Back where we started

Turn of events since yesterday. The surgeon will be operating on Lewis again tomorrow morning. Lewis' g-tube started leaking this morning, so they stopped his feeding around 11AM. In addition, the barium study that they did around lunchtime showed that there still seems to be some obstruction in the stomach, but the exact nature of the obstruction isn't clear.

The wound around the g-tube has gotten larger and is likely to expand more without intervention. The muscle wasn't mending properly around it. This leads the wound to leak stomach acid and milk, which makes the tissue weaker. Once it starts, it becomes a self-fulfilling prophesy. Since the tissue around the wound isn't healthy, we're told it is very unlikely to get better without further surgery. The deterioration that would be caused by the leaking stomach acid would be painful for Lewis and would likely make the surgery urgent within a couple of weeks. Presently, he seems comfortable. He was a pretty normal baby, reasonably happy today - but we only saw him after they stopped his feeding.

Goals of the surgery

• remove the existing g-tube button and stitch up the incision
• install a new g-tube (this one won't be a button, but more of a one piece tube, it can be switched back to a button in a couple of months, simple outpatient procedure).
• determine what is causing the blockage in Lewis' stomach
• clean up the remaining blood from the hematoma in between Lewis' stomach and spleen

The surgery won't be laproscopic, they'll need to make a larger incision in Lewis' belly. On the bright side, this will allow them to install the new g-tube using a type of incision that does not hurt the muscle as much and is more likely to heal well. It is expected to be a couple of hours of surgical time, after any prep. They'll likely get him in to the OR late morning tomorrow. Lewis will need to be intubated (put on a ventilator) again for the surgery and a couple of days after. His recovery time will depend on what they find out about his stomach.

Hopefully Lewis has paid his dues and won't have any more complications this time.