Preparing for the best

Yesterday was a good day. The last day, hopefully and Lord willing, that James will ever have had an ostomy bag. Already his little belly looks so much better than it has in the last three years! Not to say we don't still have a long road of healing ahead of us.

We do.

There are lots of things to share from yesterday, but for this post, I'll stick to the surgery and what we are looking at for the next while.

After the surgery, Dr. Parker came out to let us know how things went. He was pleased, but remains cautious. His cautions have to do mostly with the fact that James had Hirschsprung's disease as a baby. Once a child has Hirschsprung's disease, any subsequent blockages or enterocolitis are automatically 'blamed' on Hirschsprung's, because they might have missed some bad sections of intestines (they remove those parts that have no nerve cells). At any rate, while we and the oncologists were assuming all along that the enterocolitis that necessitated the ileostomy was caused by James' chemo (vincristine, in particular), the surgeons were assuming there were missed sections with Hirschsprung's disease.

So... what that means is, while the surgeons are in favor of re-connecting James, they will remain only cautiously optimistic until James' colon 'proves itself' with use over the next 6-12 months.

This was not a surprise to me. But after surgery, Dr. Parker spent a good bit of time re-iterating everything that could go wrong over the next 6 months to a year and what we need to watch out for. He does believe we likely have all the bad sections of colon removed, but he can't prove it. The only way to prove it is to hook it all up and try it out.

While surgery went well, they won't call it a success for a while yet.

Now that surgery is done, we look forward to the best case of good things that need to happen.

Over the next days, we need to continue to manage James' pain. I am truly encouraged by the epidural. It blocks the pain from about the bottom of his rib cage to about an inch below his belly button. He does have some breakthrough pain and there are meds prescribed to cover the breakthrough pain. So far, James has been pretty good about telling us when it hurts. Us is limited to me and Hannah though. When other people are in the room, he either closes his eyes or puts on a brave front until they leave! Of course, if we don't know he hurts, we can't do anything to help relieve the pain. Please pray for wisdom here.

Hopefully in the next 2 to 3 days, James will have bowel sounds (or tummy rumbles), pass gas, and stool. All that will be the first steps to prove that this 'is working'. And then he can start taking clears by mouth. In the meantime, poor guy is sure licking his lips a lot! We are putting salves on his lips and he can have a swab with water to 'whet his whistle'. Zorro has been a great comfort so far. Pray it holds! And the tummy rumbles, gas and other proof come just at the right time--after things are healed enough to handle the activity.

Once he tolerates clears, we'll be watching for any bloating (a bad sign of things gone wrong) and if all is well, James will be able to eat some 'normal' food. Then we will watch again for any sign a bloating (still a bad thing) and proof that things are moving like they should.

Dr. Parker said if everything works 'best case', we should be able to go home Tuesday or Wednesday. If anything doesn't, all bets are off. I, for one, would love to home next Tuesday or Wednesday. Even more than that, I would love for everything to work 'best case' and to give God the glory for it!