(Caution....long post!)
Everything went well with the surgery and he was out of the OR in just under 2 hours! There was more damage to the meniscus plate then they were expecting. They ended up having to cut out 1/4 of the whole plate, no fix to it. This might cause arthritis problems in that knee later on. But everything with the bone and ligament harvesting, drilling, grafting, and placing the screws went well.
We were told his heart did well during surgery also. As usual, he was longer then normal coming around from the anesthesia, but once he did, he was taken out of recovery and put into a post op step down unit. He was drinking some Sprite and becoming pretty alert. Things were looking like he would be discharged within an hour or two so my parents headed out. Not ten minutes after they left he took his "turn for the worse" that is common with him. His blood pressure plummeted and his heart rate nose-dived (down to 45 which is when his pacemaker is set to kick in) he became lethargic and his oxygen levels fell........... and all kinds of alarms went off. At this time his pacemaker part of his ICD kicked in and kept his rate paced above 45, but his blood pressure kept falling. The nurses called the post-op floor doc and they were preparing to page cardiology and transferring him to that floor. They waited 15 more minutes and checked his blood pressure again and it went up a very tiny bit and his heart rate was up to 49. So we continued the wait and watch mode for another 30 minutes. Everything gradually climbed back up. (Whew!)
After an hour of staying stable at less critical levels they had him get up and try to urinate. Getting him out of bed, into a wheelchair, and standing in a bathroom was not an easy task. After all that we find out he couldn‘t urinate. So back to bed and drinking more fluids. An hour later, they said he had two bags of IV fluids in him, one 6 oz glass of water and a 4 oz Sprite so he should be able to urinate. Got him back up, wheeled him to the toilet, got him standing in front of it, he tried, still couldn't urinate, and then proceeded to get extremely dizzy and almost fainted. They grabbed him, set him back in the wheelchair where he then vomited! (I am thinking by now that we were staying the night!)
They got him back to his bed and he practically passed out! They decided to scan his bladder to see if there were even any fluids in there. Nope! His bladder was empty, despite all the fluids he had in him. Obviously, he was extremely dehydrated!
After some more time with IV solutions, he again started coming around. We got him sitting up and drinking more pop. His vitals improved again. They decided instead of keeping him there until he urinated they would release him and we could continue pushing the fluids at home. If he had not been able to urinate by that evening we were to call them back and take him back in...........So home we went.
By 8:30 that evening his bladder was full and terribly uncomfortable and he was still unable to urinate. I called the urologist and he said since Andrew had a femoral nerve block in his groin, in addition to the anesthesia some of those nerves that get the urination process going might still be numb from the block. He said it should be wearing off by then though.
He also said when some people go under anesthesia and come back out of it some of their organs don't always "wake up" like they are supposed to. Some organs need help getting started, such as a cath in this case. And he said since Andrew had to be cathed after his last surgery to get the bladder working again, it is probably going to be needed once this time as well.
So off to the hospital we go. He was cathed and his bladder emptied. We were told that should get things jump-started. Also, by this time, the nerve block had worn off from his knee down and his knee pain was becoming quite severe. We were told if he still couldn’t urinate by morning and/or he was still numb in the thigh and groin, that we were to bring him back in.
This morning (Wed. 20th) he was still numb in the thigh and groin area from the nerve block, and his bladder was still not functioning. So back in we go. They inserted a cath line and a urine bag. He will wear the cath and bag until his post-op appointments on Thursday afternoon. They think they will remove it then, and see if his bladder will start functioning on it‘s own. They are also hoping the groin and thigh numbness from the nerve block will be gone by then. (It should have been gone last night.)
We have no idea how his incisions or knee are doing because his leg is wrapped in layers from groin to toe. We do know he is in a lot of pain! We will get our first look at it tomorrow (Thursday). Hopefully his bladder will start functioning on it’s own tomorrow too. He is one miserable kid right now!
Everything went well with the surgery and he was out of the OR in just under 2 hours! There was more damage to the meniscus plate then they were expecting. They ended up having to cut out 1/4 of the whole plate, no fix to it. This might cause arthritis problems in that knee later on. But everything with the bone and ligament harvesting, drilling, grafting, and placing the screws went well.
We were told his heart did well during surgery also. As usual, he was longer then normal coming around from the anesthesia, but once he did, he was taken out of recovery and put into a post op step down unit. He was drinking some Sprite and becoming pretty alert. Things were looking like he would be discharged within an hour or two so my parents headed out. Not ten minutes after they left he took his "turn for the worse" that is common with him. His blood pressure plummeted and his heart rate nose-dived (down to 45 which is when his pacemaker is set to kick in) he became lethargic and his oxygen levels fell........... and all kinds of alarms went off. At this time his pacemaker part of his ICD kicked in and kept his rate paced above 45, but his blood pressure kept falling. The nurses called the post-op floor doc and they were preparing to page cardiology and transferring him to that floor. They waited 15 more minutes and checked his blood pressure again and it went up a very tiny bit and his heart rate was up to 49. So we continued the wait and watch mode for another 30 minutes. Everything gradually climbed back up. (Whew!)
After an hour of staying stable at less critical levels they had him get up and try to urinate. Getting him out of bed, into a wheelchair, and standing in a bathroom was not an easy task. After all that we find out he couldn‘t urinate. So back to bed and drinking more fluids. An hour later, they said he had two bags of IV fluids in him, one 6 oz glass of water and a 4 oz Sprite so he should be able to urinate. Got him back up, wheeled him to the toilet, got him standing in front of it, he tried, still couldn't urinate, and then proceeded to get extremely dizzy and almost fainted. They grabbed him, set him back in the wheelchair where he then vomited! (I am thinking by now that we were staying the night!)
They got him back to his bed and he practically passed out! They decided to scan his bladder to see if there were even any fluids in there. Nope! His bladder was empty, despite all the fluids he had in him. Obviously, he was extremely dehydrated!
After some more time with IV solutions, he again started coming around. We got him sitting up and drinking more pop. His vitals improved again. They decided instead of keeping him there until he urinated they would release him and we could continue pushing the fluids at home. If he had not been able to urinate by that evening we were to call them back and take him back in...........So home we went.
By 8:30 that evening his bladder was full and terribly uncomfortable and he was still unable to urinate. I called the urologist and he said since Andrew had a femoral nerve block in his groin, in addition to the anesthesia some of those nerves that get the urination process going might still be numb from the block. He said it should be wearing off by then though.
He also said when some people go under anesthesia and come back out of it some of their organs don't always "wake up" like they are supposed to. Some organs need help getting started, such as a cath in this case. And he said since Andrew had to be cathed after his last surgery to get the bladder working again, it is probably going to be needed once this time as well.
So off to the hospital we go. He was cathed and his bladder emptied. We were told that should get things jump-started. Also, by this time, the nerve block had worn off from his knee down and his knee pain was becoming quite severe. We were told if he still couldn’t urinate by morning and/or he was still numb in the thigh and groin, that we were to bring him back in.
This morning (Wed. 20th) he was still numb in the thigh and groin area from the nerve block, and his bladder was still not functioning. So back in we go. They inserted a cath line and a urine bag. He will wear the cath and bag until his post-op appointments on Thursday afternoon. They think they will remove it then, and see if his bladder will start functioning on it‘s own. They are also hoping the groin and thigh numbness from the nerve block will be gone by then. (It should have been gone last night.)
We have no idea how his incisions or knee are doing because his leg is wrapped in layers from groin to toe. We do know he is in a lot of pain! We will get our first look at it tomorrow (Thursday). Hopefully his bladder will start functioning on it’s own tomorrow too. He is one miserable kid right now!
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