Wednesday, December 8, 2010

Surgical Report

Juliet was in surgery for 4 1/2 hours last night. Shortly after 11:00pm, she returned to the NICU with her surgeon, Dr. Chahine. He explained when he opened her abdomen, it was filled with infection and bile. A portion of her intestine had several tiny tears and needed to be removed. He removed about 14 cm. of her small intestine (fairly close to her stomach). As a result, she has 2 stomas again. One that will go into an ostomy bag and one that he hopes to be able to feed her through. This way her entire remaining intestine can be fed and absorb nutrition, in hopes of preventing further liver damage. Her liver was enlarged and discolored, but still soft. Apparently, this means the damage is still reversible. However, the longer Juliet remains on her IV nutrition (TPN/lipids), the more damage her liver will sustain and the higher potential for permanent liver injury. If she can tolerate more feedings through the majority of her intestine, the TPN can be decreased.

Dr. Chahine's best possible explanation for all of this is that the intestine that was stuck in a hernia at her last surgery was the section that had perforated. They repaired the hernia the last time, but it had probably been damaged a little during the process. He suspects this happened fairly quickly after her last surgery (when she was the sickest) and Juliet has been managing the perforation and infection the last 6 weeks. He also suspects the infection was contributing to her chylothorax (excess fluid that is draining in her chest tubes) as it had spread up into her chest cavity as well.

The entire team is hopeful that this is what has been making Juliet sick over the past 6 weeks and now that it is repaired, she will start to improve. So, she has signed herself up for at least one more surgery to reconnect her intestines and take-down the ostomies. When this will happen will depend on her recovery from last night's procedure. Again, like her other surgeries, she is expected to get sicker over the next few days and then start to improve. Last night, she was relatively stable. Today's goals are to keep her comfortable and to closely watch her fluids. So, our little Juliet keeps on fighting. This child not only has the will to live, but the will to make an impact. She is one special baby.

Thanks to all who took care of her last night, through the surgery and beyond. We are eternally grateful. And I almost forgot, HAPPY 5 MONTH BIRTHDAY, JULIET!! XOXO

10 comments:

  1. Juliet, you are definately a little fighter and indeed a special baby. My thoughts and prayers are continuing and will send hugs your way. Hang in there little one!!!!Becky Hinkle

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  2. Poor little lady! How awful to think she had so much infection in her abdomen. What a stoic girl to manage that for six weeks. I hope she can get off the TPN and start absorbing some "real food" soon. Her system must be under such stress--it's amazing to think that she is so small and that she is still finding the strength from somewhere to fight to get better. I am happy she pulled through the surgery. It sounds like you are working with an incredibly skilled, dedicated team. Much love to all of you and happy birthday to Juliet!!

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  3. Praying for Juliet to get through these hurdles an finally get better. Hoping that all good things happen from here on out. Stay strong for her! She is a fighter and has proved that. She is on God's hands and we trust in him. Thanks for keeping us posted.
    Love and tons of hugs to you all....aunt laurie

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  4. Jessica we are praying for Juliet every day, throughout the day.

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  5. Sweet little Angel.......My prayers are with you as continue to fight and stay strong. So many people love you and have watched you and your personality grow and shine :) this certainly has been a long and difficult six weeks for you, but God knows how strong you are and is working through the hands of those who care for you..... remember, the best things always come in the smallest packages. You can do it Juliet!...Anna Farrar

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  6. Happy 5-month day, Juliet. In such a short time, you have already inspired so many people with your resilience and strength. Keep fighting, little lady!

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  7. Baby Juliet is beyond amazing! May the days ahead be healing days! I will be praying and thinking of Juliet and your entire family!

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  8. Thinking and praying for you all day long, Juliet! Keep up the fight. You are an inspiration to many and your determination is amazing. Our Angels in heaven are looking down on you and protecting you. We are praying for your full recovery and for you to move on to getting home with your family. Love you, little girl! Best wishes for the best days ahead.
    Strength to you all........aunt laurie

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  9. Juliet is amazing! What a strong little girl!

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  10. We are keeping brave little Juliet in our prayers every day. We hope that the love of so many may support Juliet's parents and sisters through these challenges as well. In Peace, Laura and Bo and all the Tayloes

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