UPDATE: We met with the surgeons this afternoon and it looks like we will move forward with a pleurectomy on the right side with a possible ligation of the thoracic duct. The top dog of the pediatric surgery team actually developed the procedure, has had success with cases similar to Lucas, and will most likely be performing the actual surgery (he also wrote the case report linked previously). The idea is that by eliminating the pleural space it will prevent dumping of the lymph fluid and promote proper circulation. His chest tubes will remain in place until it's clear they are no longer draining which could take up to 2-3 weeks. At that point, it may be that a pleurectomy has to be performed on the left side too if drainage hasn't ceased. Once drainage has stopped it will most likely be another 6-8 weeks before Lucas would start on some form of food again. Our goals in order of priority: 1. Stop drainage and remove tubes. 2. Extubate. 3. Eat. 4. Hopefully home by Christmas (that's my own secret goal).
Lucas had chest tube #14 placed this afternoon and will have an MRI tomorrow morning. The MRI will give a more detailed view of his vascular system and check for any narrowing of vessels or blockages that would need to be addressed before any surgeries. He also had a full septic work up to rule out any infections and is getting a short course of heavy duty antibiotics. With new functioning tubes we hope he goes into the weekend breathing easier and is ready to head into surgery on Monday.
Lucas has proven he is a fighter and we're so proud of him. We can only hope this surgery will help save our strong little boy.
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The meeting to discuss surgery has been moved to tomorrow afternoon. The entire surgical staff is going to discuss Lucas' case at their team conference tonight. It will be good to get everyone's opinion on the next course of action.
In the mean time, Lucas has had a much harder time breathing over the last couple days and his oxygen requirement has slowly increased again. We were hoping to avoid another chest tube procedure just a couple days before major surgery, but the kid has to breathe. It's painful watching him struggle and even more so because he was having such an easy time breathing room air only two days ago. We're really hoping surgery will come up with a good plan to eliminate this viscous cycle with his chest tubes.
I've been begging for an ultrasound and Lucas finally got one this morning. There's definitely fluid building up in there. Chest tube #13 was just put in on the left side and he's already showing signs of improvement. The surgeon that performed the procedure dropped some hints about the plan they are discussing at conference this evening. Now I'm off to do my research and add to my already long list of questions!
Sidenote: We've been debating who he looks like. What do you think?!
