The day started rough as we took sweet Ian to the OR and after sedating him and putting in the breathing tube we felt his lungs were too sick to go on with surgery. We spent a lot of time praying over him and discussing our options. Ultimately, if we did not do surgery Ian could go home and pass away...he could have months or years, we can't say. If we did surgery it could go well and his heart could be fixed, or it could go poorly and he may not survive. We spoke with his mom and she said she believed God was in control and to proceed with the surgery. We proceeded and Ian is doing AWESOME! Kari his currently patting his bottom as we try to track down his mom to feed him! He's the cutest little thing laying in this giant adult bed. What is amazing about Ian is he is the most complex surgery we've done here and praise God he's doing well!!
As Ian was finishing up in surgery Dotto began getting sicker. Kari, Jenny, and I were in the OR to transfer Ian back to the unit. As we were waiting one of the Kenyan nurses came into the OR and said they needed us in the unit for Dotto. When we got in there we found Dotto had suddenly stopped breathing. Prior to this event he had developed a GI bleed on Tuesday that we'd been treating but he hadn't had any further symptoms of that yesterday afternoon. To make a long, very messy story short Dotto ended up in cardiac arrest. We put in a breathing tube, started CPR, gave a lot epi boluses, gave volume for low blood pressures, and started continuous infusions of blood pressure medicines(epi, dopa). We got him stable for about 10 minutes when all of a sudden we could not get a pulse or blood pressure again. We started CPR for a second time and increased all support. He was continuing to decompensate. During this Leah remembered that Brittany (Kristen's sister) was O-positive, which was also Dotto's blood type, so Brittany immediately ran to donate blood. She's so great!! We decided to scope his upper and lower GI and found a bleed in his colon. At this point I called Nez up to the unit for more help. Between Kari, Leah, and myself we weren't able to manage him, our cath patient (alhtough he was rockin it!), and our new post-op Ian. Kristen had worked the night before and was coming back at 7pm so we chose not to wake her. She arrived around 630pm and jumped right in to help us. Dotto stabled out enough so that we could all take turns going to eat dinner. Around 9pm things seemed to calm down though Dotto was still very sick. For my nursing friends he was on Epi 0.2 and Dopa of 10 with continuous blood and NS boluses and no longer responding neurologically.
Leah, Kari, Brittany, and I headed home for bed after a long day while Nez, Kristen and Jenny stayed to manage the unit. Needless to say, none of us could go to sleep without knowing how Dotto was doing. I called up to the unit and Kristen told me through her tears they decided to withdrawal care on him. We all walked back up to the unit to be with them and say goodbye to our little friend. His mother was at his bedside praying and chanting over him through her tears the entire time. Kristen said they had added a Vaso gtt and even increased his Epi to 0.25. He had started to decompensate again and they decided there was nothing else we could do, at which point they called his mom into the room to be with him. They said when they stopped all the medicines and took out his breathing tube there was an overwhelming sense of peace that came over his body and they could tell he was no longer in pain.
Dotto went to be with his Savior around 1030pm last night. For a 12 year old boy he was incredibly mature in his faith. As Kari says "he was an old soul". He would pray all day and ask us to pray with him. We found out later that Dotto had told his mom that morning to give his sister all his toys(we give them bags of goodies when they have surgery). It was as if he knew...which is what hurts me the most. He knew and he couldn't communicate that to us. I replay the day in my head and wonder what more we could have done or what we missed; but in my heart of hearts I know we did all we could and God has a bigger plan for Dotto. This isn't the first time I've lost a patient, not even here at Tenwek, but this time stings differently. We'd invested a lot into Dotto and even gotten to know him over the last week. We prayed with him, laughed with him, even bickered with him, and held his hand when he was scared. If I'm being completely honest, and vulnerable(KB-bravery point?), I'm feeling guilt. His mom and him praised God for "finding" us over and over. They were so gracious and it hurts to think Dotto is no longer here. It's difficult to understand for me that he came in with a "broken" heart that, surgically, was fixed, yet he died because of something different that we didn't know had been going on. All to say, I'm still so thankful for little Dotto and his mom. I will praise Him for this 12 year old life that made us laugh and showed me a true faith. I'm so thankful for these Kenyan nurses that have been so supportive and even helped us during those moments of chaos. Without them this would not be possible. They're so generous, helpful, and joyful. I'm blessed to be a part of this team that cares so much and gives every bit of their energy towards one another and these patients. I'm so grateful God placed a desire on all of our hearts to come serve these people for His purpose...it's such an awesome team!
Interesting note: Kari just opened her Jesus Calling book to read todays message. As she read it I thought "that sounds strikingly similar to the passage Mary found last year after Roger passed"... I looked back in my blog and found Roger passed away this same day a year ago and it was the same passage on November 8th. Just weird.
Anyway, the first surgery for today will come out shortly. It sounds like little Mary is doing super awesome! Our other kiddos Zebidi, Karen, Parmaut, Malvin, and Joyce are healing!! Parmout and Joyce were the first cath patients ever at Tenwek! Tom Doyle is cranking them out...it's so so cool to watch! All the cath kids come out super happy and fun! Despite the sadness of yesterday all of our patient's are rockin it! Such a blessing!! Pictures to come. Oh, also, I hope you all survived election day...not going to lie, I'm glad I wasn't there :) love to all!!!
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