Day One after Surgery:

The first day after surgery, was a quiet day for Katie. She was on a morphine pump at 2.0 ml per hour. She was so weak and tired that she slept almost the entire day with only a few brief moments being awake. Her face and body had swelled considerably, looking like the Pillsbury dough Boy. This is a normal response of the body after surgery. The procedure for the day included numerous position changes. She was moved via a draw sheet across the bed that two people would use, one on each side of the bed to pick-up and slide her from one side to the next and in the process role her to the opposite side. Frequent position changes are required to help reduce the risk of pneumonia setting in. With her track record we were being very cautious in this area. Her skin was very sensitive to any wrinkle or rough surface that touched her. Pressure marks were found almost every time we repositioned her. The majority of them vanished within 15 minutes but needed to be monitored for breakdown. We requested chest-physio to assess her breathing twice a day to ensure we get off to a good start without undue risk. We were to encourage Katie to cough to remove any fluid pooling in her throat from going into her lungs. You can imagine that coughing would be quite painful having an incision all of the way down your backbone. As the day went on Katie’s coughs got stronger, but they were all noticeable painful. Her air entry was good utilizing her upper and middle lobes with minimal air entry into the lower lobes which was to be expected.

In order to reduce the risk of infection she has been on a catheter to continuously remove Urine and keep the incision dry. The folley (catheter) is kept in for up to three days until the child has voided all of the extra fluid that it retained after surgery and the child is able to exercise some control over the voiding problem. At this point Katie is still retaining a large surplus of fluid. It did reduce somewhat during the first day.

Katie required oxygen which was humidified while sleeping the first night administered by a tube laying close to her face. Mask was not necessary. During the first 24 hours there were three I.V. Antibiotics given every three hours to help reduce the chance of infection. During this first day her temperature was irregular and she received 325mg + 120mg Tylenol suppositories which seemed to help with the pain