Doh!

OK, do you want the good news or the bad news? I'm certainly not waiting for poll results, so I'll just start with the good news.

The good news is that Andrew had a great night last night. His gases were good, his saturations were stable even when he was fussy, and they weaned him down to 10 breaths per minute on the vent and 27% oxygen. Those are very minimal settings, and the doctor was seriously considering extubating him either today or tomorrow. The reason she didn't go through with it...that would be the bad news.

The bad news is that they are concerned about his digestive tract. Though the feedings had worked in the past, in the last couple of days they've been completely unsuccessful and resulted in significant residuals. Worse, his vomiting yesterday made them think there may be some new obstruction. This morning they did an upper GI study, where they pour barium into his stomach and follow its progress with a special scope. They found that nothing progressed much past the bottom of the stomach or upper small intestine (duodenum). This result, coupled with bile in his vomit yesterday, leads them to believe that he probably has a kink in his small intestine that probably will need to be fixed surgically. The need for additional surgeries was somewhat expected, but this came upon us somewhat suddenly.

The details. The doctor, the radiologist, and the surgeon are meeting to discuss Andrew's case and move forward on a course of action. There is a very good chance of surgery, and that surgery would probably take place soon, on either Wednesday or Thursday. During the operation, the surgeon would attempt to kill several birds with one stone. First, fix the kink in his intestine. Second, fix any malrotation of his bowels by laying them carefully in place. Third, possibly place a gastric tube while they have the opportunity, as an alternative method for feeding. The full extent of the surgery won't be known until they get inside, as there are a few items that could possibly complicate things (Ladd's bands, intestinal damage, appendix placement, or blood flow issues).

Though we of course want Andrew to have to undergo as few stressful procedures as possible, this may be a necessary treatment and our number one priority is his continuing health. The doctor is confident that he is absolutely stable enough to get through this with no problems, and we have already seen the surgeon's great work. If this will solve most of his digestive problems, then we are fully behind it and looking forward to Andrew's recovery.