Surgery-Finally

I have been remiss because things around here have been almost mindblowingly busy. Like, "I-can't-keep-up" busy. I have wanted to write about how Gillian came to have surgery two days before Thanksgiving, and I think I primed the discussion in a previous post . Well, to pick up there, the sleep study was positive for obstructive sleep apnea (OSA), and it was apparently pretty severe. So, yay for Mama instincts, even if they were way behind the game. We met with the doctor to discuss the results and schedule her surgery. She had to have a pre-op physical (loads of fun, considering we had a ton of bloodwork and vaccinations before she could start school at her 4 year appt just two months before) at least 1 week before the surgery. So, in spite of the logistical stress we had to manage, we were able to get her in and get everything she needed to have the surgery on November 23rd, two days before Thanksgiving. You might say it was a little mean to have the surgery before Thanksgiving, but I would say something about how she doesn't ever eat anyway. Plus, I scheduled it that week because she would only miss 3 hours of school (they had a partial day Tuesday, and no school the rest of the week) and I would only have to take 1 day of annual leave because of the holiday and a trip to Ohio I had a comp day for. So, it was for the best.

They called me at the last minute Monday to tell me what time we needed to be at the hospital, and they said 6 am. I asked when the surgery was scheduled and they said 9 am. Of course, this idiocy prompted me to exclaim something to the effect of "my GOD woman, how am I supposed to entertain a 4 year old in a waiting room for THREE HOURS?!?" To which she explained I would have to sign some paperwork and get Gillian in her gown. To which I said "that takes all of 10 minutes, what shall I do with her the other 2 hours and 50 minutes?" Then she gave me the "I'm just the messenger" explanation that "this is the doctor's preference and his policy, but it probably wouldn't be a big deal if you got here around 7 am"...and I said, "are you telling me it's ok to come later? Would this keep us from getting her in?"...and she said "no, I'm not saying that at all, but you would probably be ok coming in at 7 am ...you could probably still get in". I could almost hear the winking. Like "yep-DUMB policy, but it is the policy nonetheless". Then she reminded me that Gillian could have nothing-no food or liquids-after midnight before the surgery (the idea of witholding even water from her was a terrifying thought for me because she loves to drink water).

So, I waited till I was showered and dressed (and full of water because I didn't dare drink or eat anything in front of her and deny her food and drink) in the morning and woke her up at the last second, got her dressed, all groggy, and into the car. I was armed with our portable DVD player and a brand new Little Mermaid DVD (thanks Nonni and Grandaddy!!!) to help pass the time and keep her mind off the fact that her throat was feeling like the Sahara Desert and she was starving to death. I have absolutely no idea how our forebearers managed without DVD players, but I, the Ugly American, digress.

We waited for about 40 minutes in the first waiting area before being corraled to the second where we had to get Gillian in her gown and get her weighed and get her blood pressure and oxygenation checked.

I asked to be present in the room during surgery, or at least during anesthesia, but the nurse was hesitant. She had me put on scrubs just in case I was allowed, though. After another hour and a half of waiting we were told it was time to go. So Gillian thought it was great fun to go on a ride on the "bed with wheels" and a man came and got her to take her down to surgery on an elevator.

At this point, he gave us both the little head coverings so we could go to the surgery floor, and I got this sick knot in my stomach, because PEOPLE DIE EVERY DAY FROM ANESTHESIA. And I had this flood of worry about my tiny baby being put under and how cruel it would be that after everything we (us and Gillian) had been through to get to this place, This FOURNESS, I would die if something happened to her. It might be irreparable heartbreak that would result in me immediately dying (kindof like the image I got in my head of how, according to my mom, Elvis, grieving over his loss of Priscilla, just keeled over and "died of a broken heart" (enter complete denial of that prescription drug problem)). That would be me if something happened to my baby.

They parked us in pre-op, and the anesthesiologist came to tell me, after I again demanded to go with Gillian while they put her under (I think I actually said, "No offense, but if something goes wrong, I don't want the last faces she sees in this world to be those of the strangers she is surrounded by in the operating room"), that "we usually don't allow family members in because they generally don't do well when they see a loved one go under...we saw many grown men hit the ground when their wives are put under for c-sections, so it is our policy not to allow it" (Now that I think about it, when I had Gillian Sean was not allowed in the room when I had my spinal...my doctor held my terrified hand). I held my ground, and he relented and told me if I did what he asked and asked no questions and left when I was told to I could go in. I agreed. Whatever it took. I decided at that point that I probably wouldn't do well watching the actual surgery because they force their mouths open, and by all accounts is a pretty bloody affair.

Then came the Jedi Mind Trick. The anesthesiologist asked Gillian "do you like strawberry?" and she was all sweet and innocent and eager and was like "yes, yes, YES!", so he brought her the oxygen mask that was pink and smelled like strawberries. He left it with us for 45 minutes or so so she could play with it and get familiar with it. He also asked if she liked pink balloons and she was all "YES YES YES"!!!!! Both of these seemingly innocent questions had a more insidious side, of course. So we waited and waited and waited. Gillian was a rock star and I pulled out all the stops to entertain her. Our 9 am surgery actually started after 10 am. Thank God we didn't get there until 7am. During this wait, lots of people came by top talk to her and ask her questions, and were impressed with how much she knew about what was going to happen to her. She knew they were going to make her go to sleep (not sure she knew how exactly, and she certainly didn't suspect the awesome strawberry mask and pink balloon), and then they were going to "open [her] mouth and go SNIP SNIP, and then SEW SEW it up, and then they would be all done, and then [she] would get as many popsicles and as much ice cream as [she] want[s]!!!". I had tried to prepare her the best I could so she wouldn't be scared, and she did absolutely amazingly. She was not scared at all, and everyone was great with her. I got weak knees when they finally said it was time. We wheeled her little bed into the very intimidating operating room, where 8 people were bustling around getting ready. They showed her her "warm PINK bed with a princess pillow" (translation: operating platform with pink heated sheets and circular head cushion), and she was afraid, and only wanted me to help her onto the bed and "tuck her in". The doctors showed her where the pink balloon was and now her pink mask was attached to a hose and the balloon. She only wanted me to hold the mask, the pink strawberry mask, to her face (at this point, it was clear that had I not been there, she would have been terrified and traumatized by the strangers forcing her do these things). They asked if she could blow up the balloon? And she blew it up and we all cheered. And then they turned on the gas, and she kept playing the game, blowing up the balloon. Except now she was being gassed (this is the point where I blinked back tears). Oh, how I felt terrible for that deception (and also glad I didn't stay to watch her get intubated so she could breathe in spite of the bleeding during the procedure and stuck with an IV). Her eyes started rolling back, and she clumsily kept trying to play the game that she probably couldn't quite remember, and then she was out. I was told to leave, and they said they would come get me and I would be there when she woke up. They told Gillian that too to soothe her. She verified it with me three times. And I always said "yep, I'll be RIGHT HERE".
So, it was the longest 45 minutes of my life (aside from the longest 7 days of my life when she had the staph infection in the NICU and was fighting for her life), and I prayed and I prayed and I prayed. And I waited. Finally the doctor came and told me everything went great and that I would be summoned shortly to go to recovery. Gillian would be observed for an hour or so while they monitor her vitals before being sent down to post-op for ice cream and IV removal. About 10 minutes later one of the other docs came and brought me to her. I walked into the room where about 10 people were resting post-op and heard her screaming. They didn't get me there in time. I wasn't at her bedside when she woke up like I promised. Like they promised ME. But my promises are more important, and I don't make them lightly. Four people were holding her down. In her confusion, she didn't know where she was or who she was surrounded by. I am still sad thinking about how alone and abandoned she felt. I ran to her and got in her face and told her I was here. She kept crying "where were you? you said you would be here!!". The doctor assured me she wouldn't remember I wasn't there. I corrected her, and told her she absolutely would remember-that she remembers EVERYTHING. She said statistically, 95% if patients don't remember the first 15 minutes of wakefulness after surgery. I told her MY CHILD would be among the 5% that do (and she absolutely does remember, by the way). Finally, she calmed down and they gave her some IV pain meds, and they brought me a big lounge chair to hold her on, and we navigated wires, and I was reminded of her godforsaken isolette in the NICU and navigating all those wires, and I had a moment. It even smelled the same.

My baby rested on my chest, just the same as before. I was so glad I was there, and so glad she was ok. Her tongue bothered her the most, it seemed. It was grotesquely swollen where the instrument that held her mouth wide open had been-it sliced her tongue. It looked awful. The nurse brought her a latex glove filled with ice chips to suck on. That and the narcotic took the edge off. After an hour, we went back up where we started for ice cream to see how she did with eating before they took the IV out. She was out of it and sleepy but she did fine.

We headed home 6 hours after we got there. I hadn't had any food or water all day, so I was ravenous and treated myself to donuts and coffee since Gillian was out cold in the back seat. I stopped and filled prescriptions for a steroid for swelling, an antibiotic to ward off infection, and Tylenol with codeine for pain. I took her home and she slept most of the afternoon. She woke up for ice cream and to watch a Disney princess movie and went back to bed (loathe to miss an opportunity to get things done, I was painting our newly installed fireplace and shelves like a madwoman during this time).

In the days that followed, we just kept her dosed with regular strength Tylenol and Motrin during the day and the Tylenol-codeine at night. I immediately noticed that she slept with her mouth shut, and I had to strain to hear her soft breathing. No more struggling for air. No more snoring. No more gasping for breath. No more nightmares. Immediately. The doctor said although her tonsils were enlarged, her adenoids were big enough to block her nasal passage, so we made the right decision to remove them both.

In retrospect, I can't help but feel like she lost some of her innocence that day. Every time the big world intrudes on her safe space it seems like it takes something away. I can't forget how she was almost excited about the whole thing, and what the reality was. Or how she was led to believe the mask and balloon were a game-fun. And I get this sick feeling that kids are victimized every day because of that innocence-that believing what we tell them because they aren't crafty enough to think we have ulterior motives. And I disappointed her and wasn't there when she needed me to be. Not my fault in any way, but I wish I had pushed the point that I wanted-NEEDED to be there when she woke up. At least now she has a story to tell. And we are proud of how brave she was and how little she has complained about the whole thing (drama queen that she is, that is amazing in itself). So, that is our story of how Gillian had her tonsils and adenoids removed.