Friday, 22 November 2013

Chylothorax


Not content with:-
*Pulmonary Stenosis
*Residual VSD
*Complete Heart Block

Martha Grace has now decided she would also like to have Chylothorax.
The nurse on duty yesterday noticed there was a lot of "chyle" in her chest drains, which is basically a layer of fat sitting on top of the blood in the drain.
What is happening is that the duct carrying Fat from her intestines to her lungs has become damaged and so
is leaking in her chest cavity. We can only be thankful that Martha still had the chest drains in place so the fat could drain out and alert the nurse that there is a problem.


Well I call it a problem, it's more of a complication following cardiac surgery.
The Lymph node can be damaged during surgery, but if this was the case it had more of a chance of happening in her first op as the node runs alongside the Aortic Arch - they didn't go anywhere near the Arch when closing the VSD.
The most likely cause is that Martha's heart has been used to working against a resistance (The PA Band) and when the VSD was closed it's taken a while for her heart to adjust to not having to work as hard, so there has been a lot of pressure in the right side of the heart leading to the Lymph Node becoming damaged.
She is now on a medicine milk which is called Monogen, which doesn't contain the type of fat which is absorbed by the lungs and so there is nothing to leak out.
She has been on Monogen since last night and so far it's doing the trick and she is draining less than 1ml per kilo per hour from her chest drains.
She'll be on Monogen for 6 weeks and apparently it tastes vile - but the lymph node should recover.
Just another bump in the road to recovery.

GM 
x