Peyton - Tuesday, January 20 (before admission!)
Peyton after admission, but before diagnosis of appendicitis.
Peyton after surgery to remove appendix and abscess.
Peyton well into first recovery, using his NG drainage tube as a lasso.
Peyton on MORPHINE (They are NOT compatible! terrible mood!)
We chose the name Peyton because we wanted to give him a legacy to live up to, to let him know we believed in him even before he was born. We deliberated over quite a few names, but it came down to Peyton Nathaniel. Peyton means, "from the house of the warrior," and Nathaniel means, "blessing from God." He is living up to his name through this experience. He is so brave and we are so proud of him! Beyond that, we are thankful.
I will try to provide a brief update, but if I look back at most of my posts, I tend to be anything but brief. My apologies! One day perhaps I will write short posts...
The last time I had time to sit down and write we were waiting for an ultrasound to determine whether or not the three secondary abscesses that had formed due to the ruptured appendix had resolved themselves or whether they would require drainage. The doctors canceled the ultrasound because they wanted to wait a little longer to see if the antibiotics would clear them up. They talked about switching him to oral antibiotics and doing a follow up ultrasound later (which means they likely would have discharged us sooner than later). We were a little nervous about the idea of taking him anywhere before we knew exactly what we were dealing with. It turns out that we didn't have to deal with that uncertainty, there was a different emotion for us to deal with instead.
Monday he was beetling around the hallways, bugging nurses and trying to stop Mommy's heart by careening down the hall with his speed shuffle leaving Mommy to steer the IV pumps around any obstacles in his path. After a while I decided to try to slow him down by making him manage the IV pump pole but that plan backfired. He realized quickly that he now had freedom and could move even faster! We had the charge nurse in a panic when he got away down the hall before I could catch up and all parties were worried he would slip and hurt something before any of us could get there! My strong little boy, oh how he makes me smile.
Tuesday he was alright in the morning but he didn't feel well in the afternoon and he was worse by evening. By late evening he was sick to his stomach every hour to two hours and had severe cramping (with no pain medication to manage it) that continued through Friday. He couldn't keep anything in his stomach, and even after they put him on a nasal tube (NG) drain to drain his stomach of its own contents (he was no longer eating at this point) he could only go for a couple hours without getting sick. We took him for an X-ray Wednesday, Thursday, and Friday morning in the hopes of determining if he had a blockage in his bowels as a result of his appendix rupturing. They couldn't tell on Wednesday, and Thursday's X-ray was actually better. His blood work was telling a different story on Thursday, but it was better by Friday. The surgeon decided he didn't want to take any chances so he sent Peyton for a CAT scan on Thursday morning (I quickly got over my reluctance when he explained the consequences of not sending him for one - either get one done or he would do surgery that day to go in himself and see what was happening, and he was serious!). The CAT scan showed that he had a partial blockage so they wanted to wait a bit to see if it would resolve itself. Friday Peyton was still sick to his stomach and seemed even more ill so the surgeon got one of his colleagues to review the X-rays and CAT scan with him. They came by around lunch and said, "We have to go in, and we have to go in soon. There is now a full blockage and we are worried it will be a major surgery." The disadvantage of surgery at this point of his recovery was that the chances of them being able to do it laparoscopically were slim and if they had to go in, it could end up being a 4 - 5 hour surgery, requiring a possible blood transfusion and could involve doing a temporary colostomy (where they would bring his bowels to the surface, leave a hole for drainage, let the bowels recover and then repair after they heal). We didn't know how to respond, but it was agony watching Peyton suffer so much so we were willing to do anything for him at this point!
Friday at 4:45 pm we wheeled him in for surgery and only reluctantly left him behind. It was an awful feeling walking out of that room, leaving him behind and remembering the other times we had walked out of that room knowing we were leaving someone we loved in the (very capable) hands of someone they didn't know. We left Drew in that room twice and Peyton in there twice now as well. No words could adequately describe the strange feeling we felt walking away empty-armed, a double impact.
We waited, knowing that if they didn't bring him back within an hour and a half or so it would mean they were doing a major surgery. By 8:00 we were still waiting. By 9:00 they let our nurse know he was in recovery and the surgeon walked in to tell us about the surgery. I was down in the ICU visiting the little girl we have requested your prayers for when I got a call that the surgeon was there. I don't think I've ever run faster to get someplace! Peyton's surgeon said they went in laparoscopically and found adhesions everywhere, which would have likely been the result of the abscess. One of the other surgeons mentioned during the surgery that that was great and now they wouldn't have to do a major surgery. Peyton's head surgeon disagreed. He saw bile and said, "If this is bile, there is a hole somewhere." God blessed us with this surgeon - someone else might have sewed him back up before finding the real problem! He decided he would have to open him up more to go through Peyton's bowels in search of any holes and found 3, up by the left rib cage. They were likely the result of the inflammation of his intestines due to the original rupture, which then led to a kink in the large intestines, which in turn cut off the blood supply and allowed it to start decaying. He believed the holes were the outcome of the decay that had weakened the intestines in that spot. Peyton's intestinal contents had been leaking for some time probably, as there was bubbly matter and tiny abscesses all over the cavity. The anesthetist said it looked like hamburger. Great. That belongs in the stomach itself, not the stomach cavity!
The surgeon was able to repair the three holes and cleaned the area out as well as he could before sewing him back up. They were also able to use 2 of the 3 previous incisions, although they had to enlarge them a bit, so Peyton only got two new holes out the deal. The largest one is only about 2 inches wide amazingly. The surgeon thought the surgery went well and I was relieved that Peyton wasn't going to be coming back with his stomach inside out! We tried not to contemplate how we would deal with that ahead of time, but I have to admit I found myself asking where the necessary strength would come from.
I nearly cry now thinking about the moment they wheeled Peyton back into his room Friday night. He was so brave! He had to go through going to sleep with strange people wearing strange masks and clothes, surrounded by scary equipment and then waking up with much of the same, with no familiar faces nearby. I just wanted to cuddle him close and make it all better Friday night, but he was so uncomfortable and so tangled up in cords we couldn't get too close! He came back with an NG tube in his nose to drain his tummy, a drain from one of his incisions, a catheter, an IV site with four lines in one arm and an IV site with two lines in the other, an oxygen saturation monitor on one of his little fingers, and oxygen prongs in his nose to help him breath after all the medication they had to give him. You would think a boy with his spunk would fight these bonds tooth and nail, but he hasn't for a minute! He just moves them with him if he tries to move. We went to take off the nasal prongs today and he got upset that we were going to remove them. I think he was afraid it might hurt - I can't imagine any other reason he would not want to be free of one of the many things connecting him to his bed!
The surgeon mentioned Friday night that though he felt the surgery was a success, we were not out of the woods yet. The first couple of days would be very critical to determine whether it was a success and Peyton would be at risk for a few complications. 1) The sutures might not hold, especially if there is too much pressure on them, so he can have NOTHING going through his bowels and even gas could cause a problem. 2) He could develop more secondary abscesses or infection. 3) The surgeon added a new risk yesterday after we realized Peyton was having difficulty breathing which was quickly followed by more X-rays - he could develop pneumonia as a result of the collapse of his lower left lung lobe. It was likely impacted by the inflammation of the bowel directly below it. This last risk necessitated a regular visit by a physiotherapist a couple times a day in hopes that we can open that lobe back up fully and prevent pneumonia. He seems to be breathing better today, but breathing has been challenging because it hurts to expand his rib cage and lungs.
He has been doing much better today than yesterday, so Mommy and Daddy are doing better as well. He is still very weak and uncomfortable, and we are not yet sure whether we have turned the corner so please keep him (and us!) in your prayers as Peyton continues to prove he is truly a warrior of the bravest sort.
I will try to post again tomorrow or Tuesday provided no complications arise and time allows. Thank you for following our journey!