Surgery Info and Game Plan

Here are a few details about the surgery and some info about the game plan, with a few comparisons to her first transplant in 2008.

But first, here's something that I thought was cool.  On the days of both the 2008 and 2013 transplants, Tricia was in the same room, 7813, when we received the call and when she was wheeled into the OR, she had the same nurse, BJ, she had the same respiratory therapist, Boyd, we received the initial call at almost the exact same call in the morning and the confirmation call for surgery at almost the exact same time in the afternoon, Dr. Lin was on call for surgery and told us afterward that each surgeries was one of his most difficult.  Talk about deja vu!

Surgery was eleven hours,  First surgery was nine hours.  There was more bleeding because of scar tissue, so the removal of the old lungs took longer.

Tricia was off the vent within a few hours after surgery, and out of ICU within 36 hours.  It took her a few days to get off of the vent and over a week to get out of the ICU the first time.

She started with nine chest tubes, and has had three pulled so far.  Chest tubes allow all the fluid that accumulates after such a major surgery to drain.  There is more bleeding and drainage than the first surgery.  Chest tubes cause a lot of pain, so she looks forward to having them pulled, even though the pulling is painful.  She has an epidural for pain meds that will probably be removed today or tomorrow.

Tricia is experiencing a lot of nausea, which is slowing her down.  She hasn't walked yet today because of it.  We're hoping this might go away when they change her pain meds.

She is still on a feeding tube.  She passed her first swallow test, but will need to pass another before she can eat or drink anything.  She still has her trach, but has a Passy Muir Valve that allows her to speak when she wants.  You might remember that she had some nerve damage to her left vocal cord from her first surgery that left her voice very raspy and week...she ended up with an implant that fixed the problem.  No problem with her voice this time around.

Tricia is having a bronchoscopy procedure nearly every day in her room to check for infection/rejection and to clear any mucus that she is unable to cough up.  She also has an xray and other tests daily.  So far, the doctors have seen nothing to be alarmed about.

Gwyneth and I have spent several hours each day with her in her room.  Her mother is here as well to be with her.  Unlike the first time around, she is able to sleep well alone at night, so we are all getting good sleep back at the hotel every night.  She is much more relaxed and less anxious than the first time, most likely due to the fact that she feels so much better.

Tricia is still very week from being in bed and on the vent for the past few weeks.  Her progress so far has been very very good, but slow.  Compared to the first time, she came out of surgery feeling amazingly good.  Everyone is very happy with her progress so far.  If all goes well, she'll be out of the hospital within 2-3 weeks after surgery.  She was out at three weeks the first time.

Tricia needs to meet four criteria to be discharged:

1) Walking at least one mile daily which is about 21 laps around the stepdown unit.  So far she's up to about 6-10 a day.

2) No chest tubes.

3) Able to cough, especially cough up the secretions that she is currently needing the bronchoscopy/suctioning for.

4) No signs of infection or severe rejection. They won't let her go if she's just going to get sicker at home. So far, so good.

Once she is discharged she'll be back to the Center for Living to complete 24 days of physical therapy.  Once she completes that, and is deemed healthy enough, we can finally go home!

 Nate