We had heard that James had a large PDA on his echocardiogram, but they weren't moving on anything until he was more stable. I guess when you are a baby in critical condition, stability fluctuates with the hour.
Thursday he was dealing with a collapsed lung, which we didn't find out about until the afternoon. Dr. Hawkeye was so nonchalant, he could have easily been chatting about the weather instead of something medically severe. He was certainly not worried; in fact, he was almost happy given the state of James' lungs. They were making progress on reinflating it, and apparently this kind of thing just happens in preemie land, especially in kids with lungs like James's. If you can imagine, we were having trouble digesting this, but we left it to the doctors who get paid the big bucks and hoped for the best.
By Friday morning they had successfully reinflated the left lung and were ready to operate. Dr K called and said we were a go, since James wasn't a candidate for the medicine. We'd been down this road before, and we felt like pros. Jimmy and I were on the way down to PSL for our fourth surgery in a week. Our old friend Dr K (I should say surgeon K - they are two different ladies) was on board to operate on our other twin. Talk about déjà vu.
The ligation went well, and we breathed another sigh of relief. It wasn't until post-op when nurse P started worrying about some vital sign trickiness going on with James that things went a bit downhill. As nurse P says, "I don't trust these kids."
She went to grab the Respiratory Therapy team and when she returned, a small bit of chaos ensued. Many things happened at once. On poor James, a bubble appeared on his left chest wall under the new incision. Dr E, who we'd seen but never met before rushed in with the x-ray results and and said "he's got a Pneumo!", followed by several nurse practitioners and RT's. They quickly evaluated the situation and needled the air pocket that had accumulated between his lung and chest wall due to the surgery. This released some of the air, but the pneumothorax remained slightly. Another X-ray was taken and they later determined to put in a chest tube for the next few days that would better resolve the issue.
Dr E wasn't worried, and this helped to calm our fears. We are slowly learning what to be worried about. Some stuff looks and sounds more scary and complicated than it is. After this week, it's crazy to think how we can head into open surgery for a vessel connecting the heart and lungs without a second thought or major anxiety.
James, he sure is a trooper. We are trying to learn from him.