No surgery today...

Well, Dr. Healey came in this afternoon and thought that Kaelyn needed to get some fluid off before he could close her up. So, we are going to wait until tomorrow and see how she is doing after a dose or two of lasix. She really doesn't look that puffy to me, but her weight is up a little from yesterday. I guess we will see where she is at in the morning.

We have to take her off of the Precedex (the good sedation) tonight, so it may be a long night. But thanks to Wade's mom, I am ready. She stayed with Kaelyn last night so Wade and I could go home and be with Jacob and get a good nights sleep in our own bed. It was hard to leave her, but very good to get home together.

Love to all,

Angie

Steady...

Kaelyn is steadily improving. They think that she will be able to be closed tomorrow and possibly extubated after that! It is very exciting to think that we may be able to see Kaelyn's personality return, even if she will be a roaring bear it's so much better than nothing at all.

They did take her off of her paralytic today and she is opening her eyes and squeezing my fingers. She also can shake her head yes or no to simple questions. That makes my heart feel a little better.

I think that things are finally starting to improve.

Love,

Angie

Resting...

Kaelyn is having a day of rest. She hasn't had much going on today. Which is good for her, give her some time to heal and get rid of some of the excess fluid in her body. The docs say that when her edema goes down some they are going to close her abdomen the rest of the way. That could possibly be in a few days. Her LFT's are slowly coming down, another good sign that her liver is beginning to heal. I did not get a chance to view her ultrasound today, but the surgeons are assuring me that it should be fine based on what they saw in the OR yesterday.

It is so hard for me (Angie) not not hear Kaelyn's sweet little voice and to see her so still. I miss her! I know this is all for her good, but I can't wait until she is talking and able to get around a little. Hopefully next week.

I am home tonight with Jacob, while Wade is spending the night with Kaelyn in the PICU. Jacob started 1st grade yesterday! He really enjoyed it and said he made one new friend, though he couldn't remember his name yet! He likes his teacher. He said most of what he did today was learn more rules. But he had PE yesteday and tomorrow, his favorite subject!

Love to all,

Angie

All is well...

Kaelyn is now out of surgery. Dr. Healey said that everything really looked pretty good. The blood they found in her abdomen was old, so there is not any place that is currently bleeding. Her artery that was showing high frequency in the ultrasound looked pretty stable. It was slightly adhered to the liver wall so they unstuck it. He also said that since her artery is connected directly to the aorta that it most likely will have a higher frequency blood flow. So also is carrying a lot of extra fluid which makes your blood pressure higher too. All in all, she looks good in there and her liver looks good. Very encouraging. They were able to close her a little bit more but not completely. Slowly but surely she will have a closed tummy.

Wade and I are both breathing heavy sighs of relief, and prayers of thanks.

~Angie

Back in surgery...

Kaelyn's ultrasound this morning showed some bleeding in her abdomen. Also one area of the hepatic artery had really high pressure. Dr. Healey thinks that probably with the extra fluid in her abdomen the artery is getting compressed or stretched or even rolled so the blood has a smaller area to flow through. There is visible flow though on either side of the trouble area, which is a good sign. He does not think that there is a clot. Her bleeding is probably being caused by the high amounts of heparine she is being given to lessen the risk of clotting. He is going to go in and clean up the extra blood and look for any place that it may be coming from. It may be hard to find, her blood is so thin that it could be leaking from any place. Her hematacrit dropped from 30 yesterday to 20 today. They usually transfuse her at around 23. So she will be getting some blood and platelets today also. Dr. Healey mentioned that he thinks things will get better soon. Her LFT's (Liver Function Tests) are getting better and the blood flow getting throught the trouble spot is a good sign.

She went into surgery around 10:30 am and it will be a few hours before she comes out.

Love to all,

Angie

Not so bad...

Okay, we just talked with Dr. Reyes. He says things are not as bad as the radiologist lead us to believe. Yes, the left side of the liver does not look good, but there is still blood flow to it. It is probably in trauma and he hopes that it will recover. There is no need to go back into surgery today to check things out. They are just going to keep her well sedated and paralyzed so as not to irritate things. They are also going to keep her on her heparine for a long time, probably a month at least. They want to get her belly swelling down so they can get her closed. They are also going to continue to do Ultrasounds for the remainder of the week if not longer.

So, breath a little friends...her right side is functioning well and hopefully her left will follow suit with a little time.

Love,
Angie

Oh boy,

Well here goes a doosey of a post. Kaelyn did in fact have a blood clot in her hepatic artery. This in one re-run we did not want to partake in. It was fairly hemolized, meaning that the clot had been in there for a little while (probably started formin on sunday after they discontinured her herparin dirp). She came out of srugery around 9 pm and we sat and spoke with Dr. Healey for a little bit. He was wondering if she may have some sort of clotting disorder where she clots easier than other people. They are going to be doing some testing for that . It also looked like all of the swellin and extra gas in intestines was causing all of the vessels to be stretched and thus narrowing the passage for blood flow. She was moving around a lot and that could have caused some more swelling and dislodging of clotted blood to form a more organized clot. Today she is highly sedated and medically paralyzed just for her own protection.

She has a fever and had fairly low blood pressures overnight. So they have given her extra fluid to counter act that. It has brought her fever down and her blood pressure back up. She is still running a low fever, they have cultured her and are waiting on results. She is currently on about four different antibiotics, so hopefully she is covered for what may be infecting her.

We thought her initial ultrasound went well. The tech (Jenny, our favorite) saw adequate blood flow in the hepatic artery and other vessels. The bile ducts did look dilated, which is not good, but usually can be reversed if the blood flow was not stopped for too long. But then Jenny came back with the radiologist and wanted another look at her liver's left side. They believe the left side has taken significant damamge. Where there is enough blood flow the ogan lights up well and looks brighter. Her left side was very dark, which means there may be litterl or no blood flow to that side. This is not good. They are going to report this to Dr. Healey and Dr. Reyes and they most likely will want to take her back to surgery to get a better look at what is going on. We should hear later today when and what they are going to do. One good thing is that her right liver side looks pretty good and they may be able to just resect the left side and leave her will a healty right lobe that will grow to meet her needs. We just have to wait and see.

Please pray for Kaelyn,

Angie

2nd update

Dr. Healey ended up revising Kaelyn's hepatic artery. The ultrasound post revision showed good blood flow. He is not going to be able to close her completely. Her wound will be not as big and hopefully he will be able to close her in a few days.

She is still in surgery and we are waiting to hear from Dr. Healey what happened to the hepatic artery to cause it not to function.

Surgery update

The surgical nurse just phoned us. Some suprising and unsettling news. Kaelyn's hepatic artery is not functioning as it should. They did not say what exactly was going on, but they are doing some exploratory surgery and possibly revising the artery. Wade and I are just sick thinking that Kaelyn may have to endure the exact same thing that happened with her first surgery. Hopefully all will be well and her hepatic artery will be fine. I know that in Dr. Healey's hands things will go as well as it can. I also know that our little girl is surrounded by more than just the surgical team...Heavenly Father knows our Kaelyn and he is comforting us all.

Love,

Angie

In surgery to close belly

Kaelyn went in at 4:30 pm to have Dr. Healey close her belly. She was very restless leading up to this. We, of course, were told that she would go in around 12. So we were holding off on starting her sedation until afer surgery. She was so uncomfortable and not wanting to be in that bed that we finally gave her some benedryl (I don't know why we didn't think of that before) and it settled her down. Moments later they finally came to take her in to surgery.

She is still in right now, hopefully we will have an update soon. Dr. Healey was fairly confident that he could close her, but if he can't he will move the abdominal muscles closer together and sew her as far as he can. They don't want to squish, for lack of a better word, her organs and lungs. He said that there hasn't been a case yet where he couldn't close a kid. And I thought, well this is Kaelyn we are talking about! Ususally the exception to every rule! But I am confident in him also, if we can't close her today atleast it will be a step in the right direction.

Angie

Day 4 in ICU

Kaelyn is doing okay. Her abdomin was a little more swollen than the day before. So last night they gave her some lasix to help her get rid of some of the excess fluid. It seemed to work, this morning her belly was one inch smaller than last night. Yesterday was a battle after she was taken off of her sedation. She was constantly moving and needing mommy. We finally figured out a regimen of benedryl and a suppository sedation that seemed to help her get some sleep last night.

Hopefully this afternoon they will take her into surgery to close her belly. If she is still too swollen they may still take her in and change the dressing and place additional drains to try and get rid of the extra fluid. If they can close her belly than she will probably be extubated either tonight or tomorrow, if no closing she will continue to be intubated until they can close her.

I will post again when they take her into surgery.

Love,
Angie

ICU day 3

Kaelyn is doing fairly well. Her blood pressure was on the rise yesterday, but as soon as they were going to give her some medication for it, it went down on it's own. I think Kaelyn knew that they were about to add one more med to the multitude and refused to let them (*smile*)! She is such a fighter.

Today they have to take her off of her sedation meds, she can only be on it for 48 hours and then she needs a 24 hour break. They will take her off of it at about 1 pm. I think she will not be happy, and either will we. I hope their plan of increasing her Morphine and Adavan will be sufficient. I guess we will see.

They are still going to try and close her tomorrow. But her tummy is still pretty swollen, though the rest of her is pretty dry. She looks a lot better than she did when she first came out of surgery. All of her LFT's (Liver Function Tests) look great. They are not in the normal range of course but they are so much better than they were before transplant 2.

I will post later,

Angie