As you may recall, the surgery was to serve three purposes: 1) allow Mia a way to give herself an enema so she won't have to rely on others to give her a rectal one, 2) allow Mia urinary continence(control her leaking) and a way to empty her bladder independently without having to use a catheter through her urethra and 3) open and possibly reconstruct a vagina. The fancy term for the new access to her colon is the MALONE and for the bladder the Mitrofanoff. Both procedures theoretically use the appendix to make a channel from their respective locations (bowel and bladder) to the abdomen. If the appendix is absent or not large enough, pieces of bowel are used to make those channels.
Upon opening Mia, all three surgical teams: Colorectal, Urology and OBGYN, evaluated how to go about all of the components of surgery in the best way possible to achieve their respective goals (and best result for Mia). The first few discoveries that were made were that Mia's appendix was too small to be shared as access to both bowel and bladder so additional bowel was going to be needed, her bladder needed to be made larger (augmented) and urethra closed off completely in order to achieve dryness and that her vaginal, uterus and fallopian structures were absent, however, she does have very small ovaries so hopefully hormone production won't be a problem later.
I hope you are with me so far!
The end result was this:
1. The Malone was created using a portion of her large intestine creating the channel out to her navel.
2. Her bladder was augmented using a portion of her large intestine as well. Her appendix was used to created the channel and outlet to her abdomen and the urethra was pinched closed.
3. They created a vaginal structure using small bowel seeing as they couldn't afford to use any more of the large intestine.
Having both bowels disrupted and in numerous locations means more recovery for Mia. She has three drains, two from her bladder and one from her abdominal cavity, extending out of her tiny belly. She has a large tube in her nose, called an NGtube, that extends down to her stomach and is suctioning out any fluids/secretions keeping it completely empty. She cannot take in anything by mouth until the stomach is completely cleaned out and her bowels wake up, which won't be for a few more days. In order to help her bowels to wake, we have to get her out of bed (our task for today). The sooner we can wake the bowels the better!
Forgive me for the length and complexity of this post. Many following are friends who can relate and possibly benefit from the medical portion, others, just may want to know. Anyone who may get offended has hopefully stopped reading and will pick back up on the next, not so medical, post which we completely understand!!!
Mia's post op has been very difficult on all of us, especially her. Her tiny body has been traumatized. The light seems so far and out of reach right now but we know there are so many of you praying and we will get there. Mia is having many ups and downs and I will not be posting all of those. Medically speaking, she has been very stable. Her heart and breathing have been successfully managed, she is currently fever free, her counts fluctuate but have been managed successfully. All of those things are extremely important! Pain management and anxiety have been tricky, especially anxiety!
Thank you all so much for your support. We still need so many prayers so keep them coming!