Tuesday, May 12, 2009

The Surgery

Aleks was so excited about his surgery (and his promised toy after - not to reward, but as a "I'm sorry, this sucks, let's lavish you because you deserve it after such a rough go") that he couldn't sleep Sunday night. He went to bed earlier than usual, then woke up sometime between 2 and 4 in the morning. His dad, who has chronic, awful insomnia, was of course still awake, so they played video games until it was time to go. Our neighbor was supposed to come watch Bastian while we all went, but since Jon had gotten no sleep, we opted to have Jon stay home instead while I took Aleks alone. This worked out fine.

Driving in the dark, the moon waning moon glowed blurry before us as we made our way through early morning traffic, down the hill, past the maze of hospital buildings to the last parking lot on Carnegie. Our other neighbor let us borrow his ID badge so we could get free parking for the day (which it turned out we didn't need for a surgery, just doctor's visits). We parked on Floor 2, Bird aisle and walked to the surgical center, asking employees on the way how the hell to get to where we were going. Then we checked in and waited. We spent a lot of time waiting. Well, mostly I waited, but Aleks did a bit too. He got to entertain himself by drawing, whereas I was anxious and had trouble reading Return of the King and writing about my breasts for the "anti-Vagina Monologues" feminist theatre production I'm participating in. As he usually does when we have to wait, he drew pictures of monsters and aliens and robots and dragons for all the staff.Monster, tank?, and Reaper.
I waited.
He waited. And watched Transformers and Bakugan Battle Brawlers on TV.
The staff meandered about, waiting, filling out paperwork...
We waited. And watched.

Then we got Aleks dressed in his gown and he was given a preoperative sedative. It quickly took effect and his usual goofiness was multiplied exponentially. I got a call to go talk to the dentist and left Aleks with a nurse for a minute. While I was gone, he bumped his head on the bed rail. Nice.
After awhile, we were lead back to the OR where I got to watch Aleks be put to sleep. His last surgery was when he was 3 years old. It was also an ear tube placement and he was given a sedative and put to sleep with gas in the same way as this surgery. The difference was in his reaction.

At the last surgery, we had not had the opportunity to meet all the nurses beforehand, so when we got to the OR, the room was buzzing with activity as everyone got things prepared. Aleks chose a flavor for his gas mask (which seems to be flavored lip glass they rub on the inside - I had always thought they actually flavored the gas), then they laid him down, put monitors on his chest, a blood pressure cuff on his arm, and when the mask came down over his face the anesthesiologist was singing "Twinkle Twinkle Little Star" rapidly and unconvincingly. The whole room was chattering with conversation and noise and machines. Just as the gas flowed out of the mask and Aleks took his first inhalation, his eyes widened in panic at the feel of drowning. I moved to stop them, to protect him as terror suddenly and unexpectedly gripped me. The anesthesiologist assured me his reaction was normal and continued singing. And he was out.

It lasted but a split second, but the fear in his eyes was something I can never forget. He didn't remember it at all and did fine with the surgery, but the moment has haunted me. I thought it was normal and that scared me a bit. I was prepared for the same thing to happen this time.

But, thank goodness, it didn't. Aleks breathed shallowly into the mask and smiled the whole way through, his goofiness shining through (or being hopped up on goofballs - whichever), until he finally got enough to fall asleep calmly and without fear. There was no overwhelming sensation of drowning by having taken too deep a breath in. I was thankful for it.

Once he was asleep, I went back to the waiting room, sat for a minute, then went to find some breakfast. Our plastic surgeon was eating a few tables down from me, but I didn't say hello. He was deep in some conversation with other doctors about maxofilliosomethingorother. I read the section of Return of the King where Eowyn sleighs the lord of the Nazgul, enjoyed my terrible McDonald's breakfast, then sent text messages to all those waiting to hear about Aleks.

When I returned to the waiting room, the otolaryngologist came out almost immediately to tell me he was finished. It's super quick to install ear tubes. He used T tubes this time, so they may last slightly longer than the last set did. There was lots of fluid in Aleks' ears and the drums were retracting. I could tell that he had lost some of his hearing lately and looked forward to knowing that he was simply ignoring me for the sake of ignoring me rather than not hearing me at all.

I read some more, texted people, called Anna, and then was visited by the dentist, done with his portion of the surgery. The two teeth came out easily without cutting and he placed one stitch to help the bleeding. They should heal over completely in a week and be of little trouble at all. By month's end, his mouth will be entirely ready to be messed with again for the installation of his palatal extender, in preparation for the biggest surgery: a bone graft for his gum and hard palate. The bone will be taken from his hip. He'll have to wear the extender for 6 months to a year first, though.

After the dentist took off, I waited anxiously to be paged to go to recovery. They took their sweet time. It was about 30 minutes before I got called back. They said he had woken up in the OR, but he was asleep in recovery. Very asleep.
I read the surgical notes later and it turned out that his "waking up" in the OR had just been his raising his head for five seconds. He didn't look like he'd woken up at all. There was blood on his mouth and just inside his ears, but it was just slight.
A bag on the bed held a jar with his two teeth and a dollar, apparently from the Tooth Fairy. Aleks was later convinced that he should put the teeth under his pillow to get the additional dollar he'd been shortchanged.
He slept for an hour, at least. I pat his back and texted more and read more, but mostly waited impatiently for him to wake up. I started to get exhausted from having so little sleep as well. Finally, he awoke. He said his lips felt weird and asked the time repeatedly. I knew that the time wouldn't much matter to him though as he'd have nothing to relate it to. I looked at the surgical notes to find out how long he'd slept - it was about 2 hours and twenty minutes total. Then he had a popsicle.
His poor little hand was taped up with his IV. His thumb glowed red with the pulseoximeter,
though they said it was like Rudolph.
Finally, we took all the tape and tubes and wires off and got Aleks ready to go home.
He got an escort and a ride back to the car.
Afterward, we had to go to Toys R' Us to buy the Lego Indiana Jones Temple of the Crystal Skull. We got Bastian a bike helmet and a snorkle, both of which he needed. By the time we got home, I was ready to crash.
Aleks and his dad spent the afternoon working on building the new Lego set.
Aleks' recovery was excellent. He was in no pain and decided on his own to eat solid food, which knocked his one stitch out, so he pulled it out to little effect. He does not like his ear drops as they tickle, but he only needs them for three days. He played outside in the late afternoon and was visited by Heather and Steve and our upstairs neighbor. He showed everyone the completed Temple and all the fun stuff it does. He's doing awesome. All the well-wishes are much appreciated and went to good use.


Mel said...

so glad everything went okay...kids are just so freakin' resilient, aren't they?

Is it wrong for me to wonder what my kids would be like with that giggle-juice they gave him? Oh, but that was funny....*grin*

Julie said...

Good to hear everything went fine:) In some ways I think it's harder on the parents. Damek has had 2 procedures done (one for his GERD at 10 months old and some extensive dental procedures last summer), and I swear I was going to have an anxiety attack before we even got into the dentist office. I had explained everything to him beforehand, and he seemed fine with it all, and still talks about it as if it were no big deal.

anna kiss said...

This all started for us a long time ago. I feel entirely practical about all of it. The first year was hard and I just functioned. I'm very matter-of-fact about it all though. I don't know if I'm protecting myself or what. I feel most of my sadness and anxiety outside of these events though, totally disconnected from it. I mostly just feel bad that this is Aleks' life. It makes my brain's heart sink. Sometimes I feel like I'm not questioning enough or protecting him enough because I'm so practical about it. Maybe I'm not. I don't know. But I feel mostly fine, as though it were no big deal. Except when I don't, which is rarely when I'm in a waiting room.

I got anxious waiting this time because a lot of people we know have died recently and I feel vulnerable. I just wanted to know he was okay. I'm not usually even like that though. It's weird, I guess.

Anonymous said...

Hey Anna
I just wanted to share with you that I has surgery when I was 15 and again at 18 and they used the mask and I just remember both times just being very surprised that the gas hit so fast. I expected to breathe and feel myself fall asleep but it felt almost instant! Maybe that look you saw was surprise not fear? Of course you know your son best, and I'm glad that he does not remember, and glad everything went well.
Thanks for writing, I enjoy your blog!
Warmly, Marie (May-Lily)

Lynnie said...

Glad it's over and done with! That moment of his eyes widening when the anesthesia took hold at the last surgery sounds really awful. Glad it went smoother this time around. My younger daughter had to get an I.V. when she was 1 and the look of horror and betrayal on her face will always stay with me.

Oh, and his drawings are, as always, marvelous. You should make them into t-shirts!