Let me Clarify

It has come to my attention that some of our readers are not clear on exactly what is going on with Baby J, so let me clarify a little…  Disclaimer:  There are pictures and medical type jargon used in this post.  I tried to keep it as simple as possible on the medical stuff.  If you are extremely squeamish, you may want to skip the pictures.

When a baby is developing in its mother's womb some of the first pieces to develop are the baby's internal organs and the nerves that run those organs.  When the nervous system develops it starts at the top with the brain, then works its way down the spinal cord and into the other parts of the body, always from the top down.  For babies with Hirschprung's disease, like baby J, for some unknown reason the nerves in their intestines stop developing early, so they never reach the bottom.  When this happens there are no nerves to tell the muscles in part (and sometimes all) of the child's colon, large intestine, to move digested food and gas down and eventually out.  This means stuff gets stuck inside the baby's colon from the point where the nerves stop and just builds up, never coming out.  If this isn't caught early enough the baby's belly can become distended and fat and can cause infection and even rupture if it is bad enough.  The only known way to fix this problem is with surgery.

stoma

There are two ways doctors perform this repair.  One is a direct pull through or take down, the other is a two step process with an ostomy and then a take down.  Now I will define some terms:  Ostomy: when a piece of intestine is pulled through the wall of the abdomen to allow stool to pass through, this is collected in a bag that attaches over the stoma.  There are two basic types of ostomies, colostomy, where part of the colon that is pulled out, and ileostomy, where the small intestine is pulled out.  Stoma:  The piece of intestine that sticks out of the abdominal wall.  Pull through: a surgery done to reconnect intestine to the anus, called a pull-through because the intestine is literally pulled through the pelvic floor muscles to be reattached.

colostomy bag

Baby J is having the two part surgery.  The reason for the two part surgery is to allow the healthy part if his intestines rest and return to a normal size before they are reattached (they were bloated with stool and gas before his first surgery) and to allow him to gain some weight.  January 3 Baby J went in for his first surgery.  For this surgery they used a laproscopic camera and took tissue samples from his colon every few centimeters until they found healthy nerve cells.  Once they found healthy nerve cells they created an ostomy on the lower left side of his abdomen.  In a few months he will go back for his pull through surgery during which they will reattach everything and close his ostomy.  After this second surgery Baby J should be able to function fairly normally.  For now we live with the ostomy, which really isn't all that bad.

I hope this clears up any confusion.  If you have questions feel free to ask and I will do my best to answer.