Posted (Tina) in All Posts on September-3-2008

Okay, now that things have settled a bit…here are some more details and highlights of the day.

Ella had the best night of sleep ever before her surgery. She slept solid the entire night…it was the perfect rest and she looked great before surgery.

When we went downstairs in the waiting room before surgery, a friendly face in scrubs came to visit us. Her name is Michelle and she works down in the surgery department. She expressed how she knew about Ella through a mutual friend and that she had been praying for Ella for months; Ella had been listed on the prayer chain at her church. She also reassured us that the staff assigned to the OR was amazing; she made sure that certain people were assigned to her surgery. How amazing is that…the world is so small and God literally orchestrates every detail.

After feeling blessed by her, we met the anesthesiologists and surgeons. They answered our questions and explained the procedures. We were told it would take 3-4 hours for her procedure.

As Josh alluded to in the prior post, it was fine until it was time to hand her over. Josh asked if they could stop for 10 seconds so that we could pray over Ella. During the prayer and once it was finished, we started crying hard as they carried Ella off to the OR.

About 30 minutes into the procedure, Dr. Abman and Dr. Lysinger (her pulmonologists) came out to the waiting room to discuss the bronchoscopy. They were very pleased with what they saw in her airway. They looked at the vocal cords – look totally normal. They looked at her trachea and her airway muscles. Those looked good too; they were not floppy as they originally presumed. They saw a tiny bit of inflammation at the top of her esophagus which looked like it was due to the retching and reflux issues, but nothing to be concerned about at this time. The most amazing finding: she has no scar tissue in her trachea from being intubated. Most babies that are intubated for 5 months would have some scar tissue. Everything looked great. Initially, they received consent to do a bronchscopy lavage procedure, if they noted mucous or some other findings that might be of concern. (A bronchscopy lavage is where the bronchoscope is inserted into the bronchi, or large airways in the lungs. Once the tube is in the lung, a small amount of fluid is sprayed into the lung. The fluid is then removed and sent to the laboratory for analysis. Respiratory tissues can then be observed and biopsied). Since everything checked out, they didn’t have to move forward with that procedure.

There was a glimmer in Dr. Abman’s eyes as he talked about the next steps. He expressed that we need to figure out “why” Ella is having these fluid issues with her lungs. I love it because this is a brilliant doctor who loves these types of challenges, you can just tell. He stated that we might need to do some other tests to solve the diuretic mystery. But he does want to take advantage of the fact that Ella is sedated today and was going to see if cardiology could perform an echocardiogram at the end of surgery. This would double-check her pulmonary hypertension and might provide some more insight if they have the ability to look at one of the chambers in her heart closer.

Grandpa came over to the hospital while Ella was in surgery and kept us company. We had lunch together in the surgery waiting area and just caught up on life. He was there with us while Dr. Partrick came out at the end of surgery to give his recap.

Ella did great throughout the surgical procedure. He went in the same incision. He admitted that her anatomy was a bit different than most diaphragmatic hernia babies, so I think it was great that him and Dr. Kays consulted. Her spleen was up high covering most of the gortex diaphragm patch, so not a lot of her gortex patch was visible. But you could see where the patch was sutured up against her esophagus. They were able to pull the nissen down and re-wrap it. Since her diaphragm tissue did not look that viable and knowing her history, they reinforced the diaphragm area near the hiatus with Alloderm. We’re hopeful that this will buy us more time and that as she grows, her tissue can regenerate over it.

When he looked around at her anatomy, everything looked normal. For example, he mentioned that sometimes the stomach can be smaller in these babies yet hers was a reasonable size. He was happy that the g-tube was able to remain in the same place. Finally, she was on a bit higher flow of oxygen coming out of the surgery (3 liters), but was able to be extubated without issue.

Considering everything, it could not have turned out better. We praise God for bringing Ella through her surgery successfully and for giving us so many friends, family and other Bun fans that are so willing to pray and support us. We know that is why Ella did so well today.

Tonight, Ella is resting comfortably in her crib. Because she needs IV access and is such a tough stick, they opted to leave her old IV in her left hand and added one to her right hand during surgery. So now she has 2 access points. The plan is to leave them both in as long as they are viable.

During surgery, they also placed a caudal epidural in her lower back. This helps to deliver pain meds and keep the mid-part of her body (where the surgery took place) in a numb state. As long as she has the caudal epidural, they need to have IV access.

Ella is a bit frustrated having both of her hands bandaged up. She tries to itch her nose, which she does frequently with the high flow on the cannulas, and can’t do it effectively. This makes her frustrated. She is comfortable and not feeling any pain right now, but as soon as they begin to wean the pain meds, we are expecting a fussy Bun.

Also, she has a foley catheter that will remain in place as long as the caudal epidural is in place. I guess that the epidural pain meds can also “numb” the bladder so that it does not sense when it is full and empty properly. Therefore, this will remain in place for a couple of days. Hey, we get a break from changing diapers….it’s all good.

Although it is still a challenge to work her binky and her frog pillow (her NICU souvenir), somehow she is still managing. As she went to bed tonight, she clearly wanted to escape the day too. Now, we’re hoping to join her.

Thanks again for all the love and support. It means so much during these times. And the verse that stood out for us at the beginning of the journey resonates tonight too:

Jeremiah 29:11
For I know the plans I have for you,” declares the LORD, “plans to prosper you and not to harm you, plans to give you hope and a future.

Scott Taylor on September 3rd, 2008 at 10:11 pm #

Tina and Josh, I am so glad that your little Ella did so well during the surgery. My family and I have been reading your posts every day. Our thoughts and prayers are with you.

Laura Blackwell on September 3rd, 2008 at 10:19 pm #

You must be exhausted. Thank you for taking the time to update us Ella fans. =) Prayers in Jesus’ Wonderful Name!

Adrienne (Melissa's sister) on September 3rd, 2008 at 10:23 pm #

I can not get over how well informed and WITH IT you both are…. just very well educated! It is so good so that you can continue to be that advocate and ask the hard questions to make sure Ella gets the best care! If we ever get into a medical situation I’m calling YOU for s second opinion! heheheh!

Vicki/CO on September 3rd, 2008 at 10:27 pm #

Oh, precious little Ella, sleep well, little one. And Josh and Tina, we hope you get some good rest tonight, too! God bless you all…what an awesome God we serve! How He works little details together as part of the puzzle to put things in place as with Michelle. Yea, God!

kristin on September 3rd, 2008 at 11:05 pm #

Sweet sleeps Ella, Josh and Tina. Sleep tonight. Sleep and restore your strength recoup your energy.

Proverbs 3:5-6 Trust in the Lord with all your heart and lean not on your own understanding; in all your ways acknowledge him and he will make your paths straight.

3:21-24 My son, preserve sound judgment and discernment do not let them out of your sight; they will be life for you, an ornament to grace your neck. Then you will go on your way in safety, and your foot will not stumble; when you like down, you will not be afraid; when you lie down, your sleep will be sweet.

You are all so loved.


sherry martinez on September 3rd, 2008 at 11:24 pm #

Tina congrats on ella coming up extubated. I was praying for that for you both. The exact same pain control was used on cayden for his repair. I think it is wonderful how that works on our babies to make extubation and pain control possible. I pray for both of us that these will be the last surgeries for our two angels sent from heaven. Again thanks for your friendship and please give ella a hug from me and baby cayden. love and hugs sherry

Julie Kirk on September 3rd, 2008 at 11:49 pm #

Praising God for His almighty hand through this and for a very speedy recovery for Ella.
Love and Prayers form Saudi Arabia

Brendan on September 4th, 2008 at 2:10 am #

I am so thankful to God that she did so well. God rocks!! We will to continue to pray for you and your family.

Joel Snyder on September 4th, 2008 at 3:15 am #

Ella, My sweet little “BUN” I am praying and thanking God for being with you today. I will be at the hospital today to visit with you. Love,Grandpa!!!!!!!!!!!!!

Michelle Herman on September 4th, 2008 at 3:30 am #

Wonderful news! So very glad to hear that it all went so well – she is quite the trooper!!

Barbara Mullins on September 4th, 2008 at 3:54 am #

Our God is GREAT! So happy that all went well. I’ll continue praying for you all.



Kathy on September 4th, 2008 at 4:44 am #

OH PRAISE GOD that she came through surgery like a trooper! I love that picture of her face covered. That’s how I feel sometimes. Just cover up and forget the day! I will be praying for a speedy recovery!

Jennifer on September 4th, 2008 at 4:47 am #

super yay! I’m so happy to hear all this promising news!!!

Christe Mitchell on September 4th, 2008 at 4:52 am #

I am so glad and thankful that surgery went good. Praying you all have a good nights rest and Miss Ella has a quick recovery. God Bless!

LoriAnn & The Gang on September 4th, 2008 at 5:23 am #

Praise God! He is so awesome. I am so thankful for the nurse that came out to greet you (I think nurses have a lot of power) and to make sure that the people attending to Ella were her “favorites”.
I pray that y’all had a great nights sleep and that while Ella is weaned from the pain meds, she surprises us all with NO fussiness; just joy.
We are to find joy in all situations. As I go through my day, I often think of your family: it always brings me joy that the Lord still shows such miracles, such as your family.
In Christ, LoriAnn and the Gang

Marge (Indiana friend of Keith & Liz Mueller - Chris' parents) on September 4th, 2008 at 5:32 am #

PRAISE BE TO GOD!! May you all receive His fullest blessings.

Steve and Joan Odell on September 4th, 2008 at 6:19 am #

It is these situations that make us so aware of the power of prayer and His miracles. There is such an important reason Ella is your baby and yet belongs to each of us. With much love and continued prayers – Steve and Joan

Eve Johnson on September 4th, 2008 at 6:43 am #

Our God is an AWESOME God!

Anne on September 4th, 2008 at 6:45 am #

Thank you God! Many blessing coming to the three of you from the Lord

Kristen on September 4th, 2008 at 7:17 am #

Praying you through! xoxox

Fran on September 4th, 2008 at 7:19 am #

Love you guys! Hugs and Prayers for sweet Ella! Fran

Debbie Bennett on September 4th, 2008 at 7:29 am #

Praise God! Hope you get some rest.
God Bless, Debbie

Teri Z. on September 4th, 2008 at 7:38 am #

Praise the Lord! God is so good. What an amazing report all around.

Rest well

Schultz Family on September 4th, 2008 at 7:46 am #

This is wonderful news! We are so happy to lift her up to the Father with you! Praying for a quick recovery…

Roxie (Adrienne's friend) on September 4th, 2008 at 7:53 am #

Josh and Tina, Thank you for taking the time and energy to keep us up to date. It seems like I can hear the angels in heaven rejoicing and sighing in relief that Ella did so well in surgery and the staff was so excellent! Praising His Holy Name,

Jennifer Harris on September 4th, 2008 at 7:55 am #

Wonderful Praise Report…peace be still. Thank you for the update and know that my family has you lifted- you up in prayer. Praise GOD!
Jennifer & Chelsea

Megan on September 4th, 2008 at 8:02 am #

Ella I couldn’t wait to come to the hospital today to read about how you were doing. I am so relieved to hear that you are doing well. I love to see you in pics because no matter what you are going thru you always seem to smile =) I hope everyday just keeps getting better and better!

Laura Marold on September 4th, 2008 at 8:35 am #

So incredibly glad to hear the surgery went well. Love, Laura M.

John & Estela on September 4th, 2008 at 8:37 am #

Praise God… what a wonderful verse. Thank you for the verse and as we continue to pray for Ella, you and Josh… just know that you are all loved. God Bless. The Williams

Auntie Shannon on September 4th, 2008 at 8:39 am #

Go Ella! Go God!
We love you.
Rick, Shannon, Richard, Megan, Richard, Claire and Ryan

Heidi Ham on September 4th, 2008 at 10:00 am #

Praise God! So glad to hear about the good news. We will pray for a smooth healing for Ella and lots of rest for Mom and Dad 🙂

Lisa Richmond on September 4th, 2008 at 10:31 am #

Hooray! I was so excited to come into work this morning for a quick update…I was swamped yesterday and today I was with my “little one” – Hannah…having an MRI…small compared to what you bun is going through! What a trooper! And what perfect timing to have all of the docs avail and eager to work with you…thru Him to make sure Ella shines thru w/ flying colors!

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