Esophageal Atresia & Tracheoesophageal Fistula

Now that Frankie's surgery is over and his mom and I have had a chance to let out a huge sigh of relief, I'm in good enough shape to fill y'all in on the details of the procedure. The diagram to the right illustrates several variations on the theme of Frankie's condition, his particular case most closely resembling example D, an esophageal atresia with a tracheoesophageal fistula. Simply put, his esophagus did not fully develop during gestation. The upper portion of the esophagus formed a small sack, or atresia, which prevented it from growing into the distal portion of the esophagus (attached to the stomach). In turn, the distal esophagus attached to the trachea instead, and a small opening (fistula) created a passageway between the stomach and the lungs. Had Frankie not been a preemie, this condition might not have been discovered until after he began to breastfeed, which would have created the rather more serious complication of pneumonia (fluid would travel down the trachea instead of the esophagus, and therefore into both the stomach and the lungs). In a way, it was fortunate that he came early, as the atresia was discovered when they tried to insert a feeding tube into his throat (something they general don't do for full-term babies). The procedure to correct the atresia and fistula involves two primary steps: first, the distal esophagus is detached from the trachea, and the fistula is sealed with sutures; second, the atresia is opened with an incision, then attached to the opening at the top of the distal esophagus and sealed with a circular suture. All of this is done through a small incision on the left side of Frankie's chest. The surgery did not require his ribs to be broken or his chest cavity to be opened, and he lost only about 1cc of blood. The doctor also inserted a Broviac catheter into Frankie's chest, which will minimize the number of times they have to fish for a vein when inserting antibiotics and other medications, and which will later be used for introducing fluids and nutrients. Really, it's amazing what they did, and as of this morning, Frankie is doing great, and there are no signs of any complications. If the sutures hold, he'll be ready to begin ingesting food by the end of next week.


Anonymous Marshall G said...

Glad things went well, thanks for the happy update! Just like Lance in the Tour de France, Livestrong, Frankie!

11:48 AM  
Anonymous Anonymous said...

If you see Morris you better tell him to cough up the package before I get to Austin.

1:35 PM  
Anonymous Brenda Harrison said...

I was praying R-E-A-L-L-Y hard and constantly, and I'm so relieved I could cry.

Dave & Anna, I wanted to make sure you know about Mothers Milk Bank (www.mmbaustin.org). They're a former grant writing client of mine and they exist for situations like yours when babies are in NICU and for any reason mom isn't able to breast feed. It's covered by insurance! Their operation is out of Seton but they serve all the hospitals. Hopefully you won't be needing this, but I wanted you to know it's there and your doctors and nurses will know all about it.


11:24 AM  
Blogger homegrown tomato said...

Just wanted to lend a little support on the breastfeeding front. I pumped and delivered for quite a while while my little boy was in the NICU. While I soon began to hate THE MACHINE, it was pretty darned awesome to deliver the milk every day to him. Feel free to use me as a resource. I'm a buddy of Kim B. from way back. Good luck! It sounds like y'all are doing great.

6:08 PM  
Blogger swamp4me said...

Frankie is beautiful. So very happy to hear the surgery went well.

6:55 PM  
Anonymous aunt debbie said...

Dave, Anna & Frankie,

"Relieved" doesn't even begin to describe our feelings here. We're ecstatic that Frankie's surgery went so well and that neither he nor Anna have had any complications.

Since I was in no emotional state to conduct a meeting Friday evening, I emailed my colleagues and included your blog site by way of explanation. Everyone naturally expressed their concern and offered their prayers, but there were also many comments about what a wonderful man/husband/father Dave must be. I'm so proud!

We'll all continue to pray for quick recoveries and nerves of steel.

BTW, if all this "Morris" stuff is a joke, I'm not getting it. That's not one of the cat's names, is it?

Looking foward to seeing all of you soon,

Deb, Russell, Carlee & Tressa

7:29 PM  
Anonymous Grandma Judy said...

Great Grandpa and Grandma Cunningham send their love and prayers and say they can't wait to meet little Frankie. Aunt Evon & family also send prayers and good wishes and they all say that half the people in Oklahoma are praying for us....just maybe not the bad Okie that someone wrote about earlier.

7:59 AM  

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