James had been stable for most of the day Sunday, peeing and keeping his blood pressure up. We had been visiting late into Sunday evening, chatting with Nurse L. We noticed that his abdomen was getting darker and we spoke about that - the plan of action that we had been delaying because of all of the other issues (heart, lung, blood pressure, possible organ failure, critical condition NICU baby, etc). Going home that night, Jimmy and I decided that we need to do surgery before it was too late, before it was NEC (or necrotizing enterocolitis, a very severe and deadly infection of newborn GI tracts). Nurse L told us what they look for that would be an indication to do emergency surgery, and we knew that by that time, it would be way too late for baby James.
07/09/2012, 6:24am: Nurse L called to tell us that she saw a marked change on James' abdomen, a blackness that hadn't been there before. He had been stable for almost 24 hours with regards to urine output and blood pressure, but she still wanted to let us know that Dr Hawkeye was aware and that the surgeons were coming in first thing to evaluate. "Clear your schedule," she said. We were on our way in.
We opted to do the iliostomy for Baby James after meeting with surgeon Dr. R and Dr K and Dr Hawkeye. We knew it was the right thing to do when Dr Hawkeye said it was our "window of opportunity", which is exactly how we had phrased it in the car earlier. Just yesterday, he had not recommended operating. The team went into place and surgery was scheduled for 10am.
James had his abdomen opened up and his GI tract examined. He had 2 cms removed where the spontaneous perforation had occurred, and two stomas brought to the surface that will be there for several months until he is bigger and the intestines will be reattached. He is doing much better, and following the surgery he began peeing even more and his blood pressures improved dramatically.
Dr K even told us that she is starting to believe in our kid. We're moving up in the world, one person at a time.