09.05.2008 - Biopsy

From Julian's COTA Journal

Today Julian had his biopsy.

We checked him into the day hospital at Stanford Children's at 8:30 so they could set his IV at 9:00. The IV showed up at 9:30 to prep him, and had the IV set by 10:30. At 11:00 it was time to go. I kissed him good bye as the anesthesiologist put him to sleep, picked up my pager and headed for the cafeteria.

The procedure took over an hour, and I was ushered into recovery around 1:00. The anesthesiologist reported that she encountered Julian's apnea problem almost immediately after he went under, and had to use an L.M.A. Not sure what it stands for, but it's used to keep the airway unobstructed without having to intubate him. As he came around, we had to continue to stimulate him so that he could breathe on his own.

We were in recovery until sometime after 3:00, when we were transferred back to the day hospital, where our mission was to lay still until 8:00 – roughly eight hours post-op. Julian had something of a rough afternoon as he struggled with gas, pain from the biopsy, and the after-effects of the anesthesia. However, as evening came on, his demeanor improved, and around 9:00 we were told we could leave.

We returned to the RMH sometime after 9:30, where Stacy gave Julian his evening meds. I'm in the dining room as I write this, having left Stacy and Julian getting ready for bed, and both in good spirits.

Julian has to remain relatively still for the next few days. Normally that'd be quite a feat, as his favorite thing in the world is still to “get down run around.” However, with his body still recovering from today's procedure, we're hopeful that he can lie low for the weekend. A little movement & walking is allowed, but the docs don't want him running and wrestling just yet. He's still pretty tender, so we'll have to wait and see how the weekend progresses.

And that's it for our transplant-related activities here in Palo Alto. For the time being anyway. There are still biopsies at 6- 12- and 24 months, as well as some sort of regularly scheduled visits for follow up. But as far as everything we hoped to have done during this stay, we're done. However...

Now we have a consult with the ear-nose-throat docs so we can begin to understand Julian's newly developed obstructive sleep apnea (OSA), and what needs to be done about it. The kidney docs have told us that if Julian needs surgery (i.e. tonsils), they want it done here so they can remain directly involved. Which shouldn't be a problem. It just means we're going to be here a little longer than we expected.

Thanks for all your prayers and support. Please continue to pray with us for Julian's recovery from “all of this” as well as his long-term health. It sometimes feels as if we're engaged in some sort of marathon, but through all of it, Julian has been a trooper.

David