Fistula Pre-Op

Yesterday Seth, Job and I spent the entire day together up at Seattle Children's for Job's many pre-op appointments. (Usually the pre-op appointments are scheduled closer to the surgery date but our surgeon will be out if town next week.)

Our days in Seattle are always long as they try to schedule back to back appointments in order to decrease our number of trips up north, but yesterday was especially long and so Job and I were really glad to have extra company. Sometimes too, when I'm only relaying information to Seth, I miss important details or nuances, so it was good for him to hear from the surgeon and doctors first hand.



I feel like my head is still spinning from all that we talked about and did, so this will be an incomplete update as I need to process and research some of what we talked about. Nothing bad! Maybe even something good.

We met with the surgical NP and went over the various details leading up to surgery, like the meds Job will take beforehand, and went through his entire health history to make sure all the relevant details were noted. We did a chest x-ray. We did a 12 point EKG. We met with PT to evaluate how Job has been tolerating his thickened feeds. We did a blood draw to check his CBC, INR, electrolytes, BUN, creatinine and prealbumin and give a sample for the blood bank (to reference for his post-op crit transfusion). We met with Dr. Nuri (who has performed Job's three previous surgeries) and discussed the auxiliary fistula Job is scheduled to have in March 7th. We talked to anti-coagulation about Job's elevated INR levels, decreased his lovenox dose, and discussed the likely anti-coagulation plan post-op. We went to the pharmacy. And we did an echo to check Job's heart function and tricupid valve regurgitation. Whew!

A day like yesterday serves to underscore my complete wonder and awe at the amazing complexity of the human body. I'm just so grateful that all of these evaluative tools are available now and for the knowledge and wisdom Job's doctors possess. Even though most of my days now are focused on some aspect or another of Job's health, and we have learned SO MUCH about the body, sometimes I get complacent and take Job's care for granted... And then I'm reminded again at how very complicated and multi-factorial his care is and the realization just overwhelms me and fills me with gratitude.