Chest Tube Is In

Chest tube is in.  I stayed bedside while the procedure was done and am glad I did.  As I said before the paralytic drug was not used, thank goodness.  The sedative Ketamine was given in two small doses while the doctor and nurse prepped for tube insertion.  I was watching Zoe to make sure she was comfortable and out as a momma bear would.  I began to notice a very slight and simultaneous twitch in her right hand and foot.  Pointing this out to the doctor he said that this could be a small seizure response since Ketamine reduces anti-seizure properties.  Zoe does not suffer from seizures but this drug can cause medically induced seizures.  They stopped administering Ketamine and went to two other drugs used in her prior treatments.  I am glad I was a keen eye.

the spa - fluid is about hand height

The procedure itself was not that bad to watch.  A small slit was made in Zoe's upper chest just below her right arm pit and in-between the ribcage bones.  The doctor then used a tiny tool to open the area up.  Immediately fluids began to flow out and could see that there was a lot of fluid collecting in her chest cavity.  The tube was inserted and a few stitches were placed.  The fluids were quickly filling up the atrium chest drain collector (or the bubbling spa as I like to call it).  

The color of the fluid was easily identified as Chyle, a milky substance consisting of lymph / intersistial fluids and emulsified fats.  The lymph area was most likely nicked during her initial surgery, which is not uncommon, and the fats were leaking into her chest cavity.  To remedy this situation Zoe is now on a special formula diet that does not contain or has very low amounts of long chain fats so that the area can close and heal.  This process will take about four to six weeks after seeing no more drainage from the chest tube.

I am not happy about feeding her formula, but I have to get over it.  I need to remind myself every day that the formula is only temporary.  The original decision was to feed Zoe Enfiport and after looking into the ingredients I asked for the nutritionist.  The first ingredient is corn syrup solids (what the hell?), followed by soy and cow products.  I addressed my concerns of genetically modified foods and we discussed our options.  The nutritionist agreed with my concerns and we opted to use Vivanex instead.  Vivanex still has corn and soy products, but much less, and no cow product.  Unfortunately there are no other options for Zoe's current condition.  Zoe will be reintroduced to breast milk at about four weeks after no evidence of further drainage. (Note:  Breastmilk vs formula feeding is a very personal decision.  This is not a debate about what is better or what is right, there is no right or wrong when it comes to this.  Just want to make it clear that breast milk was our personal choice and I do not judge others for what decisions they make.  It is all just a matter of personal choice and preferences. Peace.)

Now we can breathe a sigh of relief that we did in fact make the right decision to do the chest tube.  I was on the fence since it was really unknown if it would help her at all.  We can now address the situation and push forward with extubation.  Her x-ray taken immediately after chest tube placement was a major improvement from the prior x-ray taken early that morning.  Already Zoe is on a better path.

Pity party begins...

What upsets me, as selfish as it may be, is that this will make breast feeding even more difficult or maybe even impossible.  I have already been pumping 8 times a day - it is not easy at all.  My boobs are hooked up to the pump allllll dayyyyyyyy longgggg.  It was easier knowing that the milk supply was being fed to her, but now it will just pile up in the freezer for weeks and weeks.  I work hard for that milk!!! I was looking forward to the extubation and working on feeds in the very near future.  I can only hope that things will change from what was explained today.  (or I can now begin to consume a ton of wine to calm my nerves - the good old pump and dump method)

Pity party ends.