Fontan Day 8 Photos

Photos taken during day 8 of Corey's Fontan heart surgery.

Fontan Day 7 Photos

Photos taken during day 7 of Corey's Fontan heart surgery.

Fontan Day 6 Photos

Photos taken during day 6 of Corey's Fontan heart surgery.

Fontan Day 5 Photos

Photos taken during day 5 of Corey's Fontan heart surgery.

Home!

WE ARE HOME!!! WE ARE POST-FONTAN!!! WA HOOOOOOOO!!!!!!

(drumming my fingers)

Damian was on deck last night to spend the night at JHU with Corey. He had a good night, although his fluids were a bit low, and they hooked him back up to the IV. He is now off the IV.

They've taunted us with the promise that we are going home today. And now they are making us wait. And wait. And wait. Hospital time is different than real time.

We've seen cardiology, and we have spoken with the discharge nurse briefly. She promised to come back, but she's disappeared into the bowels of the hospital, and I am not convinced that we'll ever see her again. Or leave. (sigh)

"Mommy, can I have some pizza?"

That was the phrase that I woke to at 5:40 AM. YES! PIZZA! I was so excited that Corey was actually asking me to eat, that I ran to the kitchen, practically tackled a nurse in my attempt to find/get to the microwave, grabbed a packet of ketchup (Corey won't eat pizza sans ketchup), and had that pizza back to Corey in no time flat. And he ate it!

And he ate some fruit snacks! And he drank a whole juice box! All before 6 AM! Enough people have shown surprise at his eating pizza for breakfast that he now thinks it's the cool thing to do. Which makes him want more pizza, which in turn makes his mommy happy!

In general his numbers look great, and Corey is doing very well. So well, in fact, that we might (fingers and toes crossed) get to go home tomorrow. Oh! Home! Can you hear me squealing in delight at the thought?

We still need to get rid of his hand IV and work out his meds a bit, however, before we can go. Corey is having trouble with the oral potassium and sodium chloride, but they have offered him pills in lieu of liquid for the potassium at least, and as he's good at swallowing pills, this seems to be working out fine. Which is good, because his reaction to the liquid is to boot it back up immediately, along with all other medicines/food in his stomach. As you might imagine, this is stressful for all of us.

This morning Corey has had a blood draw for labs, a chest X-ray, and taken all his meds. Though it has been eventful and less that fun, he's a trooper. To our happy surprise, Corey also agreed to take a little wagon ride - he even walked to and from the wagon himself! We also saw Dr. Vricella briefly, and I once again managed, somehow, not to throw myself at his feet.

Before I sign off, let me give you some specific numbers for Corey, in case you were curious/interested.

Heart Rate: 114 when calm
Sats: 95 (WAHOO!)
Respiration rate: 28
BP: 96/51
Additionally, the Fontan was done with a 16 mm gortex shunt.

Say a prayer that we get to go home tomorrow!
Jenn

IV Fun

Corey decided he needed to poop, and when we offered him the bedpan, he yelled "NO NO NO NO!" I have similar feelings toward bedpans, so I can't blame him. Luckily they have little bedside potties here, so the nurse got him one of those. When we lifted him out of bed, he insisted on having his gown off for pooping, and when we removed the gown, his IV line in his arm came right out too.

Oh joy.

Since he lost his IV line, you guessed it - we needed a new one! This time we asked for an analgesic, in the form of a cream that they rubbed on his hand. This made the process much easier, and they were able to successfully run a line in his hand. Which he tried to take out himself at 4 AM. Now his hand is all wrapped in blue tape. (sigh)

Damian was on deck last night, and he slept next to Corey. When Damian assured Corey that he'd be right there with him all night, Corey asked, "But Daddy, where are you gonna sleep?" Damian let Corey know that he'd be right next to his bedside all night, right where Mommy "slept" the night before.

I went home for the first time since last Monday, threw in a load of wash, watched an hour of TV with the cat on my lap, and crashed. (Mason was at Nanny & Papa's.) I woke after 7 hours of dead sleep in the exact same position I started in. Man did I need that! Then I took a shower, packed some new clean clothes, got gas, and arrived back at a quiet JHU at 8:30 this morning.

Corey looks good, but he isn't eating anything. Today I plan to try every trick in my book to get him to eat. If you stop by around 3 PM, I may be standing on my head singing show tunes. We aren't going home until this child starts eating, so we're going to have to come up with some kind of inspiration. Maybe Disco. Hmmm. Suggestions? Requests?

Chest Tubes are OUT!!!

Holy cow! The JHU docs surprised us utterly and completely when they ambled over to Corey's bedside and said, "We're going to remove his pacer wires and his chest tubes today." I'm not 100% sure, but I think I managed to keep my jaw from hanging open.

There was an issue with mis-communication over heparin - the fellow who handled this was not told until he was ready to pull the lines that Corey was on heparin. So the heparin was discontinued and he returned two hours later to pull the pacer wires. An hour later they checked to make sure Corey wasn't bleeding, and they pulled the chest tubes. Whoa - those things are long.

Corey was very brave, though he did tell us, "DON'T CUT!" as well as "I'M ALL DONE NOW!" several times. It definitely was traumatic for him, but I don't think it was actually very painful. When the fellow was done, Corey said, "OK, I'd like to sleep now." As in, "Get out of here, Pal." He's very polite. And now he is watching "The Backyardigans".

One step closer to going home!

Pee, pee, and more pee

Corey had a bit of a tough night. Relatively, I should say that he's doing absolutely stellar. It was just rough because he was up every hour peeing in a jug. A result of the diuretics he's on. Once, Mommy spilled the pee right on him, which resulted in a complete change of bedding. Did I mention that this was around 2AM? Yeah. He was happy with me!

Additionally, Corey needed a blood draw for labs, as his potassium and calcium levels were too low. I tried to convince the doctors to wait until morning, but they insisted on the importance of it, and so the phlebotomist came by not long after the pee-spilling incident to poke my poor baby in the arm.

To her credit, she was good, and she got him in one stick. However, he wailed bloody murder. Actually, it was the deadly "silent cry" that he used, which is WAY worse than any noise he might make. I knew I was going to pay then.

The worst part, though, was watching the fear in his face. He looked up at me with huge, wide-saucer eyes and pleaded with me not to do it. I can't count the number of times my heart has broken this week, but it definitely broke again last night.

We hope to have the chest tubes out tomorrow.

Fontan Day 4 Photos

Photos taken during day 4 of Corey's Fontan heart surgery.

Fontan Day 3 Photos

Photos taken during day 3 of Corey's Fontan heart surgery.

Fontan Day 2 Photos

Photos taken during day 2 of Corey's Fontan heart surgery.

Out of the PICU!

We've moved down to the floor! This means that one parent may sleep next to Corey - right next to his bed on a fold-out chair, each night. Tonight Mommy is on deck, because Corey is scared after moving to a new place. Tomorrow night Daddy is on deck.

I really, really wanted to go home tonight to see Mason - I miss him terribly, and I haven't had a solid night's sleep since last Sunday. But Corey is so scared that I just can't leave him. We'll spend time getting him used to the idea that Daddy is going to protect him tomorrow night. And peeing in a jug. Corey is good at that.

The chest tubes are still in, but we are moving in the right direction

Lines are OUT!

We are still in the PICU, but Corey had another good night, and he looks really good! I spent another night in the Mom's room, and I slept until about 4:45 AM. Then I threw on some clean clothes and headed up to see Corey. The improvement was impressive. He looked so much better than when I headed downstairs to sleep last night. That's my toughie!

In other good news, the IVs in his neck and groin are out! At the same time, they removed the catheter from his little penis. So he is feeling much better now that he is free of all of that.

When they were removing all his lines/cath, he was really frightened. He cried, looked at me with those sad puppy dog eyes, and broke my heart. Damian and I held his hands and talked him through it, and luckily it was over fairly quickly.

The chest tubes are still draining, so they will stay in at least another day. When they come out, Corey will be able to move around much more, so we are counting the minutes. Today, however, he can get out of bed and sit on my lap. Yay! I'm looking forward to that.

During all this time, Mason has been hanging out with his Aunt Amanda, Uncle Shawn, Cousin Sydney, and his various grandparents. Yesterday Allan & Monica took him to the mall - a trip he loves - and he worked them over. Oh, how he worked them! He came home with several new toys and a bag full of candy. Oh yes. Later he'll probably convince them that he needs a trip to Krispy Kreme before his nap. I expect to wake up one morning and hear that he's in Disneyland.

And speaking of The Bruiser, he came to see me today! He gave me a hug, and then we rode the elevators, escalators, and played the piano (I think we are banned from that area of the hospital now). He loved it - in fact, he made up a sign for "elevator". Which is not quite as funny as his sign for "leaf blower".

Damian and I are feeling better as Corey continues to improve. Thanks to all of you for your love and support.

Still in the PICU

It's Thursday evening, I think, and we're still in the PICU. I'm kind of delirious at this point from fatigue, so I hope I'm not repeating myself, but I can't really guarantee it.

OK, so Corey is doing very well. His chest tubes are draining less and less, he is peeing out a huge amount of fluid due to the Lasix he's on, and his numbers look good. His temperature is still up a bit, but nobody is in a panic about it. So that's good. Not panicking is usually a plus.

He asked for his "black button", which he can push to receive additional narcotics. No he can't overdose himself, and no you can't have some yourself. Corey has learned that this button makes him feel better when it hurts. So he wanted to push it, and then he wanted to sleep with it gripped between his tiny fingers. My poor sweet little boy.

Hopefully we will be out of the PICU tomorrow, because I am ready to hand over night shift to daddy!

Sad in the PICU

Well, the good news is that Corey is no longer mad as a hornet, so his blood pressure is evening out and his sats are fine. His temperature is up a bit, but nobody appears to be concerned. He's being given Tylenol for it. He is also beginning the blood thinner heparin. Also, he is finally able to have apple juice at will, so he is more content.

The bad news is that the poor kid just seems to be resigned. He looks so dejected, and he flat out refuses to talk to me. I just keep apologizing for his owies and promising that it will be better soon. It's so hard to watch him suffer, but at the same time I am guardedly beginning to feel some real relief that we will have a good outcome.

More prayers are still welcome, though.

A good night!

Corey had a good night! I left him with the nurse to head down to the small mom's room, and I asked her to call me if Corey woke up and asked for me, or if he was scared at all. He's been upset, crying, and frightened a few times, which causes his sats to drop and his blood pressure to climb, so I thought that might happen again last night.

But it didn't! I woke up at 1:30 AM and called the PICU to see how he was doing, and the nurse said he only woke up once. He heard the child across from him crying loudly during some type of intervention, and so Corey's nurse sung him some songs, they had a little chat, and Corey went right back to sleep. He didn't get scared. That's my tough guy!

So I went back to sleep, and I woke up at 5:40, threw on some clothes, brushed my teeth, and headed upstairs to the PICU to see my little man. He looks good! But he's mad at me. Understandably. I'd be mad too. I sat with him, held his hand, and played "Horton Hears a Who!" on our mini-DVD player. He seemed to enjoy that, but his temperature is up a bit, they're still denying him apple juice, and so he is just looking rather resigned and sad at the moment. Poor sweet thing.

But he looks good! We may be able to have the chest tubes removed and leave the PICU tomorrow. Wouldn't that be something?

Things seem to be calming down

Corey had a great night, sleeping most of it. He stayed calm the times he did wake up. He seems to be much more comfortable now. Hopefully today he'll be awake longer, able to watch TV and have more juice.

Walking the line

Overall, Corey is doing well. However, we are having a tough time getting his pain management under good control. He wakes up, gets agitated, and then his oxygen sats drop and his blood pressure goes crazy. This is not good for Corey's recovery, so we are working on it.

He's said a few funny/cute things today. For example, when he woke up he wanted apple juice. He is only able to have little sponges dipped in water, and after he had one, he said, "I want a milkshake on this!"

He's repeatedly asked for milkshakes or apple juice, and to keep it from him, we've told him that there isn't any here. After hearing this a couple of times, he said, "Well somebody needs to go to the store!" Like, duh, people!

My baby is in there. :-)

Extubated!

Corey woke up and immediately tried to yell, though no sound could escape his lips with the breathing tube still inserted. It was apparent that he was yelling "I WANT APPLE JUICE!", however, even without the sound.

When the nurse asked if he wanted the tube out, he nodded "yes", and they gave him his wish! His first words were (you guessed it) "apple juice!" Since it's going to be six hours until we can give him any, (yes I said six) we are going to have to use all our tricks to entertain him. Luckily he's sleeping right now.

This is an excellent move in the right direction. We are ecstatic.

Out of the OR!

Corey is out of the OR and the bleeding has stopped! Thank you God! We are hoping to see him extubated later today. Seeing him try to say "juice box" and "carry me" and "itch my nose" with no voice is very sweet and so sad.

Update on the OR

The anesthesiologist came out to tell us that Corey is "rock solid", and they are cleaning, washing, and looking for the cause of the bleeding/ fluid build-up.

Corey is in the OR again

Corey is bleeding internally. We are very frightened. They've taken Corey back to the OR. Please pray.

Fontan Day 1 Photos

Here are some photos from Fontan Day 1.

Things are going well

Quick facts since I'm falling asleep...

Corey is now in the pediatric ICU. We saw him as they wheeled him down the hall to ICU. He looked great - the facial swelling was minor. The surgeon is very happy with the outcome. Corey is still intubated so he's still sedated. Corey's two chest tubes are still draining enough to delay extubation - although they have slowed since the surgery. Because of the drainage, Corey has been given at least 3 units of blood. He was also given platelets to counteract the drainage but those have now stopped.

The arterial line in his wrist wasn't working so they put a new line in his groin. The docs are saying that he may not be extubated until the morning.

He is responding to our voices and questions with head shakes/nods. He wants to cough/scream/talk to us but the breathing tube is preventing any sound.

A chest X-ray showed fluid build-up around the left lung - a common side effect. The extubation was on, off, on, now off until morning.

Corey's temperature was up a bit to 38C so they gave him some Tylenol.

That's about it. In all, things are going close to what we expected and we are very thankful.

Corey is out of surgery!

Corey is all closed up, and we watched him go by on the stretcher. Oh what a sweet sight! We spoke with Dr. Vricella, and he told us that he is happy with how things went. Then he hugged me. I love that guy!

We'll try to give more information on his numbers as soon as we can. For now, things are looking good, but we are still waiting for extubation, so Corey is not awake yet. Oh, I can't wait to hear him wake up and yell "Where's my chalk?!"

Thanks for all the support and prayers.

Off Bypass

The nurse called to say that Corey is off bypass and the Fontan was a success! Relief! Joy! But it won't be complete until he is closed and all his lines are out. I can't quite allow that last breath of relief to come through my lips, but this news is wonderful.

We should hear more in an hour to an hour and a half, and we hope to speak with Dr. Vricella around that point as well.

Dr. Vricella is in....

At 1:46 PM the OR nurse called me to say that the lines had been run successfully, and the official incision time was 1:45 PM.

At 2:50 PM the nurse called again to inform us that Corey is now on bypass, with a beating heart. Prior to the surgery starting, Dr. Vricella told us that he had expected to do the surgery with a beating heart, so this is to be expected. Apparently the entry through the incision went well, also, and the actual Fontan procedure is occurring now.

As bypass is only supposed to continue for no more than one hour, we expect to hear more news in an hour or so.

Surgery has begun

At 12:35 PM Damian and I donned pastel yellow operating room gowns, masks, and blue hats to accompany Corey to the OR. Corey himself is wearing an operating room gown made for kids, opening in the back, with his little striped-underwear butt sticking out. We walked in with him, sat him on the table, and then discussed which scent he would like for his anesthesia mask. (Apparently they use scented lip smackers to make the mask smell better/feel a little less intimidating.) After serious contemplation, Corey chose orange.

While Corey was laying on the table, the orange-scented mask was placed over his face, and Corey stood it for a few moments before announcing "I'm done!" When we didn't allow him to remove the mask, he thrashed and cried. Watching him suffer was hard for us, but it was over quickly, and Corey was asleep. We then were allowed to kiss his forehead before being ushered out of the OR.

Damian and I left the OR in tears. The numbers are on our side, but we couldn't help but think, "What if that's the last time I ever get to tell him I love him? Did I spend the last days wisely?" There's never enough time, though, and so we just have to accept that we have done our best and start praying.

Here is the time line. It takes about 1 hour to run his lines (beginning at approx. 12:35 PM). Then Dr. Vricella will begin the Fontan procedure itself, which will take about 4 hours, perhaps more. Finally, closing takes another hour. And so, we are looking at approximately 6 hours. We expect to get updates every 2 hours or so.

Another item to note is that Corey was sick recently, and the anesthesiologist was concerned about this. If there is any wheezing in Corey's lungs as they begin, they will call off the surgery. I am hoping and praying that this doesn't happen. Mostly I am praying for a smooth and successful Fontan.

When there is news, we'll let you know.

Arrived at Hopkins

We are here at JHU, and we are waiting to be taken back. This part makes me very anxious - we don't know if the previous surgery is on time, we don't know when they'll be ready for us, we don't know anything. So we're busy entertaining Corey and trying not to puke.

I'll update when there is more information.

Fontan tomorrow!

We are packed and ready to head to JHU tomorrow for Corey's Fontan. We will be arriving at 10 AM. The surgery will hopefully start at noon, but this depends on the VSD closure that Dr. Vricella will be performing beforehand.

Many people have asked about visiting Corey. He will be in the PICU for the first several days, and the rules there are more stringent than in other recovery areas. There may be no visitors during shift changes, and these occur from 6:00 AM to 7:00 AM and also from 7:00 PM to 8:00 PM. Additionally, one parent must be present with each guest, and only two guests may visit at a time.

Having said all that, please do come and see Corey. He's going to bored out of his brain, and he loves to have visitors, even when we are just at home. He often says, "Who's coming over today?" It will do him good.

We will be updating the blog as the surgery goes on. From the waiting room using Damian's netbook. As soon as we know more, you will too.

Fontan Bumped

I spoke with Dr. Vricella, our heart surgeon, this morning. The Fontan has been rescheduled for 4/21/09. This is only a one day bump from Monday to Tuesday. Hopefully this won't wreak too much havoc on travel plans.

Corey will be the second case of the day. We need to arrive at JHU at 10 AM for noon surgery. Dr. Vricella's first case is "a simple VSD closure" (his words to me), so hopefully that will all be textbook, and Corey's surgery will start on time. I'm not looking forward to denying him food and drink until the surgery starts, so we'll hope for the day to go off without a hitch.

Let us know if you have questions......

Our ride to Krispy Kreme before the cath

Here's a really cute video of Corey that we took on the way to Krispy Kreme the night before the cath last week. We thought it would be nice to give Corey a special treat - a trip to his favorite doughnut shop!

Our ride to Krispy Kreme

New Fontan Date

The Fontan has been rescheduled for Monday, April 20th. We will be arriving at the hospital at 5:45 AM (7th floor JHU children's center - ask for directions at the guard stand). If you are coming to the hospital for the surgery itself, and you want to see Corey before the surgery starts, please come at 5:45 AM. We have been told that Dr. Vricella may be working on him by as early as 6:20. If you don't need to see Corey beforehand (and that's perfectly fine, he'll need to see people afterward), come anytime that morning.

Live Every Day....

We are on a roller coaster ride. Emotions are high. And low. From wild fear to peaceful calm - the whole gambit. So I've decided to ruminate on the saying "Live every day like it's your last."

So let's think about this in its literal interpretation. I'm thinking that, if today was the last day of my life, I wouldn't shave my legs. If tomorrow is also the last day of my life, again I am going to skip the leg shaving. You see where I'm going with this. After a few weeks of this kind of living, I could give the hairy Sasquatch a run for his money. I can't imagine my husband would enjoy that much. The cat might like it, but she'd probably be the only one.

I'm also thinking that I'd eat steak and buttery lobster on the last day of my life. Neither my food budget or my arteries are going to handle that well on a daily basis. Am I going to work out on Day Last? I might go for a long walk in my favorite place, so perhaps I wouldn't actually balloon up hundreds of pounds. But wait! We haven't factored in all the chocolate cake I'm going to consume, because blood-sugar be damned, right? And the wine I'm going to drink. Can't forget that.

I have a favorite outfit. I'm definitely wearing it on Day Last. And I'm not washing it. Who does laundry on Day Last? How good will this outfit look after a couple of weeks? And smell? Do you hang out with smelly people? Do you want to hang out with me when I'm smelly?

So now I'm a hairy, smelly, drunk diabetic in dirty worn clothes with no friends. I think I'll just go back to living my life in the kind-of normal fashion I am accustomed to. There's a lot of kissing of my little children in this quasi-normal life, bedtime stories, and laughter. Mixed in with a few time-outs, of course, but I like the balance, and if I'm honest, I'm glad to have the reprieve of two more weeks of near normal with my little family.

Fontan Delayed

Dr. Vricella wants to delay the Fontan by at least 2 weeks. Our pre-op testing is good for one month, so this will still be covered. I will call Dr. Vricella's secretary Monday morning and get a new date. As soon as I have the new date, I'll post an update.

Corey has a cold - Fontan may need to be rescheduled

Corey has a cold. This may or may not mean that the Fontan will have to be rescheduled. Yesterday I would have said, "He'll be fine", but today, I'm not so sure. He has big boogers, and he has a junky cough, which are the criteria for postponement (yes those are the technical terms). Of course, given that it's the weekend, I can't get any answers. I expect to know more tomorrow.

We want to do what's best for Corey, of course, and although it's stressful to think about changing things, if this will impact his recovery, then Damian and I would prefer to wait. This is also impacting all the people who are supposed to be flying in, unfortunately. It's a big mess, but I feel oddly calm about it. Must be the black tea. Or maybe I've just freaked out for too long.

The moment there is news, I'll post an update.

The Fontan

Our 4 year old child, Corey, is scheduled for the Fontan open heart surgery on Tuesday, April 7th.  Many people probably don't know why Corey needs this surgery, why it's happening now, or what comes next. So I have decided to write information about the surgery in interview format.  There are links in dark grey below to sites that provide more details.

Let's start with the basics...

Why does Corey need heart surgery?

Corey has a congenital heart defect called tricuspid atresia.



Kids with tricuspid atresia lack a tricuspid valve, and therefore, lack a functioning right ventricle. In other words, Corey has just one functioning heart pump instead of two. Kids with tricuspid atresia typically require almost immediate intervention. Corey required emergency heart surgery when he was barely two weeks old. For six months, until his second surgery, Corey's blood circulation was in a tenuous position. Because Corey has holes between the left and right sides of the heart (required during development to allow blood to flow at all), much of the oxygen-poor blood returning to his heart to pick up oxygen was being pumped back to the body before passing through the lungs. Because of this, his oxygen saturation levels were low; he didn't have much energy to do important things like eat.

The long-term fix to Corey's situation was a two-step process to re-route all blood returning to the heart from the body directly to the lungs via the pulmonary artery – in other words, to bypass the right side of the heart completely. This fix would stop the mixing of oxygen-poor blood returning from the body and oxygen-rich blood returning from the lungs.

The first step of this two-step process is an open heart surgery called the Glenn surgery, which Corey had done when he was 6 months old. The Glenn procedure re-routes the blood from the head and arms directly to the pulmonary artery, bypassing the right heart. The next step is the Fontan procedure.  Before the Fontan can be done, a cardiac catheterization is required. Corey had his cath yesterday.

What is a cardiac catheterization, and what was discovered during Corey's 3/31 cath?

Corey's cardiac catheterization was done for two reasons. First, blood pressures were taken on both sides of the heart to learn whether Corey's circulation is such that it will allow for the post-Fontan procedure circulation. Second, the pulmonary arteries were looked at in detail to determine whether the stenosis (narrowing) Corey has is great enough to require the placement of a metal stent to open it. The pulmonary stenosis is a necessary by-product of Corey's second heart surgery, the Glenn, that he had in the summer of 2005 when he was 6 months old.

Both questions were answered in our favor: Corey's blood pressures are very favorable to allow for the Fontan surgery, and the stenosis is not great enough to require the placement of a stent.

So now that the catheterization was a success, we are able to move on to the open heart surgery Corey will have next week, the Fontan.

What is the Fontan procedure?



The Fontan procedure is an open heart surgery that Corey will have this spring, currently scheduled for April 7. (Another good overview of the Fontan can be found on Wikipedia.) The Fontan procedure re-routes the blood from the lower part of the body directly to the pulmonary arteries, bypassing the right side of the heart. The pressure and flow created by the left side of the heart will push the blood through the entire circuit on its own, without any help from the right side of the heart.

Why is Corey having this surgery now that he's older?

The doctors at Johns Hopkins like to wait until the kids are between 3-5 to perform the Fontan surgery.

The surgery cannot be performed right after the Glenn surgery because the blood pressures in babies is too high to handle the Fontan circulation.

Additionally, a Gortex conduit will most likely be used to go around the right side of the heart directly to the pulmonary artery. This conduit needs to be big enough to last Corey into adulthood without being too big to handle the current blood pressures in Corey's body.

However, Corey's left ventricle is doing a lot of unnecessary work right now to keep his oxygen saturation levels high enough since it has been pumping oxygen-poor blood back to his body for more than 4 years. If we wait too long, then this will wear out Corey's left ventricle prematurely.

So after the Fontan, Corey's heart will be fixed?

Not exactly. Corey's surgeries have been palliative, meaning that all three are intended to reduce the affects of his heart defect - the surgeries are performed as a workaround, not a fix. Since the tricuspid valve never formed, the right ventricle did not properly form. There is currently no way to grow a new ventricle. However, kids like Corey have a great chance to live long, fulfilling lives, far into adulthood.

How long will Corey be in the hospital?

Kids who did well with the previous surgeries tend to do well with the Fontan. Corey was in the hospital about a week for both previous surgeries so this bodes well for his Fontan stay. We were told during the cath that Corey's stay will most likely be in the range of 7-10 days. For the first 3-4 days after the surgery, Corey will be in pediatric ICU. After his pain is being handled and he is well enough, he will go to the Children's floor for 4-7 days until he is well enough to come home.

So after the surgery Corey will just heal and recover?

Basically, yes, but if the previous surgeries are any indication, unexpected surprises are likely along the way to a full recovery.  Corey's two previous surgeries went extremely well but there were several moments of great concern during the recovery period in the hospital for both.

Several factors determine the length of hospital stay post-Fontan surgery. Chest tubes will likely be inserted into Corey's abdomen to drain any fluid collecting around his lungs. This is fairly common after these heart surgeries. After the Glenn, Corey had a single chest tube for a few days. Another main factor in determining the length of stay is how Corey's heart and body adjust to the new blood circulation. The post-Fontan circulation will be a big shock to Corey's heart and it will need to make adjustments to adapt.

Feel free to ask additional questions you might have about the process Corey will be going through. It's tough to know exactly what questions people have. I'd be glad to answer any as well as I can.