6/8-Saturday 10:30am - Internal Shunt Placement

6/8-Saturday: Apparently there was a rush on the Operating Room this morning and last night, so we were pushed back - more waiting. However, the good news is that Dr. Gruber thought it would be tomorrow morning before we had OR time, but we were actually able to get in at 10:30! Not so bad. So here we are in the now familiar Sacred Heart "Family Waiting Lounge." Ais is in the OR downstairs with Dr. Gruber, a nurse, and her anesthesiologist getting her ready, and waiting for the final shunt to be internalized.  

Patrick: It's said that "knowing is half the battle," and I find that to be the case in this scenario for myself. There have been many times in the last ten days where this has not been the case - will discuss later. Having been involved in several successful surgeries during my short training, I find it cathartic to take myself through the surgery from start to finish. 10:30 Start some anesthesia. When she gets drowsy, roll her back to the OR suite. Transfer to the surg platform. General anesthetic, get her intubated. Placing her body in a position to be worked on, rolled on the right shoulder for access down the left side of her head and body. Scrub nurse cleans her with various antiseptic washes that you can't but at your local drug store. A drape is very carefully placed to expose only the areas to be worked on. Gruber checks with the Anesthesiologist to make sure she is fully sedated and can begin. Infiltrate skin with long acting local anesthetic plus epinephrine to decrease bleeding. As he explained, Dr. Gruber will make new incisions for this new device: they will not be using the current device, an externalized shunt, for this. He will implant the new device under her scalp, and then run the tubing from it into the cyst cavity on one side, and then down her scalp and neck and chest and then make a small hole into her abdominal cavity on the other side. Crude and gruesome, I know. This brings up in my mind how limited we really are in terms of treating such problems in medicine, which I can again discuss at length at another time: crude and gruesome, but lets not forget very effective. I digress: Test the device.... They will then suture her skin closed over her new device and close up the tiny hole in her abdomen. Test the device again... Anesthesiologist will gradually bring her out of sedation by lowering her drip dosing. She will awaken to a sleep/dream state fairly readily, and they will extubate. Strip the draping away, wash her body a bit, and wheel her off to the recovery room to spend about an hour being closely watched. Then back up to PICU and see Mom and Dad and Hammie and Nana. 
   

Nikki: She's in a room... sleeping... with some people that know what they're doing... and she comes out, and she's fine - "ignorance is bliss"