Tanner’s mom took the stuffed dinosaur he was clutching. His grandma prayed over him. His grandpa gave him a fist bump. Then, the red-headed 3-year-old from Claremore, Okla., who loves baseball and Batman was wheeled away to surgery at 7:30 a.m. to reconfigure his misshapen heart.
The surgical team would work for hours in the operating room — typically an obscure, secretive and scary place — while families sit outside for long, excruciating hours waiting to hear word.
“Patients have no clue what happens in there, and it causes a tremendous amount of anxiety,” said Dr. Pirooz Eghtesady, chief cardiothoracic surgeon at St. Louis Children’s Hospital. “The operating room is the only part that is not visible.”
But minutes after Tanner left, the phones of his family sang with an alert. They received a picture of him reaching for a gas mask, explaining the team was beginning the process of putting him to sleep.
Eghtesady has spent years trying to figure out how to make the operating room more accessible to his patients. He finally found the answer in a smartphone app, now available for every heart surgery at the hospital, and plans to expand its use.
It’s like Snapchat from the operating room.
The app is similar to the popular social media app that shares images, texts and videos in that content disappears after a minute and is not stored. But these posts are only shared from medical staff to whomever is signed up to see them — even to family members in other cities.
Tanner’s family is no stranger to the operating room. Tanner needed two heart surgeries in the first six months of his life. His recent surgery took place last month. It’s the first time his family used the Electronic Access to Surgical Events app, known as EASE.
“Part of the stress is the unknown. Being able to know what’s going on and being able to see is definitely helpful,” said Tanner’s dad, Bryan Noblitt, 30. “It makes us feel close to Tanner.”
Noblitt’s idea of an operating room comes from the movies and medical equipment he has seen, he said. “But you don’t know what it’s like in your son’s room, and now you do.”
At 8:31 a.m. came a picture of Tanner on his bed, with doctors unfolding his covers. At 9:20 a.m., a picture of his open chest, seen through a hole in the covers with the message: “Dr. Eghtesady is beginning to free up tissue around the heart. His vitals are stable.”
“Which is very comforting to hear,” Noblitt said.
‘Families appreciate this’
More than a decade ago, Eghtesady decided he wanted to open his operating room to families. A nurse had made an error during a surgery, and limited information led the patient’s mother to mistakenly believe it was her fault.
For nearly 14 agonizing hours, Eghtesady said, the family had no idea what was happening until he was able to talk to them.
“If they had seen what was being done to address the issue, that would’ve made that a different experience,” he said. “We have to be focused on communication and transparency.”
Eghtesady suggested building windows to the operating room, but colleagues feared it could affect patient care. He got so far as to wire cameras between the operating room and a waiting room, only to have the project end because of privacy concerns.
About two years ago at a conference, Eghtesady learned about EASE, developed by two anesthesiologists at Arnold Palmer Hospital for Children in Orlando, Fla.
The app uses encryption protection similar to that used for mobile banking transactions. Medical team members using the app receive special training to ensure they are compliant with privacy laws.
St. Louis Children’s is the first hospital in the St. Louis area and one of 24 across the country using the app, according to founder Dr. Kevin de la Roza. Surveys of users show it has been overwhelmingly popular.
Operating room nurse Amber Hinterthuer said she and other nurses at St. Louis Children’s were skeptical at first, unsure if the app would be something families would be comfortable using. Now she’s the app’s biggest champion.
“It was an eye-opener to see how much positive vibes came from the families and how happy they are,” she said. “It’s been overwhelming to know how many families appreciate this.”
Hinterthuer is advocating for its use in other surgeries as well as intensive care units, when families can’t continually be by the side of their loved one.
Use of the free app is now offered for all heart surgeries and is starting to be used in the cardiac catheterization lab, where thin tubes are guided through blood vessels to diagnose and treat heart conditions.
Families receive updates every 30 minutes to an hour from a circulating nurse in the room. Emergencies are still shared in person. Users let the nurse know how much they want to see.
At 10:07 a.m., Tanner’s family received a video of Eghtesady trimming the tube to be attached to the boy’s pulmonary arteries and guide blood to the lungs. Tanner’s heart was beating in the background.
“It’s intense, but to some extent I feel like it’s the least I can do,” said Tanner’s mom, Kelsey Noblitt, 30. “I can’t do anything else.”
Grandma Lynette Olsen, 59, agreed. “You want to go through this with him.”
‘Tanner is extubated’
As Tanner’s family received updates, they took screenshots of the pictures so they had copies to keep. They want to show Tanner what he was able to overcome.
“I need to print them off and put them in a book someday,” his mom said.
Kelsey Noblitt shared them immediately to a private Facebook page, Tanner’s heart, to keep its more than 1,250 followers across the country aware of the boy’s progress.
10:28 a.m.: A picture of the machine that would do the work of Tanner’s heart while his heart was stopped for the operation, and the message, “Tanner is now on the heart-lung bypass machine.”
11:51 a.m.: A quick video of Tanner’s heart beating once again.
1:17 p.m.: A picture of Tanner breathing on his own. “Tanner is extubated and heading to the ICU!”
Olsen threw her fist in the air, “Oh, there’s our boy!” Everyone sighed in relief.
Kelsey Noblitt said the picture helps her know what to expect when she sees her son, unlike his last surgeries. “It’s scary to walk in his room and see him for the first time,” she said. “This kind of prepares you a little bit.”
After a nurse talked to the family and took them to another waiting room near intensive care, the last post came at 1:36 p.m.
“Tanner is getting situated in his room,” it said, along with a picture of the small boy still asleep, his legs sticking out from under the covers.