My three year old son had a modified intracardiac fontan almost a month ago. We went home after two weeks. He initially had a couple complications and was intubated for the first two days post op. Also they took him back to the OR the second day for exploration because they thought he had clots around his heart (he did not). Anyway, after being so sick the first couple days, he rapidly seemed to progress and we went home. He is on the low fat diet (<20 grams per day) and has not developed any further chylothorax. They have begun to wean him off the diuretics, he's still on three twice per day. Just curious as to when I can expect him to start feeling like himself again. He is always so tired and whiney. I hate to see him like this and I just want him to feel better! I hope we did the right thimg by having this surgery!
It is common to have fluid collections around the lungs and/or heart (effusions) after a Fontan operation. The fluid may be relatively clear (serous), or have fat in it (chylous). The length of time that a patient will have effusions after surgery is very variable, lasting from several weeks to several months. Although some of that relates to the pressures and function of the heart and lungs prior to surgery, there is no clear cut risk factor for who gets this postoperative complication. As far as fatigue and irritability is concerned, most of that would be related to pain and mild anemia postoperatively. You should be vigilant about giving pain medication (as directed by your physician) and keeping your child well hydrated, even if he does not want to drink. The breastbone requires 4 to 6 weeks to heal internally, but the major discomfort is usually better in 2 to 3 weeks. You need to inspect the incision daily to look for any evidence of a wound infection. Fevers and a reddend wound could indicate infection, and your son would need to be checked by his cardiologist and/or surgeon. Additionally a loss of appetite, repeated vomiting or increased work of breathing can indicate recurrent fluid collections around the lungs or heart.
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