Enzo was hooked up to so many machines, tubes, and wires after surgery that it was a bit overwhelming. It was like learning a whole new language - the nurses had to tell us MANY times what everything was and what it did. I'm still not sure I have it all down, but here it is to the best of my memory:
1. Medications: At the beginning, Enzo had at least 10 lines of medication going at all times. Obviously, this included heavy pain medications and medications to keep him sedated, as well as diuretics to help get fluid off of his lungs and make him pee, blood thinners to prevent clotting, and simple lipids and fluids to keep him hydrated.
2. This is the ventilator that was doing his breathing for him. The monitor showed the number of breaths per minute, indicating whether they were done by the machine or were spontaneous breaths done on his own. The machine did all of his breathing for home for several days. It was only after they started weaning him off his sedation medications that he was able to breath at all on his own. He came off of the ventilator a week after surgery
3. This is a Nitric Oxide machine. I'm not sure of it's exact purposes, but I believe Nitric Oxide is used to help the lungs heal and help the body absorb oxygen. Enzo was on this for several days along with the ventilator.
4. Heat Lamp: I'm not exactly sure what the official name for this is, but it's basically a heat lamp. With no clothes and no blankets, Enzo needed something to keep him warm. It came with some sort of sensor to monitor his exact temperature at all times.
The pacer wires were connected directly to his heart and were attached to the external pacemaker. Right after surgery, his heart was having a hard time beating regularly on its own, so they attached the pacemaker just in case it needed help beating. As far as I can remember, he never ended up needing to use it.
These are the Ventilator tubes that helped him breath. For the first couple of days, the machine did all of his breathing for him. He gradually started taking breaths on his own and was able to come off of the ventilator at 7 days old.
1. With the breathing tube constantly in his mouth, he had a permanent binky. He was able to suck on it whenever he wanted.
2. The blue tube connected back to the machine which provided a steady supply of oxygen (and, for a few days, nitric oxide.) They would frequently add a saline solution to it to keep the air and his mouth moist.
3. This tube had some sort of pipe cleaner in it, which was inserted into his mouth several times a day to clean out mucous and saliva, which was then suctioned out. He HATED it!
1. Chest Covering: Because Enzo was so young and his chest was so small, there wasn't room inside his open chest cavity for his swollen heart and all of the fluid that would be draining off - so they left his chest open for several days. They first covered it with a sheet of flexible plastic. They then added several layers of medicated gauze to prevent any infection. The medicated gauze was covered with several more layers of dry gauze and then finally with what looked like a little corset, which was taped to the sides and tied together in the middle. This dressing was changed twice a day, during which they had to kick us out, close off his room, and put on complete medical gowns and masks for the sterile procedure.
2. Drainage tubes: 3 tubes (one large and two small) were inserted into the chest to drain off blood and other fluids. This was collected in containers on the floor at the foot of his bed, which the nurses measured and recorded every hour. He also had a catheter and a bag to collect the urine, which they also measured hourly. It was important to measure the amount of fluid output because he had a lot of fluid in his lungs (pulmonary edema). They were giving him medicine to help get rid of that extra fluid - but at the same time they didn't want him to get dehydrated either. Also, they had to measure the blood drainage to make sure he wasn't bleeding too much from the surgery.
1. EKG lines: These lines monitored his heart rate and respiratory rate. A monitor above his bed displayed these readings, as well as a couple of other ones, and would beep anytime a line was disconnected or if his rates were above or below desired levels.
2. Pulse Oximeter: This device measured the amount of oxygen in his blood. It emitted a little light which shined through his foot or hand to a sensor on the other side. Because the laser light could cause burns if left in one place for too long, they rotated this between his hands and feet. The recordings were also displayed on the monitor above his bed.
3. (and 7.) IV's: There were countless IV's used to administer medications and/or draw blood. He had them in his hands, feet, and who knows where else. The first day, he even had one in his head.
4. ART line: This line in his neck went into an artery. Also used to administer medication as well as take readings on blood pressure and other stuff.
5. Belly Button line (RA line?): He had a line going into his belly button/umbilical cord.. I'm not sure what this was for. I do know he also had a RA line, which went directly into the right atrium of his heart. I'm not sure if this was the same line, or if there was an additional line hidden underneath bandages and such. The RA line was used to measure the pressures directly in the heart. Enzo did have pulmonary hypertension, which is high blood pressure in the pulmonary veins and chambers of the heart. The RA line monitored these pressures and the readings were displayed on the monitor above his bed. Because this line went directly into his heart, we were unable to hold him until they were removed (days after his chest was closed.)
6. Temperature sensor: Monitored Enzo's surface body temperature to make sure he wasn't getting too hot from the heat lamp.
7. IV's: see above
8. Medication lines: Several different medications would be administered into one line (whether it was IV, ART, or RA). These tubes shown here would all connect to one line and then be clamped off when not being used. They would connect back to the drip machines where the medication was administered.
They closed up Enzo's chest on day 4 post-op and he was given a feeding tube. This went from his nose to his stomach. Up until this point, he had not been given anything to eat. (He had been given lipids through an IV up till this point, which are basically liquids and fat for energy.) Once he got the feeding tube, they began giving him breast milk, which they fortified with formula to give him extra calories. While we did begin giving him a bottle after he was taken off the ventilator, he still had the NG tube when he came home and used it until he was a month old.
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