Saturday, August 22, 2009

Home Sweet Home!!

Noah loves the wagon rides at Children's



Grandpa's visit



Free from tubes and wires!!


Logan was released to go home today at 10:15AM! Less than a week later, what a little rock star!! This morning he had another x-ray (which looked great) and had the final word from the cardiologist who did the 'rounds' for the day. He said by listening to Logan's heart you never would have guessed he had a heart defect. We are so blessed his surgery was a great success! Thanks again to everyone for all the prayers and concern for our Little Logan.

Ready to go home!



Yay Momma!! We're Outta Here!!

Friday, August 21, 2009

Going Home Soon!!

OUR AWESOME SURGEON DR. MAX MITCHELL!!!


GRAMMIE


GRANDMA AND UNCLE TY


AUNTIE ASH

We received some pretty exciting news from Dr. Mitchell himself this morning. He says Logan looks great and is doing very well and may be released to go home tomorrow!! As long as we feel comfortable, of course. He is only on a whisper of oxygen and taking Tylenol and Lasiks. We have to be sure to care for his incision by cleaning it with soap and water and 'scoop' him up when we lift him. We're ready to take our boy home!!




Thursday, August 20, 2009

Moving on Up...to the CPCU!!!

Thursday, 11:55 AM (Day 4). Well I am pleased to announce more good news! In the next hour Logan will be moved up to the ninth floor of the hospital, and upgraded to the CPCU (Cardiac Progressive Care Unit). This is great news!

I am pleased to report that Logan's lungs are doing great, and that he is almost off oxygen completely (he's on just a whisper). This is also great news, as the high-flow oxygen they had him on yesterday mixed a little too much with his formula and he spit up twice yesterday. Logan's normally a great eater, and has never thrown up before, but he hasn't had a problem since yesterday afternoon, so we're on the right track:)

Logan also had most of his tubes removed yesterday! They had pulled one of his drain tubes early yesterday, and they pulled the second one this morning! They also got rid of some sensor tubes, as well as an IV line and an arterial line. What this all boils down to is seeing our baby boy returning to normal and that he is quickly becoming healthy again! (It also makes it MUCH easier to hold him:)

His color looks great, his blood pressure is great, heart rate, oxygen, everything is really positive. As we walk through the CICU we are reminded how extremely lucky we are, because there are many other small children who are having some complications and our hearts break for them. We've met some incredible parents, and realize that Logan is really quite lucky and, of course, special:)

Here's a great shot of how Logan's scar looks. The top gauze is simply to protect his incision from drool and sweat. The bottom two gauze are where they removed the drain tubes. The pink irritation adjacent the incision scar is simply from the tape being removed and will heal within the next day or so.

This morning Pastor Terry stopped by for a quick blessing and prayer over Logan. Logan is certainly a testament that prayers work:) Look at how content and happy he is! The CICU nurses of course love him to death! (By the way, the staff is simply incredible at Children's. We have yet to run into a nurse or doctor that we don't like!) He's only cried a few times in here, and we've noticed his cry seems a bit clearer and not as raspy, although higher pitched.

Logan has gotten back to his normal expressions, including the random smile and smirk! Overall, we're extremely pleased at how well he is recovering, and we look forward to bringing him home soon!

Wednesday, August 19, 2009

Day 3

Logan right out of surgery. This is with his breathing tubes still in.



8:50 AM. Yesterday was a very progressive day for Little Logan. He's healing impressively well and on his way to making a full recovery! The biggest feat yesterday (by far) was getting his breathing tubes out. He was also able to get his catheter out,
also a plus. At one point yesterday afternoon, he went 8 hours without peeing, and they threatened him to reattach a catheter to him, at which point he promptly peed freely.

Logan has also started to eat again. We started him off with some sugar water, which he thoroughly enjoyed. Throughout the night he drank one 2 oz bottle of formula, followed later by a 4 oz bottle. Logan's never really had a problem eating:)
This is our most wonderful cardiac doctor, Dr. Carrie Villavincencio! She has stopped by to check on Logan very frequently, and we're simply amazed at her level of compassion for him.

One area of concern for Logan is that his right entrance to his lung is slightly collapsed. This is not uncommon after surgery, especially with Down syndrome patients. It's typically caused by shallow breathes and not being picked up and handed all about. The drain tubes in the void spaces between his lungs and heart are more than likely causing him to take shallow breaths, to avoid his lungs contacting them and causing irritation. So, in order to counter-balance this, they simply put him on a different cannula of oxygen, providing him with slightly more oxygen. This problem should be go away on its own within 24 hours.

Logan will have one of the drain tubes removed today (both were about to be removed, but he's still got some fluid draining from the right drain tube) and both are expected to be out by tomorrow. Logan will more than likely spend today in the CICU, with hopes of going to the CPCU (the step-down unit) tomorrow.
On a final note, we finally got the opportunity to hold Logan!!! I can't tell you how happy that makes us:) It's really great to have him in your arms, and Logan really seems to have missed it! He's right at home being held! He's got such a great temperament, and really has only cried twice since he's been here. We can't to get him all better and eventually home! Thanks for everyone's healing prayers; Logan is a testament that they work!

Tuesday, August 18, 2009

Breathing tube out!

9:38 AM. They just pulled Logan's breathing tube out (a process called extubation for all you nerds out there...)! This means he is recovering at an incredible rate! The breathing tube provided positive pressure for his lungs, but it seems our little super-hero continues to beat the odds! Currently they have him on a cannula of oxygen (just a small clear tube that's slightly inserted into his nostrils), but he'll be off of that soon too. Now that the tube is out, Logan will be able to "eat" relatively soon. In two hours he can have clear liquids (we'll give him Pedialite, a baby gatorade so to speak), and in four hours some formula. We personally can't wait to hold our little guy!

The CICU

6:O7 AM. Well after a huge day yesterday, today is a fresh start, and we are happy to report that Logan is doing great. His breathing is doing really good, in fact, and if his blood weren't slightly acidic now (something that's completely normal after surgery), then they would have already pulled him off the ventilator and had his breathing tubes removed. This will more than likely happen later today. (Our nurse said this is remarkable for the day after surgery). Logan had two drain tubes installed during the surgery that help his body remove excess fluid from his void spaces and lungs. This morning they are collecting less fluid and the fluids are running more clear (again, great news). Logan is currently on a few different medications (morphine, tylenol, dopamine, and lasik), again, all part of the procedure. He looks great, given what he's been through, but we can't wait to get his breathing tubes out. He isn't as swollen as I'd expected him to be, and his coloring looks good. We should be able to hold him today too, which we've been yearning to do. Yesterday they had to give him quite a bit of fluids, because his blood pressure was a bit low. Normally after heart surgery, your heart will "sag." What this means is that 6-8 hours post surgery the heart has its hardest time recovering, but that's what the CICU is for. The drugs they've given him help his heart contract more, in essence loosening it up. Remember, Logan's exterior wall of the heart had become thicker (since the heart is a muscle and it was working extra hard to get him oxygen), and so also more stiff. Now that he has 4 separate chambers in his heart, like we all do, his heart has to figure a way to pump to get all of the blood going where it should. I can't tell you what it's like to look up at his vitals and see his oxygen in the high 90's! No more tet spells for Logan (not that he's had any, but now that risk is over!) We'll get some pictures out later today as well.

Monday, August 17, 2009

GREAT NEWS!!!

We just got word of some FANTASTIC NEWS!!! Logan is off of by-pass and stable! The surgery went textbook, and with no major complications!!! Also, even more shocking is that they WERE ABLE TO DO THE VALVE-SPARRING TECHNIQUE!!! I'm in such a state of shock right now that I don't even know what to say. This means that more than likely, Logan will NOT REQUIRE ANY MORE SURGERIES!!! Thanks to all of of you who have kept Logan in your thoughts and prayers! I've always known that prayer works, but we are truly humbled by this whole experience, and know without a doubt that the Lord was in the operating room and looking after our Logan. We are so extremely grateful and in a state of awe. Logan only had a 20% chance of having this procedure done, and we were preparing for the worst. He's got to be one of the youngest babies to have this procedure done (most have to wait 4-8 months before they are able to do it). In 45 more minutes he'll be in the CICU and we'll be able to see him. A sincere thanks to everyone who has thought about our Logan. More to come...

VSD Patch Installed!

12:15 pm. Julianne just informed us that Logan just had his VSD (Ventricular Septal Defect, or the hole between the bottom two chambers of his heart) patched. They do this by cutting a small piece of gortex material and literally sewing it around the hole. Logan's hole was about the size of an adult's pinky nail. They hadn't gotten to his pulmonary artery yet, but that's what they'll tackle next, so I'll have more on that next hour. By the way, his heart is about the size of his own fist. Keep the prayers coming, they're working!

Incision & Bypass

11:15 am. Logan has had his incision and everything is going according to plan. He has been on bypass now for about 30 minutes, and everything is running smoothly. Both Dr Carrie and Nurse Julianne came out for the update. Dr Carrie said that Logan has a thymus, thus they canceled the blood test for St DiGeorge disease (one less thing to worry about!!!). Looking at the charts, they said that Logan will need to have a pulmonary valve of 8 mm in order for him to do the valve-sparring technique (although through the echos we haven't been able to get it higher than 7 mm). So more than likely he'll have the transannular patch (which will mean future surgeries), but we won't know until they get in there and physically measure it for sure. Kireta and I have been preparing for this as well, so at this point, we just want no major complications. The next step is for them to open up the right side of the heart, and start performing the necessary corrections. Look for an update in an hour.

Update to surgery

The time is 10:11 am as I write this. Dr Carrie came out to give us a personal update this morning. She informed us that Logan took to anesthesia well, and no further medications were necessary. His oxygen count two hours prior to surgery was all the way up to 88, but just before surgery had fallen again down to 78. Also, his hemoglobin was high, which is another sign that we are doing the surgery at the right time (as I had been worried that we were putting him in too early). It took a little longer to get all of the "lines" in Logan this morning, but the breathing tube went in without a hitch. As we speak they are preparing him for the incision. Dr Carrie also informed us that since they are tapping an arterial line, she's also going to send his blood away to be examined for St DiGeorge disease (a disease that is a chromosomal anomaly in the 22nd chromosome). Since it's highly unlikely that he has this disorder, I'm not going to worry everyone with the details of this disease, but just be aware they are screening him for it because of his tetraology of fallot.

The Big Day

Good morning everyone. Today is the big day, the day of little Logan's surgery. I'll try to keep everyone as up-to-date as I am able, please bear with us:) The time right now is 7:07 am, MST. Kireta and I checked in at 6:00 am, and the surgery is planned at 9:00 am. We're currently sitting in a private pre-op room, and we've just met with the anesthesiologist and Dr Max Mitchell, Logan's heart surgeon. Dr Mitchell informed us that Logan's surgery should be over around 1:00-2:00 pm or so, pending no major developments. Thanks in advance for everyone's prayers, they really do work! Yesterday Logan had at least five whole churches praying for him, which was pretty special. (Geoff informed me that he's even got a Lutheran Church in East Africa praying for him!!!) Pastor Terri Todd took Logan down to the front of the congregation yesterday, and had everyone pray for him, which was incredibly comforting. That's all for now...

Sunday, August 9, 2009

Logan's alert



Alright everyone, here's a new update on Logan! On August 4th we took him into see his pediatrician, Dr Elias. He's up to a hefty 9 lbs, 15 ozs, and his oxygen remained in the high seventies. Last week, however, I received a phone call from Dr Carrie about her conversation with Dr Mitchell (the cardiac surgeon). Dr Mitchell felt that Logan was an appropriate weight for surgery and wanted to up his surgery date to mid-August. Kireta and I were a little disappointed at first, as we wanted to wait as long as possible with the hopes of upping Logan's odds for the valve-sparring technique. After further talking with Dr Carrie, however, we discovered that his odds would more than likely not increase, due to the fact that even though his pulmonary artery might grow, Logan would also, and it's simply a matter of ratio. Dr Carrie was also concerned that waiting until October would put Logan into surgery during prime time for RSV (a respiratory illness). So after much thought on the matter, we decided to heed the advise of the professionals and schedule Logan's heart surgery for Monday, August 17th.

Kireta and I had a chance to meet with Dr Max Mitchell about a week ago. He's a very nice, down to earth gentlemen, and we both feel comfortable placing Logan's life in his care. When we met him, he had actually just come from the same surgery that Logan will be requiring! In fact, the other boy was the same age, with the same size pulmonary artery! When I asked Dr Mitchell about how often he does this particular surgery, he replied that this was the third one this week, and assured me that's it's all he does. That being said, it's still open-heart surgery, and Dr Mitchell informed us that Logan has a 95% chance of no major complications, with an even higher mortality rate.

I'll now let everyone know a little of what to expect in the short future. On Friday, August 14th, Logan will go in for his "Pre-Op Surgery." This is an all day event, and since they'll be sedating Logan to get a perfectly accurate echo-cardiogram, as well as some other tests, we'll have to stop feeding him at 5:30 am, which should be interesting to say the least:) He'll have his blood tested, followed by a Lateral Chest X-ray. They'll then do another echocardiogram since he'll be knocked out. Kireta will then meet with the Nurse Practitioner that will be giving us an hour by hour update during the day of surgery. (I'll be updating his blog every hour the day of surgery for those of you interested). Kireta will then go on a tour of CICU (Cardiac Intensive Care Unit) and the step down unit or CPCU (Cardiac Progressive Care Unit). Next is an appointment with the Anesthesiologist, followed by another meeting with Dr Mitchell.


On the big day, Monday, August 17th, we'll be arriving at the hospital at 9:00 am. The surgery will last anywhere from 5-8 hours, and we'll be updated every hour by the Physician's assistant. Here's what to expect... The anesthesiologist will put Logan to sleep (this period is called induction). A breathing tube will be placed down his throat and one or more IV's will be established to help maintain Logan's fluids. His chest will then be swabbed with iodine and a perfusionist will operate the cardiopulmonary bypass machine. Open-heart surgery means that the heart will be opened to perform the repair. An incision will be made on Logan's chest, just below his collarbone to just below his nipples to give Dr Mitchell access to the heart. Logan will then be placed on the bypass machine to enable Dr Mitchell to operate. They'll place several special tubes called "cannulas" into his aorta and the right atrium and/or the vena cavae (which collects blood coming back to the heart from the body). Blood is then transferred from the bypass machine where it is filtered, warmed or cooled, and oxygen is added before pumping it back into the body. When the tubes and monitoring wires are all in place, a clamp is placed on the ascending aorta (and at this point forward is called "cross clamp time")

The heart usually stops when the child is cold, but a drug called "cardioplegia" is used to help protect the heart. The heart will also be bathed with a cold saline solution during surgery to further protect Logan. At this point Dr Mitchell will open the heart, and decide whether or not to do the valve-sparring technique, or to do the trans-annualar patch. Sometimes, surgeons attempt to do the valve-sparring technique first, and then see how his heart works when blood pumps through it to see if the patient can handle it. If the heart has too much pressure, however, then the trans-annular patch must be used, but not without a cost. At this point, it becomes a little more complicated, which is why the surgeon has to weigh this option very carefully. (In other words, don't be surprised on Monday when I'm giving you the play-by-play that Logan got the valve-sparring technique, only to be followed by a transannular patch)

Dr Mitchell will have to resect (cut away) the muscle beneath Logan's pulmonary valve, as well as the area above (the supra valve). At this point they'll also fix Logan's VSD (Ventricular Septal Defect) by closing up the hole with Gortex. This will never again need to be fixed. Once the repairs are completed, they will warm Logan back up and the cross clamp will be removed. The heart usually begins beating once it is warm and blood is flowing through it again. Logan will be weaned off the bypass machine at this point, which is a very critical time period. After this period Dr Mitchell will place two to three drain tubes attached to Logan's chest area near the ribs. These tubes help drain fluids that accumulate inside the chest because of the surgery.
video
Logan will at this point be transferred to the CICU and the next 72 hours are critical. Kireta and I will be able to be right by his side, including modest sleeping accommodations. After about 2-3 days in the CICU, Logan should be transferred to the CPCU. We'll continue to keep everyone updated as best as we are able. Logan should be out of the hospital entirely in one weeks time, and they expect a total of six weeks to recover. (Good thing Logan's not crawling around all over the place...Try telling an infant to "take it easy!")

Never wanting to end a post on such serious news, I'll update you on some remarkable progress by our beautiful boy! First, as you can see, Logan has begun smiling! It's so cute when he does this, and it's awesome when we can capture it on film. Also, he's begun cooing which is a relief, because his cry can be quite shrill! Also, Logan has rolled over once!!! He did it a day before he turned 8 weeks! He beat Noah! Way to go Logan!!! Logan never ceases to amaze us and we are so grateful to have him in our lives! He is such an incredible blessing and we don't know what we'd do without him.

Finally, Kireta's dad and brother came out to see Logan before the surgery and it was refreshing to spend some time with them. Kireta's mom, Barb, will be flying out for the surgery as well, and of course we have Brad and Lisa right here in Parker to help us for support. Thanks for all of your prayers, we need them now more than ever! Please keep Logan in your thoughts and prayers, especially August 17th! That's all for now. We'll keep you posted.