The surgeon called this morning.
The bad news: Robbie's hiatal hernia is back.
The good news: Robbie's hiatal hernia is back.
This is bad because obviously it changes the surgery. Instead of being a 10 minute outpatient procedure with no stitches, it's a 90 minute inpatient procedure with lots more details.
The doctor said that because Robbie's stomach is attached to his abdomen from the gastrostomy (remember that yesterday this was a good thing) it will be more difficult to work around. He may have to actually detach it, do the hernia repair and then reattach it. He'll try to avoid that but the most important thing is to fix the hernia as well as possible.
He said that it's common for them to recur and particularly because Robbie was so small when they fixed it the first time (less than 4 lbs) there wasn't a lot of tissue to work with. Because he's much larger now, there is much more tissue and he has a far better chance of permanently repairing it.
All of this is good because it certainly explains why Robbie doesn't want to eat. It explains not just his discomfort but the fact that he eats a small amount and stops. What is likely happening is that he eats a bit which causes his stomach to distend upward into his esophogus, which hurts. And he's done. Who can blame the kid?
It's entirely possible that just like last time, he'll wake up from surgery and be starving. Of course, he's much older now and has learned the eating = pain, so he might not. The G tube will go in anyway just in case.
Just like last time, if he does return to eating and growing fantastically, it can always be removed again. (Though I'll probably be far more hesistant to do so right away this time.)
It also means he'll be under anesthesia longer, which of course means I'm more nervous. It's still not anticipated to be a problem, but they will try to get him awake as soon as they can. The surgeon said that if things go easily it may be as quick as an hour but if he has trouble working aroung the gastrostomy, it may even take longer. As he told me last time, "It's not a race. It takes as long as it takes to do it well."
We will be staying overnight. The doctor said that if it got to be about 10pm and we were fed up with the hospital and just couldn't take it a minute more, we could have the nurses call him and he'd discharge us, but he will need to be observed for a while after the surgery because his feedings will be held a while. We'll likely to go ahead and stay the night and go home the next morning. By now we're certainly used to the hospital life.
As always we could use prayers. Pray that the surgery goes smoothly and that the hernia repair is completely successful this time. And pray that this is truly the answer to our eating woes. For the first time in months I feel like we might really have hope that he might be able to eat normally.
The difference last time was profound. I'd love to see that again.