the volcano erupted

Wow. What a night. I came up to Duke last night. Jay went home to be with Travis. We passed each other on I-40.

I got here just after shift change. Riley was good, and they were about to do a blood draw so I had to wait a bit to scoop him up. Then it was assessment time, so the nurse and I did all that stuff and then I scooped him up. He was pretty much asleep. So for 2 hours I sat there and just held him. At one point, while just shifting my weight a little and readjusting him, I noticed some "stuff" on my gown. I got excited that his ostomy was putting stuff out. I notified his nurse and laid him in his crib, where we could see that the gauze was soaked with fluid. I was SOOO excited because his stoma has to start putting out again before they will let him eat. His replogle output also has to decrease, which it has, so this meant he could eat.

Except it wasn't his stoma.

In between two of the stitches of his incision....green pus-like/stool-ish GOO was LITERALLY BUBBLING out of him!!! I could feel my heart hit my feet. His nurse said a NON G rated word at the sight and I just stared. I just KNEW he had perforated his intestines and they would be wisking him away to the operating room. I do tend to keep a really calm head in "emergencies" and so I just turned and grabbed a handful of sterile gauze packets and gloves and handed her gloves and started opening the gauze so we could sop up the fluid coming out of him. She turned to the nurse on the other side of the room and asked her to get the doctor NOW. But the time the doctor walked in, not 2 minutes later, we had already soaked through 12 guaze pads, and by soaked I mean, it was DRIPPING and the goo was EVERYWHERE. it was literally POURING out of him and would bubble and gurgle. You could HEAR it. I have never ever seen anything like it. Had I taped it, it would be a YOUTUBE sensation!!! So she IMMEDIATLY says PAGE SURGERY. Again I felt my heart hit my feet. Then I looked at Riley.

he was laying there just as calm as could be. He had never cried. He only grunted when we held his legs down out of the way, and that was a "don't hold my legs down" type of grunt. He wasn't in the slightest bit of discomfort that I could tell. I looked at the monitors behind me. His heart rate was in the 150's as usual. His breating and oxygen saturation fine. My heart stopped pounding quite so much, but I was still VERY concerned. His nurse all of a sudden looks at me and says "Oh my God, are you ok? I didn't even think that you may not be ok, you don't have to stay here and see this". I said "I'm fine. And I'm not leaving". She smiled and asked for more gauze and we continued.

The doctor came in and ordered morphine. I'm still not 100% sure why, other than she was going to mash on his belly some and see what she found and I guess the morphine was a just in case type thing. The stuff they did was NO WHERE near as bad as what happened the other day and he really was fine about it all, no crying or anything. The surgery resident came in and mashed on his belly also.

Apparently, the fluid in his belly ruptured and came on out and everyone was really pleased once it was determined that he was OK and surgery approved the situation. The surgeon on service this weekend is the one that has done all his surgeries and he said he was thrilled the fluid came on out! Better it be out than in. So the surgeon and doctor massaged his belly until no more came out. All in all we used 12 packs of gauze and his crib and the floor by his crib looked like a warzone. He had to be bathed afterwards and he was SO alert after this was all over with. He LOOKED better and looked like himself prior to surgery. It was amazing. Gross, but amazing. His belly shrunk 1.5 centimeters after the fluid was out and he lost 170 grams in weight from that. that is a LOT of fluid. Words really really cannot describe what it looked like and how unreal the whole thing was. AFterwards, no one could believe how calm I was through it all. Had he been screaming, I probably wouldn't have been nearly as calm, but likely only on the inside. If I freak out, they'd make me leave. I would have kept it together just to stay if nothing else.

So he's OK, even though it sounds really really bad. His bloodwork has improved some, and his replogle is barely putting out anything at all, and what does come out is clear. His stoma IS putting out SOME, but it's not enough yet for them to agree to feed him. The fact that all that fluid came out is GREAT but the problem is WHAT is that fluid. They think it's stool. Thats bad. Thats very bad. If it's stool, then one of the connections they made is leaking stool into his abdomen instead of it flowing out his stoma. And 1 of 3 things will happen:
1) there WAS a leak, it leaked, has now sealed itself and all will be well now that the fluid found its way out of his body
2) there IS a leak, it will keep leaking, and stool will continue to come out his incision, and will have to be repaired, but they cannot do this for a few weeks. Right now if they go back in to do that sort of thing, he said they would do more harm than good.
3) there was/is a leak...it will heal....and stricture down, which means he will have to go back in and remove the stricture. Which means removing MORE of his intestine. We really can't afford to lose anymore.

ONLY Riley could have this sort of evening :o) Even the doctor said "Riley you DO love to do things your way don't you".

Praying whatever it is, is over now and that stoma starts putting out and SOON.