Showing posts with label PEG. Show all posts
Showing posts with label PEG. Show all posts

Tuesday, July 23, 2013

Lyla's Surgery

I have been a bit slack on the updating, yet again... I think one of my last posts was just before Lyla's gastrostomy, which was about 7 weeks ago now, so that's what I'm going to write about :)

After all the stuffing around with Lyla's surgery date, it was finally scheduled for Wednesday, June 5th.  Lyla had to fast from 6am and was admitted at 11am that morning.  She was SO happy, usually going to the hospital is a bad experience for her, but for some reason she was in a great mood.  Her surgeon came in around 1pm to discuss the operation; she would be having a laparoscopic gastrostomy, a liver, muscle and tissue biopsy, and bloods taken for genetic testing.  I asked while they were actually doing the operations through her belly button if her hernia could be fixed - it only seemed right as she has an umbilical hernia and they were going through the site, they may as well just sew the hole back up on the way - he said that was fine!  We took her through to the pre-op room and at about 2:30pm she went in.  The anesthetist said the surgery would take anywhere from 1 - 1.5 hours, plus about 30 minutes in recovery, she would then be transferred to PICU where we would meet her... 5pm came by and I was stressing out, and no one knew anything, soon after the surgeon found us to say the operation went well, they just went really slowly and her liver biopsy took longer than expected, it took 6 attempts, he said her liver looked really unhealthy and discoloured, but he did not know why.  Lyla has always had a really weird liver, obviously no one has physically seen it before, but doctors have mentioned it is quite large and her liver tests have always come back abnormal, this was the reason for the biopsy.

About 6:30pm I was finally able to see her... She was very sad and crying / screaming like I had never heard her do before.  She was hooked up to the machines and had high and low flow oxygen on, but the NG was gone!  It took a while for the PICU staff to work out her medication that night, it was every hour on the hour she would start screaming in pain, but she would react to the stronger opioid, as they would pretty much slow her breathing down to nothing, so it was a long night.  The following day she was having blue episode after blue episode, up until that afternoon when they slowly started giving her some hydrolite, then her formula, it was like a light switch and she was back to her normal self, and surprisingly did not require any pain relief for the rest of the stay!  That night I found it extremely hard to sleep (I was in her room) as her apnoea monitor was constantly going off, early morning I went into the parents room for a few hours of sleep and one of the nurses said, I cannot wrap my head around Lyla and her breathing.... If this was any other person having these HUGE dips in oxygen levels, and the constant apnoea episodes, they would have died, but her body just adapts!  I always knew she was special!

I was expecting to leave on the Friday, but we weren't allowed until Lyla had built back up to her normal food intake, so we were transferred to a ward for another 2 nights.  As soon as Lyla was hooked up to the oximetry monitors they started going off, as her oxygen levels are naturally low, and eventually, after some reassurance (me reassuring the nurses) they felt comfortable, but decided to leave her low flow oxygen on as it kept her above the 92% oxygen level, occasionally.  Saturday came by and Lyla had 2 new nurses, who remembered her from her last hospital stay at 7 weeks old... 'The baby who went blue and constantly required the medical emergency team!'.  Anyways, Lyla continued to scare these 2 nurses with her episodes, lack of breathing, low breathing and "seizures"!  NEVER have I thought Lyla had seizures, and her previous EEG's, though along time ago, never showed seizure activity, but these 2 were so sure she was having seizures they started recording them.  Before leaving for the night, the day nurse begged me to ask the doctors to do an overnight oximetry and an EEG on her, no way was I bringing this up to anyone now, we were leaving in the morning!  Lyla had another blue episode overnight and her night nurse said she wanted to bring in the doctor to give her a look over and know her base line in case something happened to Lyla overnight.  The doctor came in shortly after and she told the nurse to pretty much relax, as I was not concerned about her, and there is nothing she (doctor) can do for Lyla, this is just how she is and she cannot be "fixed".  I was so happy the doctor understood!

Sunday came and the surgeon gave Lyla the all clear to go home!  

...

Since the operation Lyla has changed so much, she is no longer coughing and gagging from the nasogastric tube, she has been making some small noises and loud cries, she is semi-interested in tasting food and will let us put a dummy in her mouth!  She is healing really well, and in about 2-3 weeks her PEG will be changed over to a Mic-Key. 












Jess

Friday, May 31, 2013

An Update

Sorry I have been MIA for quite a while, I have just finished my 2nd and 3rd uni courses, so the last month, or so, was pretty hectic with final assignments and an exam... plus all the normal everyday stuff which was squeezed in.

So what has been happening over the last month...


Lyla has started a new medication called baclofen.  The plan is for it to help relax her so she will not be as 'stiff'.  I have noticed a small difference, not exactly the difference I was expecting, like more mobility in arms & legs, she just seems to be a little more floppy in the trunk.  I was very hesitant putting her on this medication, and after close to a year of discussion with numerous doctors, I decided to just give it a go... When Lyla was born she was put on diazepan (without our knowledge, or consent) which sedated her for weeks until we had fully weaned her off of it; this is why I was hesitant.  Even though it is a different medication I didn't want it to knock her out, or change her.  

She also started a new formula, up until a month ago she was having your normal supermarket bought stuff, which is not best for a child whose only source of nutrition is a formula designed for 1 year old children who eat solids too.  I was sick of spending $40+ a week on formula.  So after a nutritionist appointment (which I was also not 100% keen on, that is another story) Lyla is now on Nutrison, a pre-made formula, which looks and smells like chocolate milk (you can now imagine the looks I get when I pull out a bottle of 'chocolate' milk) and it is normally for children over the age of 10, but nutritionally, this is best for her.  The bonus of this is, it's FREE!  The downside is the end result, no one is prepared for that!

We have now started weekly occupational therapy sessions, and the occasional speech (if she is around), in the hope to 'de-sensitise' Lyla, as she is very sensitive to unfamiliar textures etc, which, for example, makes things really hard when she has her little 'blue episodes' just because someone other than immediate family touches or holds her.  We are starting at her feet and working our way up. 

We had a follow up eye check 3 weeks ago, her eyes are FINE!!  However, we will be returning in 6 months for an actual test. 

The last couple of weeks Lyla was also very unwell, never has she been so sick before and it was horrible.  She ended up with a chest infection, which as you may know, or may not, for a child like Lyla can be VERY serious, especially with a high risk of aspirating; and sadly this is how many children like her pass away.  She was on 2 forms of antibiotics + a probiotic (which was powdered and got stuck in her NG tube, and ended with a tube change) she also had to have a chest x-ray to rule out pneumonia and avoid a hospital hospital stay, but luckily she's a strong little thing and after MANY sleepless nights, she's good as new!  Following this, we had a midnight visit to ER with a meningococcal scare, luckily that was also clear.

And finally, probably the most exciting news actually, 
WE HAVE A SURGERY DATE FOR A PERMANENT FEEDING TUBE!!!  
 We have been waiting for this surgery for a long bloody time!  There was alot of stuffing around with the date while Lyla was sick and last week her surgery was cancelled and rescheduled 3 times!  Now it is a definite for Wednesday June 5th, 5 sleeps!
The surgery involves placing a permanent feeding tube, either a PEG or Mic-Key Button, directly into her stomach, from the outside.  This means no more nasogastric tube and we will finally be able to see her face with no tube or tape!  Along with this, 3 biopsies will be done - tissue, muscle and liver.  The date cannot come quick enough, but as much as she needs this done and we want it done, I am VERY scared; I don't want her to go under anaesthetic, I don't want her to stay in hospital (staying in PICU), I don't want her to be cut open, and I do not want another repeat of our last hospital stay (I might write about this another day), but positive thinking!


Well, I think that is all that has happened over the last month in the life of Lyla, I will post a few pics too.


That is all for now



Jess