Saturday, June 27, 2009

About Joshua's Surgery

It has been 10 days since Joshua's surgery; and finally, he is doing well enough to go without oxygen and be able to take breaks (short ones) off his ventilator without affecting his oxygen saturations and carbon dioxide levels. Hurray!!!!

In fact, today... we went to eat lunch out and then shopped in Walmart for a while. And we did not take his oxygen tank with us!

Many people still ask about Joshua's surgery and what it was for... so let me try to explain. He had part of the new breathing pacemakers he will use in the near future implanted into his body.

Joshua had 2 electrodes and 2 receivers connected to long wires like the ones in this picture:
implanted in his chest...
The implanted receiver is a small electronic device, about the size of a quarter and approx. 1/4 inch thick, that receives radiofrequency energy and converts it to electrical impulses which stimulate the diaphragm.
The implanted electrode is a highly flexible stainless steel wire, insulated by silicone rubber, with a platinum nerve contact on one end, and a connector that mates with the receiver at the other..

In the diagram below, you can see where they go inside the body:

you'll also notice a black box connected to white wires with a white circle at the other end.

The box is a Mark IV transmitter like this:

and the antennas look like this:

An external antenna is worn over each implanted receiver and sends power and radio signals from the transmitter to the receiver transcutaneously. This radiofrequency coupled design means that there are no wires or plugs protruding from the skin, and no batteries in the implant that would require periodic replacement.
An antenna is a durable disposable item which requires periodic replacement. It is recommended that antennas be replaced prophylactically every six months.
Here is Joshua showing his surgery incision sites in the pictures below:

Here's a closer look:
the top two incisions are where the electrodes went in (and had to be sewn in around the phrenic nerve

the bottom two incisions are where the receivers (round about the size of quarters) went in (just under the skin so they can make contact with the antennas which will be worn on the outside)
Joshua will not be able to use his pacemakers for some time (we are still waiting to hear from the doctors when they say it is okay to try them out) but when he does, he will use this Transtelephonic Monitor to send information from his pacemakers to the company that makes them, so they can help make sure everything is working properly and they can give the information necessary to the doctors.
For much more information on these diaphragmatic or breathing pacemakers, made by Avery Biomedical Devices, check out their website:

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