As always, there is good news and bad news. Bad news first because there is less of it and it's basically over now.
Last night Sam did the impossible: he threw up...twice. It's not entirely accurate to say that it's impossible; improbable is more accurate. You see, as a result of his Nissen fundiplication, he should not be able to throw up. That means that there was a lot of pressure in his tummy forcing out formula. Basically, we think that Sam has limited gastrointestinal motility as a result of the anesthesia used in his procedure. In real words, that means he can't poop just yet. His gut needs to "reawaken." So...we had some moments of drama before realizing that we can't feed him quite as aggressively as we normally do. For a while, I thought that might keep us in hospital an extra day or two, but that leads me to the good news...
Evidently, this is a pretty common side effect of anesthesia, not to mention relatively short lived. Now, trying to pin down a precise answer from doctors is like trying to herd cats, but we managed to wrangle out a rough time frame. These symptoms should subside in the next 1-3 days, and, until then, we need only to be more conservative regarding the speed with which we feed him. As long as we do that, we (read: Sam!) should be fine. So, in short, they let us go...as of half an hour ago, we're home! Hooray!
More importantly, the cath doctor was relatively optimistic about the results of the procedure. Sam had both an x-ray and an echo today to check the results of the balloon plasties, and the docs liked what they saw. Of course they cannot make any promises, but they are optimistic about the implications of Sam's cath. They feel that the SVC narrowing has been significantly redressed, to the point where, had he not been a great candidate before, he now is likely to be a good candidate for his Fontan procedure (which he is slated to get when he weighs on the order of 30 lbs). They also liked what they saw with his descending aortic arch narrowing; as a result of the plasty he now has less pressure differential in the different veins and arteries and stronger, more pulsatile pulses in the areas past the arch. These are good things. And while there are no guarantees that these interventions will be permanently efficacious, their effects are promising. Perhaps we've simply bought another year before he needs another cath, but as Kristin and I were reminded of the difficulty of day-to-day living in the hospital, that year is likely to be wonderfully spent at home with a happy, chunky little boy.
So...as always thank you for caring to follow along; any strength we possess is largely due to the strength of the support we have around us. Thank you also to the amazing doctors at Children's. Here are a couple more pictures for you as I go back into turtle mode: I hope you all have as much to be thankful for this week as we do!