A good day. D's parents and brother came down and we went by the hospital twice, with a break for a nice lunch at Jake's Del Mar. They had taken Andrew off both the sedatives and paralytics, and he was very active when we arrived. He was pushing his foot against my hand, gripping my finger with his hand, opening his eyes and looking around, and generally squirming all over. It was as active as we had ever seen him, and it was great to have proof that he is still in there and fighting to get better.
His flow got down to 30 over the course of the day, and the doctors came up with a 'new plan' moving forward. Instead of turning up the ventilator and making him use his lungs more quickly, they have decided on a somewhat less aggressive approach. They plan to let him relax through the weekend, slowly bring down the ECMO flow, and then shoot for the surgery early next week. However, in order to do the surgery, he has to show them that he'll be able to survive off the ECMO, which means getting his flow down around 5.
We spoke with the surgeon, who made us feel pretty good about the surgery itself. As long as he can get stable before the surgery starts, I'm convinced that he'll be able to pull through afterwards. The surgery involves a rather large incision on his left side, just below the diaphragm. They'll open him up and carefully pull his abdominal organs down through the hole, then patch the hole with a sheet of Gore-Tex. If the hole is small enough, they might even be able to sew his diaphragm closed without the patch, but I don't have high hopes for that. As he grows, the patch will become a smaller and smaller percentage of his diaphragm, so it will never need to be replaced.
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