Day Zero

This is my story of the first 24 hours or as it is called at HSC, Day 0. It is a bit long and detailed. In some parts it also gets a little graphic. Here goes.
So we arrived early at HSC and by early I mean before six am early. I knew something was up, but everyone that met me was so nice. They weighted me and took my vitals and measured me and so on. I was getting really hungry but all they gave me was a small bit of sugar water.
At 0730 we went over to the pre op area. There were alot of crying children. Now I was really wondering what was going on. My fears were put to rest as a beautiful young nurse came over and played with me. She was so nice. Mommy and Daddy look sad. I don't know why. The nice nurse and I were going somewhere. I was off to an adventure!!!!
I was put on a bed and more people came over to play with me, including a real nice man I met in pre op. He said he was with anastasia. I don't know what that is but it sounds pretty cool! Before I knew it there was a mask over my face and I guess I fell asleep.
From here on I'm going by what Daddy told me. It is kind of detailed to appease the medical people that are reading this. After I went to sleep I was intubated with a cuffed 3.0 tube (this is important later). Then they proceeded to put an arterial line in my neck, two IVs, a urinary catheter, an NG tube and monitored me with various other devices. They made an incision in my chest, cut through my sternum and gained access to my heart. I was hooked up to a heart lung bypass machine where i took one unit if blood. This was because I weighed in at 6 kgs. My body wouldnt be able to lcirculate enough blood to keep my organs alive. Once that was set up and running well, the surgeons began the repair of my TOF. They patched the VSD (ventricular septal defect) and a tiny ASD (atrial septal defect). Then they inspected cusps of my valves for my pulmonary artery. Although they aren't perfect they are "acceptable". Luckily they didn't have to do a valve replacement. In the future that might change, but for now the valves aren't leaking. The surgeon also said my pulmonary artery is narrow, but that may change as I grow up. To finish up the surgery they took me off the heart lung bypass to make sure everything was on the up and up. They also placed pacing wires directly on my heart incase I suffered a bout of bradycardia or some kind of bradydisrhythmia. Two wires remain hanging out of my incision and should be removed when I go to 4D. Two chest tubes where also placed to allow blood to drain from my chest cavity. Wow what a morning. I'm glad I was asleep for that!!!
At 12:00 The surgeon came out to tell Mommy and Daddy that I was doing well. They were very relieved. Now they had to wait for one hour to see me in the CCU. What an eternity it was for them.
Finaly at 13:10 Mommy and Daddy were taken to see me. I was heavily sedated, hooked up to the vent which was breathing for me. I had heparin, plavix, morphine, and antibiotics running through pumps. My urinary catheter was draining well and so was my chest tubes, although the blood from my chest was quite dark and thick.
My blood pressure and heart rate were a bit high. My blood pressure was 124/56 and my heart rate was 176. I was satting very well, but my Etco2 was quite high. In the high 60s and low 70s to ne exact. My blood work was showing I was a bit acidotic. On top of this some gunk was in my lungs. They suctioned me but because I was intubated with a small 3.0 endotracheal tube, they couldn't get it out. They decided to take the tube out and re intubated me with a 3.5 tube. I was re sedated as I was able to open my eyes a bit and squeeze mommy and daddy's fingers. A 3.5 uncuffed tube was placed with no problem. Unfortunately there was a large leak. I started to blow bubbles out of my mouth and other nostril! So after some discussion with respiratory and the attending doctor I was again intubated with a larger 4.0 tube. That helped because they could suction the crap out of my lungs, and it was tight enough that there wasn't much of a leak around the tube. My Etco2 then dropped to the low fifties, witch is better but still not great.
During this time my blood pressure took a tumble to 68/48 and my pulse remained at 170. The decision was made that I might be volume deprived. An order for an albumin infusion was ordered and started. For those that don't know, albumin is a blood product. Within a fairly short time, my blood pressure was up to a respectable 90/54 and my pulse was dropping to around 140. It was working nice. My Etco2 was a near perfect 41mm/mg! I was making progress. The sedative was starting to wear off so I was able to grab mommy and daddy's fingers again and I would move my toes if someone tickled them. I was also trying to suck, so mommy put a soother in my mouth. The RT started to wean me off my vent. This was a slow process that took all night. Blood gasses were taken from my arterial line every few hours to make sure the drugs and ventilation support was working in harmony. I really started to arouse around midnight. I tried to do my usual wake up smile, but something was very wrong. My whole body hurt. I started to cry but nothing would come out !!!! What the hell???
The doctor and the RT started to debate the pros and cons of sedating me yet again. It turns out they did two intubations in the OR not one, so that ment I had been intubated 4 times in 12 hours. Luckily the last 2 daddy watched and agreed that they were not traumatic intubations so my airway should be okay. They gave me alot of morphine to control my pain but I was still very upset. I laid on the bed trying to cry but with no success.
Mommy, daddy and the nurses did all they could to keep me calm. At 0330 am Iwas switched from assisted ventilations to CPAP via my tube. What this does is increase the tidal volume in my lungs when I can't do it myself. As my drugs wore off I was getting so agitated I was trying to pull out my endotracheal tube. Jack the RT and daddy had a big discussion with the doctor about getting me extubated ASAP. At 0630 I was extubated by Jack. It hurt but at least I could cry properly.
My throat was so raw and sore. I had a plastic oxygen tent that looked like a space helmet put over my head. My O2 SATs stayed at a beautiful 100%. They repeated my blood gases and before 0900 I was doing great and didn't require any oxygen what so ever. So ended "Day Zero". What a busy day!!!!