Wednesday morning, a little after 12 hours post surgery, William's ventilator was removed. The surgeon had anticipated he would be on the ventilator for at least 24 hours, if not more. He was assigned 2 nurses during the night after surgery and during the middle of the night, one of the nurses had to go find something else to do since he was doing so great!
Thursday was a day of tubes. They removed all arterial I.V. lines, his chest tube, and foley catheter. He was a champ---especially since line placements and removals are his least favorite things. He'd pick a shot over any of those. He still has an NG tube up his nose to drain his stomach since his bowels and stomach are still asleep after such a long and action-packed surgery. He also continues to be on oxygen, but at a low rate. Last night he was started on TPN (I.V. nutrition). His pain and breathing exercises are the main items of attention. His pain is controlled with a constant baseline dose and a PCA button he can push any time he needs a little extra boost. His lungs are showing a little fluid build up, but that can be expected after all the fluids he received during surgery.
- lost 4000mls of blood. That's 4 liters.
- received 12 adult-sized units of blood
- received 4 units of platelets
- received 5 units of FFP (fresh frozen plasma)
- received 1 jumbo cryoprecipitate
- received 1 unit of factor VII
Today we also learned the pathology on William's tumor. It showed most of the tissue in the tumor was removed was dead, or necrotic, in response to the last 2 rounds of chemotherapy. As soon as he recovers from surgery, which could be as soon as the middle of next week, he will start radiation on his abdomen and ankle 5 days a week for 3 weeks and will also continue to get chemotherapy at the same time. We'll see how the details unfold. In the meantime, William continues to improve a bit each day. It has been quite a week and we are extremely grateful for his progress and good spirits.