Surgery Update

O.k. I still have only had 4 hrs. of sleep but I am going to attempt to explain Reagan's marathon surgery from yesterday. Rod and I had planned on taking a nap today but Reagan has kept the drs. busy so we've stayed around the hospital all day to make sure things were o.k.  First let me start by saying she is o.k. and was able to receive her complete repair.  Wooohoooo!!! It is so weird looking at the monitor and seeing her oxygen levels at 97,98,99 & even 100.  She has never in her life had oxygen levels like this before.  She is a little pistol with oxygen sats in the 70-80s.  I cannot imagine what a handful she will be now that she gets oxygen like you and I.
Needless to say, yesterday was a long, grueling day for us.  We dropped Reagan off about 7:30am and weren't able to see her in CVICU until 2:45am.  Dr. Hanley spoke with us prior to going into the OR yesterday and Rod asked him if he thought it was going to be a marathon day, as all of Reagan's surgeries have been.  He actually said, "No, hopefully I might be out by 3 or 4pm."  Around 11:30am and then around 3:30pm we got an "update", if that's what you want to call it, just telling us things were going fine in the OR.  Then around 5:00pm, someone told us that they were able to do the complete repair and were just working on getting her off bypass but that it still might be 2-3 hrs.  We felt so relieved until 2-3 hrs. passed and still no Dr. Hanley.  Then around 9pm someone else came out and told us things were fine and they are talking about putting the patient on ECMO.  I said, "Excuse me, things aren't fine if they're talking about ECMO."  Rod asked if Dr. Ramamorthy was still in there who is the anesthesiologist we have developed a good raport with.  He said he would go get her and have her come talk with us.  Well, by the look on her face when she came out, without any words spoken, I could tell things weren't good.  She said Reagan is just a complex case but that around 6:30pm when they tried taking her off bypass, the heart function was not good, so she immediately went back on bypass and that she had alot of bleeding they were trying to control. Dr. Hanley was working to try and figure out why the heart was not pumping as it should when taken off bypass and that he was going in to explore her coronary arteries and discussing putting her on ECMO.  Dr. Ramamorthy then looked at Nolan and asked when bedtime was and said to us "you might better get him to bed".  In other words, it was going to be a long, hard night. MiMi and PawPaw (Jen's mom & stepdad) then took Nolan back to RMH to get him to bed.  Rod and I both lost it as soon as Nolan left and began praying for God not to take our sweet precious girl like this.  After spending my time crying lying face down in a dark room, I finally was able to update you all out there who stayed up clinging to every update and praying for us.  We so appreciate you guys!!! It was late already here in CA and all of you were hours ahead of us and yet still followed along with every update, leaving us encouraging comments.  We love you all and can't say thanks enough!
After getting Nolan to bed, PawPaw Lonny stayed with Nolan and my mom came back over to the hospital.  Mom, Rod and I all sat around talking about it and could not figure how her heart function could be bad when she was jumping on the bed over and over again until she was out of breath, the night before surgery. Something had to have happened because this little girl is too strong for a surgery to knock her down. After much talk and worrying, Mom finally started working on her computer to get her mind off things, I finally was able to close my eyes while laying on the floor, amidst the cleaning crew trying to clean the waiting room and Rod couldn't stop pacing the floors.  Every time the cleaning crew came through the door we thought it was going to be Dr. Hanley but it never was. After losing track of time and Rod, he literally disappeared on us, I hear the door open and Rod comes running in with the biggest smile on his face and pumping his fist into the air saying, "She's good, she's good."  Mom and I jumped up saying, "How do you know?"  He said, "I had had enough and had to find out what was going on so I went up to the CVICU because they are in contact with the OR so they'll know when she's about to come there.  Rod ran into the ICU attendee and said "Where is she, where is Reagan and what the heck is Dr. Hanley doing in there?"  The super nice attendee, Dr. Ziebrak, lit up and said "she's good, they're almost done and she's about to come to CVICU."  Rod said, "Is she on ECMO because last we heard she was going on ECMO?" Dr. Ziebrak said, "No, she's not on ECMO, she's off bypass and Dr. Hanley is just watching her numbers and making sure everything's good before bringing her to CVICU."  We all about fell to the floor when hearing this news and just then we looked up and Dr. Hanley was walking through the door in his normal cool, collective style. (For those of you heart moms out there who know what I mean) We all sat down and he then began telling us the saga of the OR.  He gave us the rundown on some of Reagan's arteries and veins that he had to work on first that had some narrowing in them and then he performed the complete repair part of the surgery in which the hole in Reagan's heart was closed & a pulmonary valve and conduit placed. At this point, he tried taking her off bypass and for the first minute or two she was good and then her numbers dropped so immediately put her back on bypass. He then began looking at her coronary arteries which are the arteries that supply blood directly to the heart muscle itself so it can pump.  It is then that he discovered that like almost everything else about Reagan's anatomy, her coronary artery pattern was not normal either.  One of the arteries branches off from the left and comes diagonally across her heart back up to the right side. This is exactly the place where Dr. Hanley makes his dissection of the heart in order to do the complete repair.  It is then he realized he had severed this coronary artery during the dissection and did not know at the time because it was hidden by scar tissue.  Dr. Hanley then did what Dr. Hanley does best and worked a miracle.  He then peformed a Coronary Artery Bypass Graft on Reagan to fix the severed artery.  He said this is the same surgery someone would have who suffers a heart attack.  He used her own tissue so nothing further will ever have to be done with this.  It should grow normally with her as she grows.  Once the coronary artery was back intact they took her off bypass again and her heart performed beautifully.  He said due to such a long surgery, her recovery will be longer than he was initially anticipating but that she's good and stable for now and they will be watching her closely. After his explanation, he asked if we had any questions and Rod said, "I'd like to know what word you used when you discovered you severed her coronary artery".  Dr. Hanley just smiles and said, "You don't want to know what word I used---expletive deleted!"  We then told him "thank you so very much and to go get some sleep".
Finally, at 2:45 we were able to go see our sweet baby- she is such a tough little girl!

As far as overnight and today, Reagan has had some excessive bleeding issues. They have had to take the sterile drape off her open chest twice today and flush out all the extra blood to see where it's coming from.  Both times they never found anything other than alot of oozing.  Then one of her chest tubes clogged up and the blood starting pooling under her sterile drape.  The second time they went in and flushed things out, an additional chest tube was placed.  Dr. Hanley is pleased with her output now from the chest tubes, not too much but just enough. Hopefully, this bleeding will begin to slow and heal. Also, earlier today Reagan's blood pressures were on the lower side so they have been using her pacing wires to send signals to the heart to correct for this.  We are pleased with her day and that she has remained stable.  Please pray for a good night and that we can catch up on our rest as well.

Thank you all again for all your support!!