Samuel had a very quiet day, with his anaesthetic having worn off but still on morphine. He was asleep all day, but responded to touch and noise, but not waking. His colour is better, his heart rate is significantly lower averaging 140 per minute (it was averaging 170 pre op). Generally he looks puffy and his stomach is very distended, but this is common after an operation and they expect the fluids to start draining over the next 24 hours. His kidneys are working at 10% of normal capacity (for a healthy person) even though pre-op his kidney function was within the normal range. The renal specialist thinks this is due to the effects of morphine, being on ventilation, the effect of 'shock' from the operation and the reduction of fluids being given to him to help 'dry out' his lungs. Today there was some debate between doctors as to the amount of fluids that should be transfused into Sam, in order to maintain kidney function, whilst at the same time not increase the amount of fluids retained in his body. The consensus was to keep him on the same amount of fluids for the next 24 hours and see what happens.
The care Sam has been receiving is incredible. The heart surgeon personally popped in to check on him first thing this morning, as did the cardiologist, urologist (bladder), gastroenterologist (bowel/stomach) and nephrologist (kidney). They all liaise with each other and we are touched by the care they show interacting with us and Sam - it really is hard to put in words how incredible they are and how grateful we are to them. Today his lovely nurse (Janni) explained (interpreted!) much about Sam's care for us. The nurses are in a whole league of their own too!
It seems they want to ensure Sam recovers from this op and seeing how it affects all his other areas before putting him through another op, so it looks like next Thursday he may have his bladder and stomach operation (more about that next week).
All we can do now is wait for his kidneys to start to strengthen from the increased blood flow which should generate increased urine flow that has dropped off significantly as a result of the operation. Also his lungs still need to 'dry out', even though the flow of blood has been stopped, the lungs still retain a lot of fluid that can only be drained via the kidneys and bladder. This needs to happen before he will be able to breath without assistance. So it was a long day with a lot to take in, but we were pleased to see him looking a bit better and to know in theory the operation went well - we just sit and wait and pray for an improvement in reality over the next 24 hours.
We have been overwhelmed by the kindness of so many friends who have posted us gifts, dropped in meals/groceries, had the girls to play, brought us up coffee and sent us cards and messages. Thank you all for your thoughtfulness and generosity.
Francis & Shirley