Progress

Andrew will be two months old tomorrow, so I thought it would be a good opportunity to show everyone just how far he's come. These are x-rays that have been taken over the last two months, along with some commentary. All of them are chest views taken from above, with his left side (the side with the hernia) on the right side of the image and his "good" side on the left side of the image. In an x-ray, fluid and flesh appear white, bone and plastic appear bright white, and air (and well-inflated lungs) appear dark.

June 18, three days after he was born. His chest is almost entirely filled by intestines on the right side and his heart on the left. His bowels have come up through the missing diaphragm and pushed his heart all the way to the chest wall. The only portion of his right lung that is visibly inflated is the bottom left corner....his heart is impeding the rest. The plastic on the left is his chest tube, draining air from around his lung after his pneumothorax. The plastic tubes in the upper left are from the ECMO machine and have been threaded down into his heart. On the right, it's mostly intestines, possibly with some liver and stomach...it's mostly an indistinguishable white glob. On the upper right of his chest cavity, you can see a tiny area that's a bit darker...that's his tiny left lung. The plastic/metal on the right is a temperature probe that was under his armpit.


June 25, after his diaphragm surgery. On the left, his heart has now moved over a tiny bit, so there is a sliver of lung available in the upper left corner. On the right, from top-down, are his lung (the streaky white part), empty space where his intestines were, and his Gore-Tex patch. Moving the intestines allowed the lung to expand a bit, but it's still only about 30% of his chest cavity. The patch on his diaphragm is raised (compared to the other side) because the surgeon put in extra so it would have room to stretch out. It's domed upward, and will flatten out as Andrew grows.


June 28, after the empty space had filled in. On the left, his heart has moved over more, and much more of his right lung is visible. On the right, fluid has filled in the portion of chest cavity not occupied by lung...this is a normal process, and the fluid does not impede on his lung at all. The ECMO tubes are gone, though you can faintly see his ventilator tube. The bright plastic circles are stickers on his skin, holders for his CO2 monitor.


August 3, one of the more recent views we have. In just over a month, he's made incredible progress. His chest tube is gone, his heart has moved over significantly (it's supposed to be very close to the center), and his right lung is much more visible. More importantly, his left lung is also quite inflated, and takes up a large portion of his chest cavity (perhaps 60-70%). If you compare this picture to the first one above, it makes quite an impression. We're very proud of his progress (as are the doctors) and we hope it continues at the same rate.


If you can't see something or have any questions, feel free to post a comment. I can explain further, or post another picture with appropriate labels.