Dr. Anderson came by and let us know that Memphis is scheduled for surgery tomorrow. It may or may not happen, but if everything continues on the trend that it on right now, he wants to go ahead and do it. He also explained all of the complications that arrise due to the congenital hernia. He told us that all CDH babies have some sort of gastrointestinal issue, be it small or moderate, they all have them. They all have reflux problems also. The diaphragm is part of the body that controls reflux, and due to the damage to it, it can't do it's job. The fix to this is an antireflux surgery called a fundoplication. CDH babies also typically have issues with eating. If they cannot recover and start eating through the mouth, they are given a tube through the nose for feeding. If this doesn't relieve the problem then a g-tube will be put in their stomach. This is for direct to stomach feeding. Due to the lack of a lung on the one side, they usually have a open cavity there. Fluid will start building in this cavity, and if the body can't absorb and regulate this fluid, a chest tube is inserted for draining the cavity.

There may be a need to insert a dialysis catheter in his abdomen eventually, and it was origianally part of the plan to go ahead and place it while he was open. After further thought on the matter, Dr. Anderson does not want to do it. He feels as it may increase the chance of the patch of his diaphragm becoming infected. If Memphis doesn't start producing urine though, this will become another procedure that he will have to go through.

When they have him in surgery, and are repairing the hernia, they will have to pull his intestines out of his chest. During this they will check for a narrowing of the main blood vessel in his intestines. They expect there to be some, but how much will indicate whether or not they have to do any repair on it.

After placing all of the intestines back in the abdominal cavity, they expect some intestinal malrotation. This is because the intestines are not attached to the inner wall like they should be. They cannot attach the intestines surgically, they basically have to let them fall like they want to.

Another weird issue is that after all of this, his appendix will not be where it should be. This is not threatening at all, but just necessary to know because that later on in life, appendicitis is more difficult to diagnose.