Elias is recovering well from his Laparoscopic Nissen Fundoplication. He did not have to spend the night in the PICU as they expected him to, but returned to his room in the IMC within hours after the surgery. Typical Elias, exceeding the doctors expectations. He was still very out of it for the remainder of the day and slept seemingly comfortable. He is on pain management services getting Tylenol every six hours and morphine as needed. We have only had to administer one dose of morphine to this point and that was only because his nurse last was clumsy. He has a drainage tube connected to the G-tube that just hangs off the bed. Well she lowered the bed rails on that side and it pinched off the tube and was pulling on the G-tube and stomach, so Elias was obviously in a great deal of pain. This morning they have decided to hold off a little longer to begin feeds. The drainage from the stomach is still a little dark telling them he is not ready to start digesting just yet. He is getting IV fluids at the moment and it is perfectly normal to take a few days before the stomach is ready to feed. They also placed and left in a 3.5 trach tube, which is slightly larger than the one he usually has (3.0). His leak is so large that when they place him on a ventilator for surgery the have to upsize the trach to maintain the positive pressure. They plan to replace the 3.0 size today or tomorrow, but that is also causing him a little bit of discomfort. One reason is he can not produce sound like he is able to and that seems to be a little frustrating to him. Overall, the surgeon was pleased with the way everything looked and the recovery so far. While this was not the cure all for Elias lung and respiratory issues, it was a significant contributor. The doctors reminded us of that the day prior to the surgery, he has chronic lung disease and unfortunately a Nissen is not the cure. We can expect respiratory issues still to remain, but we should find things more manageable and hopefully less severe. Thank you to everyone for your thoughts and prayers yesterday. It was a nervous day with a pleasant ending.