Surgery Day: Wednesday....
We were up bright and early to make it to the hospital by 6:30am. Luckily Grandpa Cliff and Grandma Diane came the night before, so they got to sleep in until Sylvie woke up later that morning. Mary was allowed one cup of clear fluids up until 7:30am, which included apple juice. We registered at the hospital and were in the surgery waiting room by 7:00.
This time around we put the Emla numbing cream on both of Mary's hands before leaving the house (to make the IV insertion less painful), as last time the nursing staff forgot until just before her surgery. We meet briefly with the operating nurse who went over Mary's particulars and then we changed Mary into some unflattering yellow pj's and went into a new waiting room. The anesthesiologist, two plastic surgeons and operating room nurses meet us in the waiting room and discussed their plan for the morning surgery. The anesthesiologist was the same one who was present at her first surgery, and he gave permission for Mama to take Mary to the operating room and stay under she was under. Mary was a bit more apprehensive going into the operating room this time around but did not cry. Mama sang to her and rubbed her tummy while the IV was inserted. Mary did not enjoy having the mask placed over her face, but overall cooperated with the nurses. She was under quickly and I gave her a quick kiss good bye before leaving the operating room.
Cory and I then went to grab a quick breakfast at the hospital, as the surgery was scheduled to take about one and half to two hours. Afterwards we spent time pacing in the waiting room until the plastic surgeons were finished. Dr. V came out to talk with us and told us everything went really well. We asked when we would know that the surgery was successful in staying together and he said at one week we could be reassured. (It is very rare for the lip surgery to dehiss, but we were not taking any chances this time). Mary was in recovery, and we were told to wait upstairs in the Peds ward for her to be transferred.
Luckily we were able to wait in Mary's room for her. There was another patient but thankfully they were being released shortly. We were able to get all Mary's toys set up and movies ready before she arrived. We were also allowed to have a bed this time around instead of a crib, but needed to sign a waiver form to sign as Mary is not yet three years old.
Mary was rolled into her room just after 11:30 in a rolling crib. She was lying on her side an had tears in her eyes but was not screaming and hollering like last time. The nurse told me she was asking for Mama as they were wheeling her down the hall. As much as it hurt to see her in pain, I was so happy that she recognized us and wanted us to hold her. When she came out of surgery the first time in January, it was a truly awful experience for the first hour together, she did not know us, and was fighting to escape - we had the bruises to prove it. I crawled into Mary's bed and the nurse lifted her down beside me, and Mary wanted desperately to snuggle into me. We were able to keep Mary on her side, but had to make sure that her nose and mouth were not touching me, which was so hard as she wanted to snuggle. She did not want to face away from me either.
We asked about her pain management and they told us she received a morphine shot in the recovery room. We asked about a morphine drip, which is what she had the previous two surgeries and were told that was not ordered and they were only using Tylenol w/codeine now. We were surprised, but I guess that shows us to ask more specific questions next time and not to assume everything will be the same. Mary spent the afternoon dozing on and off with Mama on the bed. In the later afternoon her pain became quite bothersome to her and we asked the nurse to page the doctor. It was determined that we could also add ibuprofen as needed to help relieve her discomfort.
We remembered from our last hospital stay how much Mary liked riding around in the little race car. So Daddy went and grabbed it from the play room and we did a
hundred or so few laps around the Peds ward. You can also see the arm restraints the OT's came to make for Mary. These were to help ensure that she did not touch her mouth or nose during the first few days.
Mary loved the car so much that we ended up keeping it in our room for the next few days. Mary did not enjoy sitting in her hospital bed, even if it was elevated into a sitting position, so this was the perfect compromise.
Mama stayed the night at the hospital with Mary. She received her next dose of Tylenol with Codeine just before 8:00 and she drifted off to sleep. The nurses needed to check her vitals every four hours, which was also combined with her IV antibiotics and pain management. Overall Mary had a good night in the hospital for her first night. Mary was on a liquid diet today. She began drinking small amounts of apple juice in the later afternoon and even tried some milk. Overall she drank about 250 ml of apple juice.
Day One: Thursday...
snugglewraps.com/
The plastic surgeon Dr. W stopped by right before Mary's nap today to have a quick look at her. He felt she looked great and was happy with everything. He let us know that the plan would be to stay in the hospital for two more nights to ensure Mary had several doses of her IV antibiotics to ensure an infection would not develop in her surgery site.
Mary spent most of the day either in her little race car or in her bed. She needs to be hooked up to an IV to administer her antibiotics. This makes walking around a bit more challenging for her as we need to follow quickly behind her as her IV tubing was not very long. Since she was drinking so well, the nurses did reduce the amount of fluid dripping into her IV which helped to reduce her puffiness. Even though Mary was down one hand, she impressed us with her tenacity to still click her safety strap herself, no IV is going to slow her down!
Another food hit for Mary today were Popsicle bites, where Daddy would break the Popsicle into little pieces and we could pop them into her mouth. So far orange seems to be her favorite flavor.
Daddy spent the night with Mary tonight. Daddy reports that Mary had a good night, but needed to be flipped over onto her back every once and awhile (poor Mary is a stomach sleeper, this side and back sleeping is hard for her). We are still putting the arm restraints on her for nap times and bed times, but are leaving them off during the day when we are beside her. Mary is doing well with not touching her mouth or nose, but often wants to rub her eyes, which are dry from surgery. So we are reminding her to ask us and we are wiping them down with a warm cloth for her.
Day Two: Friday...
Mary's appetite has returned! Cory feed her breakfast this morning which consisted of oatmeal, yogurt, and applesauce along with a container of milk. We find that it is most easiest to feed her liquid/soft foods using a catheter syringe, which has a nice long tip on it to guide around her mouth incision. The catheter syringes work best with oatmeal, soups and other pureed foods. We use the 10 ml medicine syringes to feed Mary her applesauce and yogurt.
The big excitement today was the nurse deciding to cap Mary's IV. The needle still needed to stay in her hand so they could administer the IV antibiotics, but she didn't need to be attached to the pole anymore! Mary was so happy to walk freely around her room and the playroom. This made going to the bathroom so much easier too, so Mama was very happy as well. I think the nurses were happy too since we spent most of our time in the playroom or walking the halls which drained the battery on the IV machine which required them to reset the IV machine each time we returned to our room to plug it back in. By this time we were already on our second IV machine since we killed the battery on the first one. After being released from the IV pole, this is how Mary spent most of the day in the playroom...
Big sister Sylvie was able to visit with Grandpa Cliff and Grandma Diane. I think the girl's missed each other, but Mary certainly didn't miss having to share toys!
Riding around in the wagon was a big hit!
Day Three: Saturday...
Mama stayed last night with Mary again. Unfortunately Mary did not have a great night. The Peds ward was VERY noisy last night. There were quite a few new patients being added all night long, and many were on monitors, and the alarms continued to go off ALL NIGHT LONG. Every time the alarms would go off (we could still hear them in our room from next door, Mary would wake up crying. I stopped counting the number of times she was up crying after ten...at that point I think she was so tired that anything would wake her up, including the nurses coming in to check her vitals, which she used to sleep through before. It took me ten minutes of rocking and singing to her at midnight to get her calm enough to take her Tylenol with codeine and her IV antibiotics, and she is usually a rock star with taking medicine. The real bummer was being woken up at 5:30 am to change rooms. Unfortunately they needed a private room for another patient and we were moved down the hall to a room for four patients. I was glad we tidied up the room each night before bed, but it is still a bit disorientating to try to grab everything and move it when you are still half asleep. We forgot the camera in the bedside table drawer, but luckily it was still there later in the afternoon.
When the nurses came this morning at 8:00 to give Mary her last dose of IV antibiotics they discovered that her vein in her IV had collapsed, and the meant the antibiotics could not be pushed in. Since the nursing staff needed to call the doctor anyway to request oral antibiotics, I asked for them to inquire when we were going to be discharged, since today was the plan. We found out the surgeon gave us the ok to go home as soon as we wanted and he would call in the oral antibiotic prescription to our local pharmacy. I quickly called Cory and began packing and feeding Mary her breakfast. Cory was at the hospital by 9:00 and we were back home as a family of four by 10:30. Mary was happy to be home and immediately began playing with her toys.
Even though our last night in the hospital was not fun, we can't say enough about many of the nurses who helped take care of Mary. We were lucky enough to have some of the same nurses as our last stay and they were very excited to see Mary again. However, there is nothing like being at home...
