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Saturday, July 23, 2011

Day 1

At about 5am this morning, Becky's Mom arrived at Oakes bedside. This is the email that she sent out to us:

Good Morning, All,

I got to the hospital and CICU this morning just in time to don my yellow plastic gown, mask, and royal blue plastic gloves (standard attire for EVERYONE in Oakes' room now). Keep your nasty germs to your self! (And the the gloves are definitely presenting a challenge to keyboard accuracy.)

As soon as I got myself in place, Rounds moved in front of Room 9, Oakes Place. There was a full on team! My best laywoman's interpretation of all of the numbers and technical jargon is that at a little less than 24 hours out, all is going about as well as could be expected. They are watching the monitors, heart rate and oxygen levels, drainage, temperature, and he is getting a plethera of drugs to paralyze, sedate, block pain, regulate heart rate, and God and the Attending only know what all else.

Both surgeons were present and lots of technical data was exchanged. When they were ready to move to the next room, Dr. Huddleston, the primary pediatric cardiologist, who has performed most of Oakes procedures turned to me and said, "So basically everything is okay right now." And that's okay by me.

Dr. Caroline Lee, the cardiologist (not surgeon) who has been following Becky's pregnancy and performing cardiograms and echocardiograms stepped into the room just to satisfy her own curiosity and check Oakes out herself. She is the closest thing to having a cardiologist in the family. She is so personable, and obviously very attached to the Ortyls. She asked me all about the family, how many children, where everybody lives, and expressed her gratitude that our family keeps rally behind Becky & Greg and showing up for the big scary procedures. She said it was heartwarming to her to walk into the private waiting room on Friday and find all of us there keeping vigil with Becky & Greg.

Dr. Lee admitted that she is not an expert on lungs, but that she was relieved to see how well Oakes was tolerating he surgery, and her interpretation of all that was said during Rounds was that so far, everything was good.

Before she left, two doctors from the Pulmonary Team came in. Keep in mind, everyone is draped and masked, so there are all of these blue hands shaking each other. I don't think I could pick these doctors out of a lineup, but they both had very kind eyes, about all that is left of the person. They also said that things were going about as well as they could hope for right now. Their biggest concern is the rejection issue, and Oakes is at a higher risk than the already high risk infant lung transplant because of his elevated antibody levels. There are medications that they are giving to help to alleviate the antibodies. They also completely transfused his blood during the transplant to eliminate as much of the rejection issues as possible. Today, Oakes will begin a 5 day process of plasmaphenesis. Essentially, through one of the already inserted ports, they will pull his blood out of his body, through a membrane that will capture the antibodies, and the circulate it back into his body. Depending on his size and how well he tolerates this process (heart rate, oxygen levels, etc.) this could take several hours. They will repeat it for 5 days. Then they will give him donor antibodies to help him maintain the normal immunity that a healthy body is supposed to have. Yesterday,they used a scope to examine his trachea from the inside. To check the points where his trachea was connected to the new donor lungs and branches. This, too, they said looked good.

Another bit of info that I picked up in rounds, and was confirmed and explained by Dr. Lee and the pulmonologists is that the donor lung was a little bit too big for Oakes' lung chest cavity, which required the doctors to do some trimming. Apparently, in cases of infant lung transplant, this is not unusual, and that is easy to see why. I asked them what kind of trauma that creates for Oakes, and they said that it really didn't add to the trauma he was already experiencing. He mentioned something that I'm thinking was there were some drains at the point where the lungs were trimmed. We'll definitely need to clarify all of this.

Becky and Greg, when the pulmonologist left they asked if you two were coming up today, and said they would try to talk to you when you got here.

So, that's it for now. This is a busy corner of the CICU this morning. And I assume it will stay that way, for now. Oakes looks like a little angel, with a wild hairdo. I think the prayer vortex has swept him up to his safe and happy place for now.

Love from Connie Fox Moore/ Ena (Grandma - Becky's Mother)

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