Things Are Looking Up!

There he is…..my guy.  I wanted to say he was happy, but he is a bit sore after his procedure.  Look at his face.  He isn’t unhappy, I guess he is just “uncomfortable”.  If you saw what they did to his intestines it would make you uncomfortable as well.

The GI Team actually did the roto-rooter deal.  They took a spaghetti scope and inserted it into Zack’s ostomy.  The camera allowed them to inspect his small intestines.  They advanced the camera slowly and about 18 cm into the small intestines they found a spot where a turn in the intestines was constricted. The explanation I understood was that the intestines are so dilated that they are pressing on this turn and sort of flattening the turn and thus not allowing the fluid to flow freely past.  Got it?  Whew.

The surgeon then took over and “invented” a stent from an NG tube that had holes in it.  They then inserted the NG tube in with the scope past the blockage up to about 35 cm.  Then they turned on the suction to make sure it worked and it did.  The hope is that gravity will pull the fluid out of his intestines into that tube and out into a bag outside of his ostomy bag, under his bed.  Wow.  That sounds confusing.  Let me add a few pictures to help me describe this crazy deal.  If you are squeamish, skip right on over these few photos:

Z’s ostomy bag with tube coming out of the lower portion:

By the way, this is an adult collection bag to accomodate the amount of tubing coming from the site.

Next photo is the bag coming from his body to the edge of the bed:

Finally, the collection bag under his bed:

Not all of the fluid will be collected by this tube.  It is hoped that the remaining fluid will follow the tube and come out into the ostomy collection bag attached to his body.  We hope to keep the tube in for 24-48 hours.  The doctors think Z’s body will probably push the tube out over time.  We also hope the swelling of the intestines will diminish allowing the constricted turn to open up and drain on its own.

Now the if’s…

1.  If the drain stays in and drains properly, we will disconnect it in 24-48 hours and see if his body can work on its own.  If so, yay…we can go home early next week.

2.  If the drain stays in and drains properly and is disconnected and does NOT work properly, we will go back to draining his ostomy manually.  Jim and I will be taught how to do this until his body can do it on its own.  Joy.  BUT we could still go home :).

3.  If the drain does not drain properly, Jim and I will be taught to drain it and can go home early next week if everything else remains the same.  If his body does not begin to work, we will continue draining the ostomy until his body is healed enough to perform another surgery in the near future.

As you can see, most of these options include us coming home sometime next week.  I am afraid to type this…..I hope it is really true…..

Another exciting thing for Z is that his NG tube was removed.  Most of the fluid was making its way down the intestines away from the NG tube, we weren’t getting much waste from that.  Zack has been so brave and strong through all of this and rarely cries.  Having his NG tube messed with sets him over the edge.  Having it out was a big deal for him and that makes me happy.  If all goes well tonight, Zack might get to have a drink tomorrow.  He’s already planned it out and has decided his first drink will be apple juice.  Sounds wonderful.

Zack would like to post a picture of his crayons.  So here you are:

photo (26)

Overall, a very good day indeed.  We needed that!

Dawn

Holding Steady

Yep, that’s right.  Holding steady.  It’s better than sliding back.  Not quite moving ahead, but  we’ll take it.  My days are a bit blurred together, so forgive me if I have it out of sequence.  Wait, you won’t know!  Ha!  What a relief.  I’ll do my best to give you Zack’s update and as a bonus, I’ll throw in a few cute pictures.

Come on…how cute is he?

When last I typed, things were pretty rough again after a day and a half fake-out of happiness.  The surgery team thought a lot about what their next step should be and ultimately decided to do a CT scan with contrast to check for an abscess.  Z had been looking unwell, lacking energy, sweating and having a good amount of pain.

The results of the scan were both good and frustrating.  We know Zack does not have an abscess.  That is super good news.  We know there isn’t something visible blocking his intestines which would account for their lack of motility.  The frustrating part is that his intestines are not moving.  As I understand it, we still don’t know what is causing the problem.  His entire intestinal tract is now dilated except for a small bit near the stoma opening.  Because they are so distended, radiology will say he has an obstruction, but is it a true obstruction?  That is a question we cannot answer yet.  Since he had a CT with contrast, Zack will have x-rays over the next several days to see if the fluid moves at all.  If it moves, it could show a place where it stops and thus indicate an obstruction we can’t see right now because of the swelling.  If it doesn’t move it could be a motility issue.  We really can’t guess or plan until we have more information.  I’m a planner.  I do not like this.  Jim is a calm, mellow fellow and he is OK with not knowing what comes next.  I also think this is because we DID rule out some serious health concerns….again….good.

I really appreciate the surgery team and how honest they are with us.  Even though I feel frustrated with not knowing, at least I know they are on top of his care.  In addition, today they found out that Zack’s albumin level is low.  Again, I’m not a doctor or a nurse or a dietician, so I copied this from WiseGEEK.org:

Within the human body, albumin is an important component of life. It transports essential fatty acids from adipose tissue, otherwise known as fat, to muscle tissue. The protein also contributes to the regulation of osmosis, helping to transport hormones, drugs, and other substances through the blood. A deficiency can lead to medical issues, and medical professionals may request a blood albumin test when investigating a patient’s medical condition.

Zachary’s surgeon is working with the dietician to get this level figured out.  They also discovered his iron level is pretty low, but not  low enough to require a transfusion.  Um, yes, let’s hope we can skip that please!

So, here we are…holding steady.  Zack can’t leave the hospital because without machines sucking gunk out of his stomach, fluid being drained from his stoma and nutrition through a PICC Line, he couldn’t survive.  BUT he isn’t “sick”.  We just have to wait for his body to decide to kick in or for something to show up on x-ray that would indicate another issue.  He had a bit more energy today.  He has colored pictures for his nurses and doctors and is currently playing with cars.  He is pale and has sunken eyes and his tummy still hurts, but we can deal with those things.

Now the question is, how will tonight go?  Don’t worry though….my family and friends have been increasing my chocolate stash.  Now if I could only bank sleep I’d be all set.

Dawn

Update

I wrote most of this last night before Z went to sleep.  He had a pretty tough night.  Lots of pain.  The first time it was managed by flushing his NG tube.  Everything in Z’s stomach has to be suctioned out or it will continue to build up since it does not have a place to go.  It is collected in a container and measured every two hours.  Whatever comes out is then replaced with IV fluids.  This is what the container looks like:

photo (16)

Zack also has his heart rate and breathing monitored continually with pulse oxygen levels every four hours.  The pulse ox thing is just because he is not a fan of the monitor and they can tell he is doing alright.  The machine:

photo (17)

And finally, Z has his IV pole.  There are typically 3-4 bags of things hanging there.  This picture shows 4.  One is the fluid replacement which is mixed in the pharmacy according to what the morning labs show he needs.  The big brown one is the TPN mixture minus the lipids.  I’ve been told the lipids and this bag not mix well, so they are separated out.  The white milky stuff is his lipid bag.  The 4th thing is medicine.  They mix this one up.  Sometimes it is a pain medicine and sometimes he gets Protonix, which is like Prevacid.

photo (14)

Ooops.  Sorry, went on a rabbit trail, but thought you might like to see all the “stuff” Zack has monitoring him.

Shortly after the NG tube was fixed, Z was in a lot of pain.  He was moaning and squirming and crying.  His nurses were surprised to see him in so much pain.  The Surgeon of the Day was called and drained another 250 ml from his stoma.  He was drenched in sweat and we had to change his bedding and pajamas, etc.  I think we finally got him settled and sleeping by 2:30 and he slept soundly the rest of the night.

The surgeon came in a little bit ago and gave us our new plan.  If nothing changes for Zack today, he will go back to the Pediatric Sedation Unit tomorrow for another procedure.  This time his doctor will insert a scope into the stoma so that he can examine the intestines and see where the fluid is building up.  He thinks it is possible that because his small bowels are so distended, one of the loops may have collapsed in onto itself.  He does not anticipate Zack needing any other surgery.  I hope he is right.

We are extremely ready to check out of this fancy hotel.  It’s been nice and all, but we are d.o.n.e.  Hopefully we will be able to give some good news tomorrow.  I wish you all a great day and remember to hug your kids!

Counting My Blessings

It’s been one of those days.  It started off so well.  Actually, Sunday was pretty darn good as well.  Zack had a good night’s sleep.  No doctors had to be called overnight.  Sunday found him smiling and joking and with more spunk.  We walked the hall three whole times, sat in a chair for two hours and made it the entire day without Dilaudid.  Last night was a little bit rough, but that’s probably because mama was back.  In my defense, the night nurse called the surgeon because his NG tube was having a mechanical issue which in turn made Z’s tummy hurt like crazy.

Back to today.  Zack woke up happy.  The surgeon didn’t have to drain anything, the NG tube was working again.  Zack walked the hall and then the Child Life Specialist came and played with Zack and they painted a picture for his cousin.  Shhhhh. It’s a secret.

After that, we had visitors and played.  About 1:00 things started to go downhill.  Zack began asking for Dilaudid.  Yes, he knows the name and he knows when he wants it.  We gave him one dose and he fell asleep for about 2 hours.  Jim arrived soon after he woke up and then Zack began crying….not because his dad arrived!  It was soon evident that this was some big pain.  Z’s main surgeon was paged and actually happened to be right by the ward.  He came with two of his residents while Zack was still in a lot of pain.  Usually by the time they arrive he has calmed back down.

His surgeon drained him through his stoma while one of the residents worked on the NG tube.  Between the 3 of them a liter of fluid was collected.  We have been trying to keep from giving Zack Dilaudid. The surgeon wants him weaned as do we.  Today the surgeon said we needed to give him a dose.

That brings us to right now.  We were getting ready for bed when Z began asking for pain medicine again.  We started with the IV Tylenol at 8.  It’s a pretty busy time then with shift change and medicines being switched, vitals being taken and other important things.  Zack was complaining of pain the whole time.  At 9:00 I took him for one last walk.  He made it half way down the hall and needed his spiffy car.  While I drove him around he kept sliding down the seat because his tummy hurt.  He also rode with his head completely on the steering wheel because he was so wiped out.

By 10:00 we decided to let him have more Dilaudid.  I expected he’d go right to sleep.  Turns out the medicine did nothing for the pain.  He started crying and the staff decided to call the Surgeon of the Day.  While we were waiting for him to arrive, Zack started crying that this was an emergency and to get the doctor.  I have to tell you, I don’t like nights in the hospital.  The doctor finally arrived and Z asked him to PLEASE drain his tummy.  It makes me sad that my 6 year old feels so bad that he begs the doctor to drain his stomach through his stoma.

Zack’s intestines were drained, NG tube fixed and plans made to check in again.  His main surgeon has said that if he is not better in the morning, Zack will have a CT Scan to check for the possibility of an abscess.

You may be wondering what this has to do with counting my blessings.  When things go all kerflooey, I’ve got to stop and count my blessings.  Let me count them for you:

1.  Zack is not in the PICU.

2.  Zack is not the sickest child on the ward.  I’m not happy the other children are in worse shape, just happy that Zack is doing better.

3.  Zack’s stomach looks better.

4.  We have a wonderful surgeon and surgery team.

5.  Our nurses have been amazing.

6.  Last week, the doctor in charge of the ward was a GI doctor and he watched Z like crazy.

7.  Our neighbors have been helping us with our dog and feeding our middle child.

8.  Our church has been bringing us meals and visiting us at the hospital.

9.  I have great friends who check on me daily.

10.  My mom and sisters have been coming and sitting with Z so Jim and I can get some food and leave the building for a moment.

11.  LOTS of people are praying for Zack.

When I list those things out, our current situation doesn’t seem so overwhelming.  Add in a little stress relief in the form of exercise, an amazing husband and kids and our faith in God and things start to feel manageable.  Most importantly, I remember to take each moment as it comes, keep my eyes on today and when all else fails, eat some chocolate.

Dawn

Zack’s Update — Surgery #1

I apologize.  I had great plans.  I would bring my laptop to the hospital and write all about Zack’s surgery and keep you all updated….and then life happened.  I also wanted to be witty and fun in my posts, but this time I’ll just be relaying information.  It’s really all I can do right now.

It all started out as we expected.  Zack was admitted to Bethesda Naval Hospital or Walter Reed National Military Medical Center as it is now called.  We did the clean out.  Over 3.7 liters of GoLightly later and nothing.  For over 9 hours.  Seriously.  I had been second guessing myself about the surgery.  Yes, he needed it.  It really was our only option. Still, that nagging anxiety about sending your baby into surgery kept me wanting another option.  Z holding 3.7 liters of that stuff inside his body was confirmation that there was indeed no other way. I’ll spare you all the messy details, but some came out overnight.  The rest (we thought) was cleaned out during surgery.  If you are a parent getting ready to go through this surgery and want all the details, I’ll be happy to share.  Just leave me a message….

The morning of surgery was a flurry of activity and waiting.  We saw the surgery residents, the surgeon, the ostomy nurse, the pediatric residents and doctor.  Zack got in his ride and off we went to the OR.

Since Z had an IV placed during the cleanout phase, the anesthesiologist gave him some versed and got him loopy before taking him away.  Oh my heart.  That was incredibly hard.  Knowing that this surgery was important, but also that it was going to mean changing Zack’s body, I had such a flood of emotions and just wanted the day to be done already.  Why does time seem to stand still in times like that?

Soon the surgeon came to get us.  The surgery went well.  Zack’s colon was decompressed first.  The surgery was able to be done laparoscopically.  When everything was done, the surgeon decided he thought the stoma looked a little “tight”, so he did some reconstruction to make it just right.  He felt good about it and we felt enormous relief that surgery was over.

Once Z got back to his room, he slept most of the day.  He had pain meds on board and a local at the surgery site and seemed to feel great.

That night, he started having a lot of pain.  We were up most of the night.  We found out that the orders for the pain meds were not relayed correctly and that Z was only getting 1/2 the dose of morphine he was supposed to and instead of IV Tylenol and Zofran, they were giving it to him orally.  That lead to vomiting.  It was a long night.

On Tuesday morning our surgeon arrived and was not impressed by the events of the night.  He assured us that would not happen again and we knew he meant it and has been true to his word.  All meds are under control and all staff have been great working with Zack.  Zachary had visitors on Tuesday and his cousin, Ronnie, came and played Minecraft with Z.  Z even sat in a chair for a time.  We were so happy that things were looking so good.

About 9 p.m. all that changed.  Zachary began to vomit again and was in a lot of pain.  His pain medication was not touching it and his stomach was distending and he was not urinating.  Our nurse was wonderful.  She really took charge and got the Surgeon of the Day up here, x-rays taken, etc.  In the end, we had to wait for the morning for our surgeon to hear that Zachary had a bowel obstruction and ileus, complications from surgery.  We’ve been told that developing an ileus is not uncommon.  Ileus is a type of bowel obstruction. It results when peristalsis stops. Peristalsis is the wavelike contractions that help push stool through the colon and small intestines.  Narcotics can also slow the return of intestinal function and morphine is a narcotic.

On Wednesday the doctors decided it was time to figure out if the obstruction at the surgery site was due to swelling or if the actual procedure might need to be redone.  They also decided that they needed to place an NG tube so that they could suction Zack’s stomach.  His stomach was very distended causing lots of pain and they wanted to decompress it and remove fluid.  Further, they wanted to put in a PICC Line to start Z on TPN or Total Parental Nutrition.  These are nutrients placed into the blood stream to help people who are not able to eat.  He had not eaten since Saturday and was vomiting and losing fluid through the NG tube.  Unfortunately, the Pediatric Sedation Unit was completely booked and he had to wait until Thursday for the PICC Line placement.  The good news on Wednesday was that they were able to switch Zack’s pain medicine from Morphine to Toradol.  It is a drug used to reduce moderate to severe pain, but you can only receive 6 doses total and then they would have to switch drugs.

Wednesday night was much of the same with pain, vomiting, low urine output.  On this night, however, a pediatric resident was reading his file and realized that he was super dehydrated.  In addition, when he stood up to try and go to the bathroom a stream of blood came out of his ostomy.  People really started moving then….more xrays, more surgeon of the day activity, more everything.  In the middle of the night when people start hurrying around your child, it isn’t the greatest feeling.  I had been staying overnight while Jim went home to be with Jake.  Each night seemed to be one crisis after another.  Our surgeon had said that he expected that night to be a good one, so I gave him some ribbing about that in the morning.  Zack and I were now running on about 10 hours of sleep total since Sunday.

Thursday morning Zack was able to have the PICC Line placed.  I had never even heard of a PICC Line before.  Basically, it is a central line, IV, that is thread from the upper arm to just above his heart.  Zack’s has two “heads” which allows him to receive both fluids and nutrition.  To place it, we had to go the Pediatric Sedation Unit where he was again under anesthesia.  Jim and I were allowed to stay and watch and it was really amazing.  A little lady who looked a bit like Edna Mode from The Incredibles came in and took control.  She watched Zack’s veins through ultrasound to pick the best one, and moved with great precision and speed and got that puppy in quickly.

Just before  the PICC Line was placed, Zack’s surgeon was able to insert a tube into his stoma and retrieve over a liter of fluid from his intestines.  Besides the relief of getting that fluid out of his body, the surgeon was also happy that the stoma, though not working, was made properly and felt confident that no other surgery would be necessary. The NG tube produced and ostomy produced about 1.5 liters of fluid and some other bodily fluids added a bit more for about 3 liters that day.  That’s a lot of stuff coming out of one little body!  While he was still under anesthesia, we also gave him a good scrubbing.  Being clean does a body good.  He also got some balloons from his Sunday School teacher.

Friday brought more news of the intestines just not cooperating.  X-ray showed distended small bowel loops with lots of air.  The NG tube stuck to Zack’s stomach wall and had to be flushed and repositioned.  The doctor switched Zack to Dilaudid for pain control and over the course of the day decided to do 2 hour doses to help keep ahead of the pain.  That night Zack began breathing funny and lifting his arms as if he couldn’t breathe.  Pulse/oxygen levels were good, so everyone decided that it was the abdominal distention leaving Zack feeling breathless.  In addition, the output from the NG tube was going down and it was decided the tube had attached itself against the side of his stomach.  Several x-rays and repositioning led to a better drainage flow.  All the repositioning led to vomiting.  The kid can’t catch a break.

That leads us to today.  Today Zack was pretty tired.  The surgeon explained that his small bowel was now very distended.  If you can remember way back to the beginning of this blog, we had the ileostomy because his large intestine was so distended, but his small bowel was fine.  The ostomy is open, but not draining because nothing is moving in his small intestine.  Why is the question.  The doctors say it is a waiting game now.  Because Zack also has motility issues, it is really hard to say when the intestines will begin to work again.  They cautioned us to be ready to be in the hospital for a long time. They said one patient ended up being there for 40 days.   I’m pretty sure my heart dropped with that statement.

I’ve tried to include a lot of details for those who may be having this surgery soon.  Not everyone gets these complications or they wouldn’t be complications.  Zack’s body has always reacted a bit different than the usual child to medical procedures, so this may just be a Zack thing.

My husband and I are exhausted.  I came home for the first time to sleep tonight.  It feels strange without my boy.  He’s in good hands with his daddy though, so I’m off to try and get some sleep.

Dawn

Get Ready To Be Schooled!

All right people.  Time to learn something new.  Exercise your brain.  Come on, you know you want to learn new and interesting things about your colon!  Today we are talking about ileosomies.  Just remember, I’m a mom, not a doctor.  I do like to pretend I’m a doctor late at night as I diagnose all my children’s illnesses, but I digress…

An Ileostomy is a surgical procedure that can be done a couple of different ways.  The least invasive way is laparoscopically through a few small insicions in the abdomen.  It is our hope that this will be how it happens for Zack.  The other way is an open abdomen procedure and the recovery can be a little longer.

During the surgery, the surgeon will pull a loop of Zack’s small intestine out through the right side of his abdomen.  He will then cut the loop in half, not all the way, and then basically turn it inside out and make a cuff which will be stitched to his skin.  This is called a stoma and looks red like the inside of your cheek.  One direction of the loop will allow stool from the small intestine to empty into a collection bag.  The other direction of the loop will be used to allow medical things to happen in the future.  It could be used to flush the large intestine, it could be used for a colonoscopy/manometry in about 18 months to see how things are progressing and probably other things I’m not aware of yet. It is called an ileostomy because they are making the ostomy (hole in the abdomen) using the last part of the small intestine or ileum.  When the surgeon uses the large intestine (colon) it is called a colostomy.  See how smart you are now?

Zack’s loop ileostomy’s main purpose is to divert his stool away from his large intestine.  Because he has such a severe case of constipation, everything is very distended.  Because it is so distended it does not have the strength to move stool along properly and needs a rest. Did you know the intestines can shrink back to normal?  How cool is that!  Our hope is that after a rest of 18 months, Zack’s large intestine will be able to function normally again and the ileostomy can be reversed.

Both the GI doctor and surgeon have cautioned us that Zack’s Sigmoid Colon is severely enlarged and could be past the point of healing.  We won’t know that for sure until it has been given time to rest.  The Sigmoid Colon is the last part of the large intestine before your rectum and has a bit of an S-shape.  If it doesn’t shrink down, it may have to be removed. Not to worry, though, you can have your Sigmoid Colon removed and still have normal bowel function.  Who knew?

To help explain all of this to our 6 year old, we found an ostomy doll.  Really, I don’t make this stuff up.  There is a company called Shadow Buddies that makes dolls for all sorts of medical conditions, pretty cool.  Check out this photo:

This is Zack’s Ostomy Buddy.  He could care less about this doll.  He says dolls are for girls.  I think it is cute and will come in handy when we get to the hospital.  It came with a wafer and bag to place over the stoma as well.  I’ll write about that later.  Zack’s doll also has a hospital bracelet, coming home outfit and discharge papers.  So cute..maybe the doll is more for me?

While all of this is a bit scary to us, our doctors assure us that ileostomies are easy to perform.  The surgery itself should take about an hour.  They do it all the time.  Of course, we think it is a pretty big deal as it is happening to our baby.  While it may be an easy operation for them, they are still cutting our child’s intestines and he will be stooling in a bag.  Not so easy for us.

Zack’s GI doctor tells us that Z will be able to all the things he currently does without limitations – once he heals of course.  He can go swimming, play ball, run, jump, basically anything he wants to do.  Our biggest concerns will be keeping him well hydrated and skin care.

In addition, Zack should feel a LOT better.  Can you imagine how you would feel with such a distended belly?  He doesn’t know he feels bad, because that is how he always feels.  We are excited to get this surgery behind us.  We are thankful for the doctors God has provided, because I cannot even begin to tell you how wonderful they are….they are probably ready for Zack to be healed as well because we/I ask a lot of questions.

Now you know all about ileostomies.  If you have read this far, congratulations.  Now go outside and enjoy this beautiful day.  Hug your kids and give thanks for their health.

Dawn

The Road to Zack’s Loop Ileostomy

One of the main reasons I decided to jump into blogging is because Zack has a lot going on medically right now.  I thought that writing it all out in one place would help keep my family and friends informed without blowing up their Facebook wall or email.  In addition, it might also help others getting ready to have the same surgery.  I was surprised at the lack of information available about actual kids who have had ileostomies on-line.  I guess it makes sense, people want to protect the privacy of their children.  However, in the middle of the night while I was stressing out about what to expect, how to help Z cope with the changes, and what being home would look like, a story from an actual family would have been so nice.  I did find one blog, but it hadn’t been updated since 2009.

That, my friends, is how I came to the decision to write about Zack.  If you are squeamish and bodily functions gross you out, this post is NOT for you.  The rest of you, proceed with caution.

Z suffers from severe chronic constipation.  Part of it is behavioral and part of it is probably due to some genetic issues.  I won’t get all in to that now or I’ll have nothing to write about once our current crisis is done and, well, that would be boring.  Suffice it to say, I am an expert on all things poop related and never knew there was so much to learn about the GI tract.  As a means of trying to simplify things:

  • First symptoms began when weaned at 4 months.
  • Tried lots of different remedies and medications.
  • Moved to Germany at 18 months and got on a Miralax regime.
  • 2010 went to visit my sister and realized when looking at this photo all was not well:

  • February 2011 started seeing stool through the skin.  Not pretty.
  • March 2011 admitted to hospital for cleanout German style (no pain meds).
  • Barium Enema to rule out Hirschprung’s Disease and ultrasound of abdomen.
  • Talked about taking medivac back to States, decided to wait 4 months until our move.
  • Moved to Maryland and assigned world’s most awesome Pediatric GI..seriously.
  • Increased Miralax added Dulcolax.  Seemed to be working for 5 months.
  • February 2012 x-ray showed upper GI tract blocked.  Began home cleanout which  did not work.
  • March 2012 Anal Rectal Manometry, Botox in sphincters, abdominal decompression.     ARM was to test again for Hirschprung’s Disease.
  • Liquid stool for entire year, no improvement.
  • March 2013 Sitz Marker test showed slow motility all over, but in particular Ascending Colon.   Sigmoid Colon very dilated and at risk for Sigmoid Volvulus.
  • May 2013 Rectal Biopsy to completely rule out Hirschprung’s Disease.  Decompressed abdomen again.
  • May 2013 Pediatric GI Team and Pediatric Surgery Team decide to proceed with Diverting Loop Ileostomy.
  • Recent photo, though not my favorite, shows belly before biopsy:

So, that brings us to today.  We are two days away from being admitted for a hospital cleanout.  If it is successful, Zack will undergo a laparoscopic Loop Ileostomy on Monday.  If it is not successful, but I think it will be, Zack will have an open abdomen procedure instead.

Whew.  I’m tired from typing all that.  I’m sure you are tired from reading it.  Over the next week I will probably post most days as I try and explain what will happen and keep people in the Zack loop.  I’m off to make a puzzle with Zack.  Have a great day!

Dawn – Maybe I’ll even learn how to have a fancy signature one day.  A girl can dream…..