Mental Junk

I am heading downtown again.
He is heading back into surgery – probably to get a colostomy bag.
Temp – we hope until he heals.

Nathan's belly has decreased in size but is still distended.
He was sent for X-Rays and it showed free air in the abdomen.  They use carbon
dioxide to inflate the abdomen during surgery, however that was 5 days ago now,
so it is expected to be absorbed by now.  It is possible that he has a leak or
perforation in th bowels.  His white blood count is high indicating an
infection, so he is now being barraged by antibiotics to kill off whatever is
growing.

He is going for an ultrasound sometime today to get a better look at what is
going on inside.  At this time it is just a waiting game – make sure he
doesn't get worse and find the problem.

Rob.

We brought Cameron into Sick Kids to see his younger brother – Nate had just had his first surgery.

Michelle was going to stay the night (and ended up staying until Nate came home) but Cam and I were heading back home afterwards.

After a five and a half hour surgery Nathan is in the recovery ward.

A series of biopsies were performed along the length of his large intestine and the section of
diseased colon was mapped out and removed.  He has had about two thirds of his large intestine
removed as well as his rectum.  A pull through operation was performed connecting the remaining
healthy ascending colon and part of his transverse colon to his anal sphincter.  (this past few
months have been a crash course in human anatomy for us)

The doctor was able to partially reconstruct a rectal 'pocket' that may help him develop some form
of normal continence.  Although all this sounds very serious, what this ultimately means is that he
will have to be mindful of his diet and bowel movements for the rest of his life.  He is to expect
loose stools and more frequent bowel movements, all in all – manageable lifelong considerations.

For the interim we need to be mindful of infection and constipation while he heals.  There are other
possible problems we may face- but we will deal with what we have to as things may develop.  There
is no word regarding when he may come home or when he may start eating normally or anything as yet.  
Those questions can be answered as they come up.  For now he is doing well and enjoying his well
deserved morphine high.

Rob.

Sorry for the late update, just got the chance.
Nathanial's biopsy came back and the results show no nerve cells in the sample.  This means that a
clinical confirmation of Hirshbrung's disease has been made.

The good news is that he is now scheduled for surgery first thing Saturday morning.
Will keep all posted as I can.

Nathan will be getting the biopsy early Monday morning.
The results will take at least 3 days to return and he will stay at Sick Kids until the results are
back.

They are also going to keep him in until all gas and feces are out of his system and he can remain
undistended.

Rob.

Nate was transferred to Sick Kids this afternoon and will be placed on the surgery list for a biopsy
of his lower intestines.

We are hoping that he will be diagnosed and treated in the same surgery, but was informed that since
he is stable, they may hold off the surgery for another date.

Will keep you posted.

Rob.

Nate is fine – and he is being transferred to Sick Kids either this afternoon or tomorrow.  We are
just waiting for a free room down there.

All tests have come back and show distension without rupture (great news didn't expect different,
though – but nice to hear) and the infection may just be a head cold and not worthy of antibiotics.

We have been told that Nate is being transferred directly to the surgery ward instead of just
pediatrics which means that things will happen really quickly once we get him there.  Planned
biopsy of the large intestine to confirm Hirschsprung's disease and to determine the extent of
nerveless intestine.  Once that has been done – he will be slated for surgery to remove the
affected section.

I will keep you posted as I know more.

Thanks for your prayers.

Rob.

Nate has been admitted to Ajax hospital overnight.  Michelle is staying with him – so Cameron and I
get the house to ourselves tonight.

Nate's stomach is distended and may have an infection, so they are doing tests.
The Pediatrician is amazing – he is trying to get this dealt with as an inpatient instead of having
to wait as an outpatient.

As far as I know – being an outpatient will delay tests, results, biopsy and resultant surgery.  
Where as being an inpatient he may be in recovery by next week.

There are additional tests that have been ordered for tomorrow morning and after they come in he may
be transferred to Sick Kids.

I will let you know when I find out.

Rob.