Michael's second surgery

Michael's first surgery in Cincinnati was 9-24-12.  All went well with no surprises or complications.  For the next 5 days, we kept Michael fairly still with his legs bound together to promote healing whenever he was not up walking for exercise.  His incision looked like it was healing well so we removed the leg restraints that evening.

Kayla and Michael on our 3-hour pass to unhook
from his PICC line TPN and go for a walk without
leg restraints or IV pole.

The very next morning we new something was not right.

I went to change Michael's diaper after a good night sleep, and I found bright red blood in his diaper. I immediately closed his diaper and called for a nurse. The nurse did not think the amount or color was too alarming since he had just had major colorectal reconstructive surgery.  I also noticed that some of the incision looked a bit more open than it had and told the nurse and Dr. on call on the floor that day.  He too was not terribly alarmed.  The next morning a bedside exam was performed by Dr. Pena and he agreed that an area of the incision had 'spread' and wanted to see if the area would close on it's own over the next couple of days.

In the meantime, Michael was scheduled for a sedated ABR hearing test on Wed so Dr. Pena decided to go ahead and do a sedated exam since Michael was already going to be under anesthesia for the ABR.  Turns out, this was a blessing as more stitches had turned loose and Dr. Pena needed to repair the area.  Anesthesia started at 11:50am (ABR) and Dr. Pena began his portion about 1:00pm.  Surgery was over at 1:57pm and I visited with Dr. Pena just after 2:00pm.

Waiting to be taken to OR for second surgery

Michael's patient number for surgery ~ 518936

After surgery, Dr. Pena entered the parent post-op visitation room still in his scrubs with a serious look about him.

"Something very unusual has happened."  I knew with that one sentence to brace myself for what was to come next.

"The entire outer layer of stitches pulled apart..., but the second layer held intact.  Had the second layer also came apart, Michael's bowel would have recoiled up into his abdomen and he would have needed a colostomy.  We had to restitch the entire... area.  We have no idea why this happened, it just did.  Michael will need to stay in the hospital on TPN for the next seven days and after that time, if all the stitches hold, we will reevaluate and tell you where we go from here."

We knew going in that some stitches has pulled apart but we did not know the full extent until afterward.  We are just so thankful to be at Cincinnati Children's Hospital so Dr. Pena can take care of emergencies like this!

Michael is recovering well.  He only had 3 doses of morphine after the second surgery and nothing else.  We keep both of his legs in one pant leg of a pair of sweats and that seems to be keeping his legs together very well while allowing a little movement to keep the blood flowing.

On Wed of next week, 10-10-12, Dr. Pena will evaluate the newly stitched area and decide if everything is healing enough to allow Michael to begin eating by mouth again so we can see how well his intestinal tract will work.  If all goes well there, we will be allowed to stay at the RMH and start the Bowel Management Program.  The BMP consists of daily x-rays of the abdomen and clinic visits with Dr. Pena to evaluate how well food is moving through Michael's digestive tract and exiting his body.  Depending on how that process is coming alone, we will give meds to regulate and control the waste as it forms.  Once we complete the BMP we will get to come HOME!!