Very rocky road after PDA Ligation

Hello Everyone,

My little boo, Isaac, is really struggling right now. He had his pda ligation surgery on Wednesday and since then he has had nothing but bradys and apnea spells. Before the surgery he was doing much, much better. He would have and A&B a few times a week but not it is several a day and even several within an hour. The doctors told me that they expected his recovery to be bumpy but I did not expect this at all. I am left feeling like I should have never approved of the surgery and had them just leave him alone for a while longer. He seems to be doing so much worse now than he was before. He looked healthier back then and was already on the bubble cpap at 30%. As I type, he is intubated and at 63%!! I recognize the old, get worse before you get better, saying, but this is really distressing me. The doctor told me that he was in pain and that would cause him to stop breathing, then she said he would fall into a deep sleep and that would cause him to stop breathing as well. I feel like my little man has yet to get some kind of restorative sleep after this operation.

Isaac is 33 weeks old and weighs almost 3 lbs. He has pulmonary hypertension and his lungs still need to heal from ventilator damage. The doctors said he has yellowish mucos in his lungs and they have started him on a round of antibiotics tonight. They have taken xrays and we haven't gotten the results yet. His blood gas was good but they are very concerned. I wanted to know if anyone has had this same experience or something similiar when it came down to pda ligation.

By 29weekevan
Posted November 8, 2009 at 8:09 am
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I'm sorry you guys are having a difficult time. We did not have these problems, but I do remember them telling us we might. He was on the vent about 36hrs after surgery. The pain meds made him too sleepy to breathe very good on his own and he needed the pain meds. My main concern was that he couldn't cry afterward extubated, and was very hoarse. One of the possible complications of the surgery is vocal cord paralysis. It took about week, but he did get his cry back.
My son had pulmonary Hypertension also and his left ventricle was enlarged from working too hard. He couldn't get off the cpap. The surgery was necessary or he would not have gotten better. Maybe this is just rollercoaster NICU moments when you have to step back in order to forge ahead.
Also, I don't know if this is part of it, but they can't pull that PDA too tightly closed or it could become friable and fall apart. So they pull it closed as much as they safely can, and then it has to scar closed the rest of the way. Evans murmur was worse after his ligation for a week or two while this process happened.
The yellow mucous might indicate a new problem though, an infection or something. I hope they figure it out so you guys can forge forward once again. Hang in there.
Lisa

By CalliesMommy
Posted November 8, 2009 at 11:15 am
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We also experience our baby having problems because of the narcotics given after the PDA surgery. We are very happy we had it sone, and wish it could have been a few days sooner then it was because even thouggh it seemed really badright after, we think the damage from an open pda would have been worse and could have kept her on the vent longer.

By aviatorjj
Posted November 8, 2009 at 2:24 pm
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I could be wrong but it doesn't sound like the problems your son is having are from the PDA ligation but more so the hypertension and possible infection. I know it's frustating, it's so hard to know exactly what is wrong with preemies, it's not like they can tell us.

By jbennion
Posted November 8, 2009 at 2:40 pm
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Our 23 weeker also had the PDA surgery. This specific procedure takes some time to recover from, since it basically changes the whole way the body deals with blood flow (blood pressure). Anytime this happens, you will most certainly have a few rocky, rough days. Our sons blood pressure was all over the place and he definitely required much more respiration wise.

The one thing to remember is that it is impossible for your child to grow and progress unless the PDA is closed.

Please let us know how your little one is doing!

By Feistylioness78
Posted November 9, 2009 at 1:04 am
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Bren had a long long recovery after his pda closure he had CLD and PH. your son will pull out of it. The infection may not be helping much.

By rainysmom
Posted November 9, 2009 at 9:33 am
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So sorry you are having to deal with all of this. Our daughter, a 26 weeker, had coded after she bled out due to an allergy to surfectant. She had three proceedures (read emergency surgeries) to insert, then remove tubes in her lungs after they collapsed. This was all in her first few days of life. She did require the PDA ligation, and had tremendous difficulty stabilizing afterwards. There was a team of docs and nurses around her bedside almost non-stop for about three days. She had a hole and a cyst in her lungs, and really needed surgery for those, but wasn't yet stable after the PDA surgery. She was put on the oscillating vent (for the most severely ill) and remained on it for I don't even remember how long. She also developed an infection, and they suspected NEC. Thankfully that all resolved and she did stabilize after about ten days. Infact, she ended up not getting the surgery on her lungs, and though she's had major respiratory issues, at 2 years ten months old now, she's resolved all her issues to date. She has not had a nebulizer treatment in 7 months. All babies are different, but I believe our preemie babies are amazing. Hang in there. I kept talking to her softly, reading her stories, and they let me be with her everywhere except the OR. I sang to her when her boold was drawn, had my hands on her head and feet as often as possible. When I did these things her numbers got better. I was encouraged to get to know her. Learn her likes and dislikes. They have ways of communicating with us, like the splayed hands, the waving, means "stop". A calm preemie is usually still, and can smile. Yes, real smiles.
I will pray for you and your family.
Much love, Lisa

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