Monday, November 14, 2011

Tonsils and Adenoids - Gone

First of all, I really want to say a giant THANK YOU for all of your tonsil and adenoid stories on my previous post. They were really, really helpful in letting me relax a bit and feel better about our decision to go ahead with the surgery for Eden.

Eden's T&A surgery was last Monday, Nov 7th, with a hospital arrival time of 1:45pm. This was our first shot at an afternoon surgery, and it definitely wasn't pleasant keeping her without any food or drink after 6:45am. Morning surgeries are definitely the way to go if you have a choice!

She and Holland both got a little weepy and emotional that morning as Holland was getting ready for school. They were feeling nervous, worried, and sad that they were going to "miss" each other, and we did have some tears. Once Holland was off, they each perked up and were fine until the drive to the hospital. Then Eden started to get all teary and emotional again, and I overheard her telling her doll "Pinkalicious" that she was afraid that she was going to die(!). That freaked me out a little - but I didn't show it. I just gave her a lot of reassurance that everything was going to be fine and it was no big deal - at the same time reassuring myself that this would be the case.

Once we were at the hospital and she had met the team of doctors she seemed to be feeling okay and didn't cry at all as they took her back for the surgery. We asked to be brought back to recovery ASAP because we were worried about how she would be waking up without her hearing (cochlear implant). She wouldn't be able to hear what they were saying, and we didn't want her to be afraid.

The surgeon was unable to do a "typical" T&A with Eden because the use of cautery (or anything electro/magnetic) during surgery can interfere with the internal component of her cochlear implant. Instead, they did what they called a "completely cold" procedure and we chose an ENT who has experience specifically doing the T&A on kids with cochlear implants. My understanding is that with this type of procedure there in increased risk of bleeding during surgery, but maybe less pain in long-term recovery. We asked to be kept overnight for observation (to watch for bleeding and to keep her hydrated), and they agreed to keep her.

The surgery itself took less than an hour, and we were brought back right away. The hour following was by FAR the worst part of the whole experience. She had a very difficult time coming out of the anesthesia, felt sick to her stomach, and was literally writhing in pain. At the same time she was figuring out that it was painful to swallow, breathe, and talk. It was awful to see and brought back a whole flood of memories and emotions. Once we finally got the right amount of pain medication on board and I picked her up and cuddled with her in the rocking chair, she was able to relax.

Four hours later they wanted to wake her up and start her on oral pain meds so she could "prove she could take them." Since we were staying overnight on an IV, I insisted that that first dose post-recovery be given in her IV, and that she be allowed to sleep. (This is where all of our NICU/hospital/surgery veteran experience proves handy;)) We agreed to wake her after a good 8 hour stretch of sleep to start the oral meds. This was the 2nd worst part of the experience. I got them in her, but it wasn't fun. Luckily it got easier each time. Even though the medicine was disgusting and she hated it, we were at least able to reason with her (and have a tasty drink handy to help her wash it down).

This surgery was done at our local University hospital, rather than at the hospital where we spent plenty of time in the NICU and pediatric unit, so it was a bit of a foreign environment. We had to share a room rather than having our own space. As (bad) luck would have it, the girl in the bed next to Eden was moved out at 10:00 pm. At approximately 2am a parade of people began coming in the clean the room, move furniture around, and bring in a new patient. The best part was when I woke up to see them actually taking off the foot of Eden's bed and PUTTING IT ON THE BED so they could move the other bed out of the room. Insane. I seriously think someone should do a Saturday Night Live skit about what it is like to "sleep" overnight in the hospital. It should start with a doctor telling a patient to make sure they get enough rest so they are able to heal..... I got a combined total of about 2 hours of seriously disrupted sleep. I finally just resigned myself to staying awake because it was less painful. Lucky for us (and for them), Eden is deaf and wasn't bothered at all by the noise. Between that, and the fact that it was just one night, I was able to find the humor in the situation and let it go.

At 5am the morning following surgery Eden woke up saying she was hungry and proceeded to eat a whole cup of vanilla hospital ice cream before falling back asleep. By 8:30am she was asking for scrambled eggs and french toast. One of my biggest concerns going into this was regarding weight loss and regression in eating, and I am happy to report that this really has not been a problem.

Another thing I stressed about was the expected "voice change." Eden has always had a really soft voice, and I was concerned that any additional muscle weakness resulting from the surgery would make her voice even softer and more difficult to understand. This hasn't been the case. Her voice is definitely different...maybe a little more nasally and a little bit "funny" sounding, but she is still intelligible and maybe even a little louder?? It will be interesting to see how this goes as she heals.

On the pain scale with the faces, Eden was rating her pain at 10 the first day. We were down to 8 by day 2 (between medicine doses), 4 by day 3, and 1 or 2 by day 4. At day 5 she told us she was a 0 and we weaned her off of the Lortab (vicodin) and onto straight Tylenol. Yesterday we increased the time span between doses to 6-8 hours, and quit waking her up at night for meds.

During the very first night I could hear an improvement in Eden's breathing during sleep...even with all of the swelling and gunkiness in her throat. The past couple of nights she is SO silent when she sleeps that we have to get really close to her to make sure she is still breathing! This alone is a great relief. We are very hopeful that this winter will bring fewer throat infections, less sickness overall, and an easier recovery when she does get sick. Only time will tell.

Today Eden went back to school. It was so nice this morning to walk her in and to hear all of her little friends exclaiming, "Eden's back!" They all smiled, waved, said hello, and a few came up to give her high fives. The best part was the huge smile on her face when she realized that she had been missed, and that everyone was happy she was back!


Anonymous said...

What a relief! Glad she's back at school. Good luck!

Shosh said...

wow! glad it went well! my son had this surgery when he was 3. the waking up from anesthesia was the WORST! he was literally inconsolable for 45 minutes. screaming and crying and nothing could calm him down. once that was over, he recovered very quickly. i think that many kids have a hard time waking up from anesthesia.

katie said...

Glad the surgery went well for her!

Heather said...

I'm glad her surgery went well. Zack had his out at about 2 1/2 and the week following was awful because he hurt and didn't want to drink or eat anything. So glad to hear Eden's recovery was much better.

Lori said...

I hope you have the same luck we did after our son's tonsilectomy. He had absolutely no virus illnesses for 4 years following! He's been relatively virus free and is now 21!

Anonymous said...

I'm so glad it all went well! I cried a little reading the post when she arrived back at school and realized she'd been missed. Best wishes :)

Sara said...

Oh good! I'm so glad that it's over with and that she had a great welcome back to school. How lovely!

MissEm said...

So glad the surgery went well. It was interesting to read that her surgery was done differently due to her cochlear implant.

All my kiddies have had TAG's (Tonsils, adenoids and grommets)I always found that first 7-10 days pretty tough but the change has been incredible on so many levels, eating, breathing, sleeping and of course no more nasty tonsilitis. So I am super glad they are gone!

I hope that Eden has a better winter with a lot less illnessx

Sarah Pope said...

I know you must be relieved that the surgery went well. No joke that hospitals are the WORST place to sleep (and good for you about standing up for what you know is right for Eden. I swear medical professionals don't always 'get it.') I'm glad she is doing so much better.