Justin had his surgery on Friday. It's only been two days but it seems like a week. So many emotions in such a short amount of time. And it's not over yet.
Justin was taken into the OR at about 12:30 on Friday and we didn't see him again until after 9 pm. We got word from one of the OR nurses at 1:45 that they had started the procedure at about 1:30. We were told that the procedure would take about 4 1/2 hours but they said they would give us updates every couple of hours or so. Around 3:45 we got a call saying that things were going along fine and they were still working on exposing the tumour. My mind was blown! Two hours into the procedure and they hadn't even gotten to the tumour yet. That speaks of the delicate nature of this type of surgery.
Our next update came at approximately 6:00. We heard that the surgeon only needed to take a 2-3 inch section of the involved rib, and was able to leave the ribs on either side. What great news! She also removed the tumour, but was a little disappointed that she wasn't able to get it all out in one piece. She did find a couple of small areas of concern on the lung so she removed two small wedges from there as well. The neurosurgeon was able to scrape out the areas that were involved around and between the vertebrae and another small section of that rib that joins up with the vertebrae, but did not need to remove any part of the actual vertebrae itself. We were told that the surgeon was just closing up and should be done around 7:00.
Just after 7 pm the surgeon came out to talk to us. She told us that Justin was awake and talking. He said he's fine! He woke up not needing any tubes down his nose or his throat. He had a chest tube in to drain any fluid from the lung cavity, a catheter and a wound catheter that infuses anaesthetic directly into the wound site. The surgeon explained that she was unable to get the tumour out in one piece for fear of further damaging the muscles and structure of Justin's back and because of that, there would most likely be residual cells left behind. Not the best case scenario, but more chemo and radiation will be done to hopefully get rid of that. He was taken to the PICU (Pediatric Intensive Care Unit) and we would be able to see him once he was settled in.
Around 9:00 pm we were finally able to see Justin. He was hooked up to so many tubes and wires but he looked good! He was hooked up to a continuous infusion of morphine and ketamine along with a self-administering morphine button, he had the wound catheter putting freezing directly into the wound and he had wires monitoring blood pressure, oxygen and so on. I was surprised at how alert he was considering all of the drugs he had on board! He told us that he was sore but felt okay. The plan was for him to be in the PICU for 2-3 days and since they didn't have 'beds' in there we had booked a room at the Canad Inn attached to the hospital. We didn't stay too long as he was pretty tired, so we said goodnight and went off to the hotel.
Saturday
In the morning we were pleased to hear that through the night his vitals were stable and they were
thinking of moving him to the ward that afternoon. By 1:00, less than 24 hours post-op, he was being moved to the surgical ward. Things went pretty well during the day. He was off oxygen and his vitals continued to be stable and is pain was being well managed. Just as I was about to head off to bed for the night, Justin spiked a fever of 38.9. My heart sank. This was my worst fear. This could mean infection. The doctor said it was too early to be alarmed. They would administer Tylenol and Advil and see how it went during the night. Justin wanted to be alone in his room, so off I went to the hotel. I was assured that they would call me if there were any issues that I needed to be aware of or if Justin needed me. Such a brave young man.
Sunday
I walked into his room in the morning and was surprised to see that he was back on oxygen. The nurse told me his levels had dropped a bit through the night so they put the nasal prongs back in his nose. It wasn't dangerously low, just at the bottom end of where they like to see it. His temperature was back down, though, but they said if it spiked again they would take blood and urine cultures to check for infection. At around 10 am his temp spiked again. They took blood and urine samples to send off but would not have results for 2-3 days. The decision was made to take the catheter out because it is a prime site for bacteria to enter the body and cause infection. One less tube in his body! The physiotherapist came in later in the day to get Justin doing some deep breathing exercises to help with re-inflating his lung. Since they did a wedge resection of the left lung, it was collapsed and it takes a bit of time to get back to normal capacity. His oxygen levels did come up during the day, so they took him off the oxygen and by bedtime Sunday night, his fever had come down some as well.
What a ride this has been! So many emotions have been felt...fear, worry, relief, hope. Justin has shown so much strength throughout this whole journey. Fighting through blinding pain (his description) and overcoming many obstacles, all the while maintaining his sense of humour. Moments like when he is lying there in bed with his eyes closed and you think he's sleeping, he chimes in on the conversation with a witty remark. Never cracking a smile or opening his eyes, but out it comes. I have learned so much from him over the past few months. He has opened my eyes to the person that he truly is. And I have never been more proud to call him my son.
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