Day 22: March 8, 2019 … 3lbs 7.38oz
Today is surgery day. We met with his Surgeon, Dr. Michael Handler, who is the Associate Surgeon-in-chief. Ryker’s day nurse said he is her absolute favorite Doctor of all at the hospital. He was really nice, and explained the procedure to us in detail. Ryker’s condition was hydrocephalus, which is a build up of cerebral fluid in his ventricles (center of the brain) due to blood clotting from his grade III & IV brain bleed. This was not allowing the cerebral fluid to pass out of his brain to his spine. The surgery was to place a ventricular subgaleal shunt into his ventricals in order to release the cerebral fluid that was building up. The fluid would float into his scalp to gradually be reabsorbed. He was too small to receive a Ventricular shunt, which is a tube that is placed under the skin to release the fluid into his abdominal cavity, which reabsorbs much faster. There is a small chance that the existing shunt could be a temporary fix and the clot could resolve itself and allow the cerebral fluid to pass normally. If this does not happen, then Ryker will have to go in for another surgery to receive the ventricular shunt at a later date.
Ryker was wheeled back for surgery at 11:40. It was pretty nerve wracking and unsettling for his room to be completely empty.. I’m so grateful Nick made it down and was able to take the day off to be there while we waited to hear how surgery went.. One of the hospital social workers had popped in shortly after they wheeled Ryker away, which ate up a good chunk of time during surgery and kept our minds occupied.
Around 12:45, we received news from his nurse that the surgery staff that Ryker’s neurosurgery went well and they’d be rolling him back to the room in about 20 minutes. What a relief..
Once back to the room, they set him up on all the monitors and ventilator. Their hopes were to get him back on CPAP by tomorrow. His face and head looked fairly different- less swollen looking. You could actually see his skull plates touching and somewhat overlapping. He now had what looked like a goose head on the top of his head with the consistency of a water balloon. This should gradually get reabsorbed. They didn’t have an exact time frame as I suppose each baby is different. He now has an incision about 1-1.25″ long on the top of his head as well..
Ryker came out of anesthesia pretty fast. Moving his arms and legs, and eventually looking around to see what all had happened. He’s always had a little harder time opening his left eye, but now it was just as wide open as the right. It was nice to see his sweet face again. It took some time to get his pain managed, and throughout the remainder of the day he continued to have large drops in his oxygen saturation. The nurses and doctors weren’t quite sure as to why. They did a Chest xray to see if the ventilator tubing was positioned correctly. They said it seemed a bit deep in his chest, but didn’t seem to be too much of a concern at that time. They kept giving him boosts of oxygen from the ventilator when he did dropped, often sitting in the 40% range, then would hang out at 90-100% for a good chunk of time. They checked is hematocrit as well. It was down from surgery.. likely do to the bit of blood loss from the procedure. They’d test again at midnight to see if there was a change. They also have a head ultrasound scheduled for Sunday to see what his ventricles look like now that the fluid has had time to release.
I ended up staying the night at the hospital. His frequent drops seemed to gradually taper some and were a little less severe (60-70% range vs 40%). Hopefully things will continue to calm down after the meds to wear off, his pain is managed, and he gets some rest.