood oxygen saturation. That was the last thing to come off before we left the hospital :)

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Sheridan spent most of his first 24 hours with a nurse dedicated entirely to him and only him. And we had a private room - I worked endlessly with the social worker, child life specialist, nurse manager, etc. to try to ensure he would have a private room. He is still sensitive at times to other children (especially when they cry or make loud, unexpected noises) and when he loses it, he LOSES it. And everyone was worried about what that might do for his pain and keeping his heart rate under control, etc. So, because they had space and no other child had a medical need for the private room, Sheridan got it. And the nurses were glad - they told the managing nurse, docs, and others that Sheridan was ULTRA sensitive to noise (they would just open a drawer to get something out and he would wake up and start crying) - so everyone agreed it was the best place for him so he could focus on healing and stay calm. 

Here he is the morning after... smiling, playing, much more interactive... and enjoying time with his Nonna!

Because Sheridan was doing so well, they moved him to the Level 2 ICU (still in the same "ward" - just 2 rooms over from his first room - but now his nurses cared for him and one other baby). Before they moved him they took the cuff off his left arm so he could bend it and get more comfortable, and start using his left hand (although, he is right-handed).

In his new room he snuggled in with his seahorse (a Christmas gift he received from Becca) - it really comforted him, along with the BEST pre-surgery gift EVER from his buddies Joaquin, John Michael, Gracie, and Gabby. Read more about the quilt - it was truly a remarkable gift and kept Sheridan so secure and cozy.

 

The sleep you saw in those two pictures was pretty rare... he shared this new room with another baby - she was much younger and actually REALLY quiet (they had a patient who needed to be in isolation so Sheridan was moved to a new room with 2 cribs, divided by a half wall). It was pretty tough on him (and the nurses tried their best to protect him): it wasn't the baby, it was all the docs, and nurses, and specialists, etc. Sheridan's roommate had a LOT of people in and out around the clock and they don't try to speak quietly (why should they? seriously, I was never mad about it, that's just how hospitals are, but in the 24 hours he shared this room he slept no more than 1 hour at a time - and often he would be startled awake 5-10 minutes after falling asleep and then again 15 minutes after putting himself back to sleep - it was a nightmare because he was so desperately tired but couldn't actually get good sleep). But, we made it work and did our best to help him rest. I think they picked his roommate because she was such a sweet, quiet little thing :)

Here you can see where they took his central line out of his neck - I finally got the last of the sticky-goop left by the tape off TODAY (more than 2 weeks later)!

The next time he woke up I finally got to hold him! It was a traumatic experience, in all honesty. He was still hooked up to some IVs, had all but one of his lines still in, had both drainage tubes - the nurse tried to organize everything while I sat in the chair waiting for her to place Sheridan in my arms. He cried uncontrollably - the tubes hurt (they were his biggest source of pain the whole time), he was scared, the nurse was a bit frazzled (not in a bad way, she just wanted to hurry and find a way to get him in my arms so he would calm down and wouldn't be upset anymore). The nurse was struggling to make it happen - she had a hard time figuring out the best way to pick him up with so many tubes. I got so scared and anxious for him that I was freaking out. I told her to hurry up (I didn't want Sheridan to be this upset) and either pick him up and give him to me, or just stop and we could try again. I just needed him to be okay. Luckily she was able to scoop him up and I got to hold my baby - I was nearly in tears and he was so happy for me to hold him.

by the way, notice he's off the oxygen

they weaned him off oxygen in under 24 hours

 

There's not much you can do with a baby on bed rest and who is tied to machines, tubes, etc. We brought 2 suitcases for Sheridan - a large one with a bunch of toys, leg warmers, books, activities, snacks (for him and us!), etc. that stayed at the hotel, and a small carry-on sized bag that we used to bring what we needed (for him and us!) for the day. It allowed us to rotate books, toys, etc. to make sure we had something to keep his interest every day. Of course, a few favorites stayed in the hospital bag every day we were there, including Hooray for Fish! - he LOVES this book. And the little fish is on every page so when we ask, "Where's little fish?" he will point to it. Books and music were the biggest hits while we where there. No surprise, they are the biggest hits at home, too.

Next up: the next 24 hours, including the first peek at the scars...

And by the way, fell free to ask questions - ANY questions - especially if you are getting ready to go through this. I'm more than happy to answer them!