Here's an update from Keith with more details about the surgery James had yesterday and how he's recovering...
We got to meet with the surgeons and other doctors this morning. James made very good progress overnight. He is nearly back to where he was before the surgery for his statistics for breathing on the ventilator and he is peeing very well which will help him release the fluids in his body. It is also a very good sign for his kidneys, which is always a concern after these types of surgeries. The stoma and areas around the incisions all look exactly as they should. Directly after the surgery he was very unstable last night, and we were told that things were really to be looked at and judged on a minute by minute basis. Since then he has stabilized substantially and has had very positive progress.
Lisa mentioned in one of her emails what his surgery might involve, but here is a brief description overall of what they did. They went in and removed the dead area of the small intestine, which essentially ended up being a large section in the middle of the small intestines. The took the end that comes from the stomach and ran it outside the body (that part of the procedure is call an ) to a stoma. This allows the waste to leave his body while the rest of his intestines heal. At the other end of they put catheter so that they have a way to drain anything that may have been in the lower area. His incision was left open (it has a protective film and dressing on it, that gets changed out every few hours) to allow room for swelling which typically happens after theses surgery.
If he continues to do as well as he did overnight and his swelling goes down as it should, sometime in the middle of the week they will move the section with the catheter closer to the stoma and close up the incision. At some point much further in the future, they would then go back and reconnect the pieces together.
One of the things that complicated the surgery last night was that James has a PDA (patent ductus arteriosus.) All babies have vessel which connects the two main arteries in the body while they are in the womb as part of there normal blood circulation. After they are born this vessel closes. In premature or growth restricted babies it is not unusual for this vessel to stay open. The opening allows oxygen-rich blood from the aorta to mix with oxygen-poor blood from the pulmonary artery which can put strain on the heart and increase blood pressure in the lung arteries. This was causing his blood presure to fluctuate wildly during the operation and made the whole thing very touch and go. Our hope is that this is going to close on its own, which does happen with many of these cases. Sometimes the can give medications which cause it to close, however, those medications can case issues with the stomach, so James would not be able to take those medications, and would need surgery if it does not close on its own.
It is going to be a very tough next couple of weeks for James, so we would ask that everyone please keep him in their prayers. We have been very grateful for the outpouring of prayers and support we have recieved from everyone. Please keep Madeline in your prayers as well as she will have to go in for her surgery .
I will probably send slightly less frequent updates over the next few days unless there is a dramatic change, but take that as sign that things are progressing forward in a positive manner.