Thursday, February 27, 2014

Surgery Day

It's about 6:00 am and we just now found out some info finally! Dr. Bansal is hoping to only have to open up the bottom of Danny's sternum to remove the problematic stuff that's in there (Danny refers to it as his growing alien). If it's pus or infection of any kind--high probability I think...they will take a culture to be sure of exact bug so they can use the best antibiotic. In that case, he may be on antibiotics for about 6 months. Bansal may cut out Danny's zyphoid process (little, useless bone at the center, bottom of the rib cage) if it appears to be hindering the sternum from healing properly. Whatever he sees when he goes in, he is going to fix. Because Bansal isn't sure exactly what he is going to find, Danny had to sign all sorts of consents...two types of anesthesia, blood transfusion, and something else I can't remember. 

I feel very comfortable with Dr. Bansal just doing what he needs to do to fix whatever is causing Danny's extreme pain. He is very detailed, picky, and demanding of how hospital staff cares for his patients. He's fun because at first one might get the impression that he is just difficult...but that's not the case at all. He absolutely cares about his patients and wants the best for them. Danny and I really appreciate him and know that the Lord uses him to perform wonderful medicine! 

All that being said...I'm feeling excited and hopeful about this surgery because I know that Danny is in good hands and will be on the road to feeling great soon! 

I have no idea how long surgery will take, but the OR people have my cell phone # in case I'm not in Danny's room when they call. I don't know if he will be discharged today or if they will keep him a bit longer for pain management and/or observation. He's in the TSU (transplant step-down unit), so it's very much like being back at home. Transplant patients are like family around's a very nice environment! 

I'm going to blog throughout the day as more information becomes available. Danny and I are accustomed to being "fluid" (not knowing the plan and just going with the flow). That's the life of an LVAD/transplant patient. However, I realize that lots of people want the info ASAP so I will do my best!!

Thanks for prayers for an amazing surgery and recovery. 


9:15 am...still no word from surgery. Just waiting patiently!! over. Dr. Bansal came up to the room for the update. Danny did fine. He didn't have to cut the entire sternum open. The bottom 6 cm of the sternum is what was not closed correctly. That part wasn't wired shut (wasn't supposed to be). Stitches are commonly used in that very bottom part of the sternum. Danny had a huge amount of inflammation and fluid collection. Bansal removed and flushed out the fluid. He scraped (with a medical "sandpaper" in easy terms) the edges of the tissue on the sternum so it can grow back together properly. He put that bottom part of the sternum that wasn't joined together correctly back in place (like puzzle pieces) and used very tight stitches to hold them in place until healing happens. He didn't use wire there because if there is infection he wants the stitches to be able to dissolve without having to open him up again. They did not see pus, but are sending the fluid off for a culture. Danny was intubated for surgery, which he won't like...but on the other hand, whatever Bansal felt he needed to do I'm glad he did! I'm also very glad he was able to deal with the sternum as well as the fluid today. Bansal said that even though he sewed the stitches very tight at the bottom of his sternum, he wouldn't be surprised if that area started leaking again (that is the same area where fluid was literally squirting out of Danny's abdomen a while back...that was wild!! Here's a pic of that craziness... :)

Bansal said it might leak because Danny has soooo much inflammation right now and once the inflammation starts to go down, the stitches may loosen...causing leakage. In that case, Bansal would put in a sponge vac, which is a sponge stuck to the leak and a vacuum type device on the other side of the sponge to draw out the fluid. 

He expects Danny to be in a lot of pain when he gets back to the room and they are going to give him a pain pump for while he is here. Bansal put in one drain tube (chest tube) and will remove it Saturday IF the fluid output is very low. 

Bansal did remove a stitch from the LVAD that was missed during the transplant surgery. I don't know that the stitch caused problems, but why leave something in there that serves no purpose?! 

Bansal wants the heart failure team to drop Danny's steroid level for a while so the sternum can heal well. The steroids aid in anti-rejection...which means that they try to stop the body's natural attempt to heal itself. Since a transplanted organ is not what God put in the body, the body knows that it's foreign and would automatically try to attack it. The steroids and other anti-rejection meds stop the attack. That's good...but the downfall of anti-rejection meds is that his whole body is now not doing it's natural job of self-healing. It would be cool if there was a medicine that only stopped rejection of the transplanted organ and didn't effect the rest of the body. 

So the trick will be to find the fine balance between a low enough steroid dose that allows his sternum to heal properly and high enough that his body won't reject the heart.

Danny isn't back in the room yet because it takes a while to be extubated. I'll update again when he gets back to the room and I know more!!


9:20 pm  Danny got back to the room about 3 pm I think. He has been very groggy from the anesthesia and in and out of sleep since then. 

Using head rest as a splinting pillow to ease pain

Trying to untangle wires

He is plenty silly when awake:

"I got this T for my T"...later it was his gladiator helmet!!

When the nurse told him he HAD to urinate or the doctor was going to order a catheter Danny said "Now, remind me what that is...will that be pleasurable?" lol 

"Hey Trish, see my lasso?"

"Come over here and tell me what the extracurriculars are all over my back." He had some stickers for the heart monitor leads still stuck on his back from surgery and this huge round bandaid thing over his bottom. I'm still not quite sure what that's for but when I went out to ask the nurse if it was ok to take it off, I started by saying "he has this big, round...". She finished my question with laughter and said "bandaid on his butt?...Yep, they didn't tell me that was still on, you can take it off. just let me know if it has anything on it."

Front and back pic...I have no idea!!!!

This nose flap this is just hilarious. It's a O2 and CO2 sensor for patients with pain pumps. If his levels aren't correct, the pump won't allow anymore medicine...So it certainly serves a purpose and makes sense, but looks absolutely ridiculous! Danny, the nurse, and I were all laughing. There's  this unbelievably ridiculous show on TLC called Myrtle Manor we watch sometimes for a good laugh. The security guard for the trailer park has a "gostache" (a mix between a goatee and a mustache...not joking...) Anyway, this is Danny's gostache!!!


Though he is in a lot of pain at the moment, I'm excited that pretty soon he will be feeling better than he has in years!!!! 

Will update tomorrow...

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