Friday, February 27, 2009

Surgery update

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.



Michelle said...

I'm so glad you have some answers, an explanation for what has been going on. Mostly I'm glad that you have validation that this was beyond your control. You are a great mom. I hope that things go smoothly.

Monica said...

yea!! for good/bad news. I am glad that you guys have some answers and you will for sure be in my prayers.

Adriane said...

This is great news in the overall scheme of things, right? I am praying that this fixes the issues you've been having. I'm sure you are so relieved to just have a diagnosis, and even more so, that it's fixable. yay!

Boo for the hospital stay - but the silver lining has to be the ice cream/frozen yogurt machine in the cafeteria, right? :-)

Praying for Robbie and many hugs to you! I hope the wake up from anesthesia is not as long and scary as last time. You are in my thoughts.

Malloryn said...

I'm glad to hear that they might have found the problem. You guys are in my thoughts... I hope that everything goes smoothly.

Kierstin said...

hope this is the answer, my fingers are crossed and prayers said

Heather said...

Wow! The hiatal hernia explains a lot. I knew of a distant relative who's baby had this and he had lots of growth and eating issues too. It sounds like the surgery is going to fix a lot for your little man. Good luck!

Mrs. Spit said...

Answers are great things, once you have them, there's a path forward.

Always praying for you.

Celine said...

Hoping things go well, lots of prayers coming your way.

Lisa said...

I never thought I'd be 'happy' his hiatal hernia was back, but hopefully that's what the problem has been and now things can be fixed for good. At least it must be nice so have a concrete answer to why he was having such eating issues. Hope all goes well. If you need anything Wednesday just give us a call.

Dawn said...

I hope this is the answer to your prayers and fixing the hernia repairs Robbie's eating woes once and for all! :)

tryingin2007 said...

it looks like you now have an answer. that's "great." I'm sorry to hear about the surgery though. that's not so great. I'm thinking of you and your little guy. stay strong mama! you're doing an awesome job.


Anonymous said...

I so very much hope this is the answer for you! The next thing I want to hear from you is that your little Robbie is a piggy!

- dr.girlfriend

O.S.B. said...

It’s so good to hear you say things like this:

“For the first time in months I feel like we might really have hope that he might be able to eat normally.”

You guys are always in our prayers, we’ll pray extra hard that this really is the answer to sweet little Robbie’s tummy issues (which it certainly sounds as if it is) and that surgery goes quickly and smoothly.

Keep your chin up Trish, I think there is light at the end of this tunnel!!

Sara said...

I haven't been able to keep up as much because I went back to work but I think of you all daily and pray that this is the answer to Robbie's eating problems. Take care of yourself and keep us posted!
Sara (lilyvalley)

Heidi said...

I've been trying to think of the right thing to say. Wow.

I'm going to focus on the good, that you have a diagnosis and can move forward. It's just so...huge!

All my best wishes to you and Robbie. I think a very happy ending to this whole ordeal is in short order!

Kristin (kekis) said...

It sounds really promising and like a definite step in the right direction - and scary, too. You know prayers are already coming, and they won't stop now.

Me said...

I'm sorry honey. I know it must feel like you've been in he!! forever. It has to get better soon though. I swear.