Saturday, August 20, 2011

Another Trip to the OR and Comfort from a Familiar Face

Yesterday Owen had surgery to remove the cholesteatoma, which was discovered mid-July, from his right ear. We had to be at the hospital downtown by 6am. My mom was going to be keeping Carter for the day and thought it would be easier (and would make Carter feel special) for him to have a sleepover there on Thursday night. He had fun and did well, except for right before bed when he was missing Owen. We got to the hospital and checked in at Outpatient Surgery Registration. This was Owen's eighth surgery, but only his second outpatient surgery. For the first outpatient surgery we had to check in on the pediatric floor, pre-op was a bit different this time.

Besides being worried about the surgery in general, wondering if the cholesteatoma would be attached to his eardrum and cause a more complicated surgery, I was anxious about how Owen would react to all of the pre-op activities. The last time he had surgery he was 18 months old. He was having surgery about every two months and had unfortunately become somewhat routine. We knew what to expect taking baby Owen to the hospital for surgery. This time we were taking almost-three-year-old Owen to the hospital for surgery. Our first obstacle was the fact that he was NPO after midnight. This of course was no different than previous surgeries, but now Owen requests his milk within seconds of opening his eyes in the morning. I was expecting this to be a serious problem, complete with a probable meltdown. Surprisingly he didn't start asking for milk until we had already been in pre-op for about half an hour. It certainly didn't help that two different nurses told him that he could have a Popsicle after surgery. How about we don't talk about food or drink to a toddler who is NPO. Thanks. The second obstacle that I had anticipated was Owen being tired/bored, as we would have to wait about 2 hours at the hospital before surgery. When we took baby Owen to the hospital before the sun came up we would scoop him out of his crib and deposit him into his car seat, where he would promptly drift back to dreamland. Not the case this time. He did however ride quietly almost the entire way to the hospital, possibly because he was asleep with his eyes open. He asked once why it was still dark out. Good question, Little Man.

Not too long into our wait in pre-op the anesthesiologist that was going to be taking care of Owen during the surgery came to introduce himself, ask us questions that we had already been asked at least five times, and answer any questions that we had. I recognized him as soon as he appeared inside the curtain of our section of the pre-op area. Dr. B had been the anesthesiologist during two of Owen's previous surgeries. He is my favorite anesthesiologist! Very nice, compassionate, always takes the time to make sure that we as parents are comfortable with the procedure and the anesthesia methods, and he is very pro-active in recovery. The two other surgeries that he was involved with happened to be the two surgeries after which Owen had a difficult time in recovery. Neither time were these issues Dr. B's fault. After his cleft lip repair he had breathing issues because he had a difficult time coming out of anesthesia and the intubation tube caused irritation to his airway. This is almost exactly what happened this time in recovery. It was great to have Dr. B there, having known what happened previously and acting quickly to improve the situation. The second surgery that he was involved with was Owen's bladder reconstruction surgery. He spiked a fever during that surgery and they had to use cooling blankets in the OR in order to be able to continue with the surgery. In recovery his temperature climbed as high as 103.8 degrees. As it turned out, they think he had gone into surgery with the start of a virus and that was the culprit. Dr. B remembered Owen and remembered us. He was very nice, commenting that he was so sorry to see Owen back for another surgery. He couldn't believe how big he had gotten, and pointed out that it is a lot easier to see the changes in a child when you aren't seeing them every two months.

Owen got his Versed (silly juice) at about 7:20. After about 7 minutes he was definitely acting quite silly. He had purple latex gloves on and was playing Dr. Owen while sitting on my lap. He found it all very funny. The nurse anethesist came to take him back to the OR at 7:44 and Wes and I went to the waiting room. After sending my baby back to the OR and sitting worrying in the waiting room eight times, it does not get one bit easier. Wes' dad came a little bit after 8 to sit and wait with us, which was very nice.

The surgery took about an hour and fifteen minutes. Dr. Gold, the surgeon came out to the waiting room and explained to us that the surgery went very well. The cholesteatoma was easily removed and was not attached to his ear drum, therefore none of the ear drum needed to be removed. It basically went as well as it could possibly have gone, for which we are extremely thankful. He said it was definitely a benign cholesteatoma, but it was sent to pathology for testing to be 100% sure. As I mentioned above, Owen had a difficult time coming out of anesthesia. He was very agitated, crying and disoriented. As soon as he was sufficiently awake he noticed the IV in his hand and got to work trying to rip it out. I informed the nurse that he would rip the IV out. Since he wasn't receiving anything through the IV it could be removed. As the nurse went to get supplies to remove it, Owen continued trying to pull it out even after we tried covering it in the hopes that he would forget about it. Dr. B came and noticed that O was having trouble breathing (his oxygen sats were still staying above 96) and sounded very raspy and croupy. He ordered a breathing treatment to help him breath easier, which allowed him to calm down a bit. Shortly after the breathing treatment he was falling asleep and then waking himself up each time he got upset. Since his vitals were good, the nurse paged Dr. B to come check him one more time. He gave us the go-ahead to take him home as soon as we felt comfortable. After deciding that part of the reason he was getting so worked up was that he was still in the hospital and still being disturbed by the activity there, we decided he was fine to go home. He fell asleep before we even left the parking lot and slept the whole way home. Within minutes of walking into the house Owen put on his man boots and a hat. He ate a great dinner and acted almost totally normal after a nice long nap.

Two doses of Motrin and a good night's sleep and he is pretty much back to his regular self today. A huge thank you to all of our family and friends who sent prayers and positive thoughts our way. We feel very blessed to have so many people who care about Owen and our family. We are also extremely fortunate that Owen has such wonderful doctors. In this case, it is wonderful that Dr. Bill caught the cholesteatoma while it was so small. That obviously played a huge part in the ease of removal.