Sarah's Surgery

We're four days post-op, and Sarah is doing well!  I wanted to take some time to decompress from the last few days and to write down all that's happened so I can remember it.  I wrote about Sarah's surgery a few weeks ago, so you can learn more there as well.

Back in December we saw an ENT in Springfield for Sarah's recurring ear infections, and he suggested that Sarah get ear tubes and an adenoidectomy.  We thought that Sarah's anti-reflux surgery could be a good time to do these other two procedures, so on Thursday, January 18 we went to an ENT in St. Louis.  Initially we were disappointed that we drove all the way there because immediately he said his threshold for doing this surgery is six ear infections in a year, and Sarah only had four.  We thought we'd totally wasted our day, but while we were there I decided to ask him about Sarah's "leaky" eyes.  He said that's an ophthalmology issue, and he suggested that we go down one floor straight to the eye center and request an appointment.  The scheduler was able to get us an appointment for the next Wednesday, one day before Sarah's surgery, with the promise that if Sarah needed something done that they could do it the next day.

Robert's dad, Ray, came up to visit us on Monday and stayed with us until it was time to go to St. Louis.  We all road together, and it was so nice to have an extra adult in the car with Sarah.  The drive went well, and we only had to stop twice.  We ate lunch at Imo's Pizza, and then he dropped us off at the hospital.  While at lunch I got a call from Haven House saying that Robert, Sarah, and I could stay the night with them for free!  I had applied with Ronald McDonald house a week before and hadn't heard anything, so this was definitely last minute and totally a huge blessing!

At 2:00pm on Wednesday we met with an optometrist named Dr. Timmerman.  She was so incredibly sweet and awesome with Sarah.  She seemed like she was about my age or maybe just a bit older.  She listened to me tell her about how Sarah's eyes had been tearing and dripping since she was two weeks old.  She did a full eye exam and dialated her eyes.  Once she did the dialation eye drops we got to go to a play room for half an hour.  It was great!  Two story slide, tons of toys, and Sarah got to pick out a sucker.  We went back to Dr. Timmerman.  She said Sarah is far-sighted but that she compensates well and could grow out of it during her early elementary years.  She diagnosed Sarah with nasolacrimal duct obstruction.  Basically, hear tear duct was clogged and too narrow so tears couldn't properly drain.  This effects 5% of infants, but it spontaneously clears up in 90% of those children during the first year of life, so I guess mathematically that would mean that only 0.045% of children still have obstructed ducts after one year of life like Sarah, so I guess you could say it's fairly rare.  Since Dr. Timmerman is an optometrist she couldn't do the surgery.  She said Dr. Leuder the ophthamalagist would need to do it.  He was scheduled to be doing clinicals with his students at Washington University in St. Louis on Thursday.  His scheduler, Rhonda, pulled some major strings, and Dr. Leuder had compassion for us and totally rearranged his schedule so he could do the probing in conjunction with Sarah's bilateral ureteral reimplantation.  Praise God!!!  For the surgery, Dr. Leuder would take a probe down Sarah's inner eye tear duct and clear out the duct with pressure and grinding around the probe.

Dialated eyes

We loved all the cats in the hospital

After our appointment we walked to a park nearby, and Sarah actually fell asleep on the walk.  We just sat down on a park bench, and Sarah napped for half an hour.  Then we met up with Robert's mom, and she took us to Haven House.  This place was such a blessing!  We got to stay there for free and have dinner and breakfast the next day.  Serina ate dinner with us there, and then we went to the play room and craft room.  Serina and I went and got ice cream for us all, and we enjoyed it in our room.  Serina gave Sarah a bath because she was supposed to get all cleaned up in preparation for her surgery.  Serina headed back to her hotel that was attached to the hospital, and Robert, Sarah, and I settled in for a terrible night of sleep.  We had a queen bed and two twin beds.  We never share a room with Sarah, so we expected a bad night of sleep.  While trying to fall asleep Sarah asked, "Umm...I was just wondering, when are we going to the beach to get seashells?"  I think she thought we were on vacation.  Another time she came over to me and said, "Daddy isn't talking to me.  Can you open his eyes?"  She eventually fell asleep in bed with me from 10:00-2:00, but we were all awake after that.  I got to take a nap for an hour, and Robert and Sarah napped for 30 minutes, but other than that we were up for the day.  Sarah couldn't eat anything, so at 7:00 we gave her apple juice, and after that she didn't get anything to eat or drink until after surgery.  Robert and I took turns going to breakfast so she wouldn't have to see us eat. 

Napping in the park

Playing at Haven House

Crafts at Haven House

Ice cream for her last food before surgery

Robert's dad had stayed the night with a friend, and he came to Haven House at 8:00 to pick us up to go to the hospital.  Sarah fell asleep on the way to the hospital and slept in the parking garage for 45 minutes which was nice.  We went into the hospital to meet Serina and checked in for pre-op at 9:45.  Robert, Sarah, and I went back with Nurse Luci, and she did things like take Sarah's height and weight, blood pressure, and temperature.  A variety of doctors and nurses came in and out.  I think we saw a doctor and nurse for ophthalmology, urology, and anesthesia.  Sarah got to play with a mask like the one they would use to put her to sleep.  It was strawberry scented which she liked.  She put on fish pajamas and socks.  We had some time to kill so we went to the play room in pre-op.  The hospital had play rooms everywhere you turned which was really nice.  While we were in the play room our good friend and worship minister Derick showed up.  What a cool surprise!  He and Robert got to talk while I met Dr. Coplen the urologist for the first time.  He was so kind.  I learned that Sarah's condition is even more rare than I had realized.  VUR effects about 10% of children, but that's for every grade of reflux, 1-5.  Most of those kids have a 1 or 2 and grow out of it.  I know that Dr. Coplen is only 1 of 150 people in the world with his certifications.  St. Louis Children's Hospital serves all of the midwest, and he's the only one who does this particular surgery in the area, and he said he only has to do this surgery ONE or TWO times a month!!!  I couldn't believe it.  It made me wonder if Sarah could be the first person ever needing bilateral ureteral reimplantation and nasolacrimal duct surgery at the same time.  Surely, right?  I asked Dr. Coplen, and he said if we have future biological children that he can pretty much guarantee that he or she would have some grade of VUR.  He said it's most common in people with blond hair, blue eyes, and fair skin.  It actually made me kind of surprised that I didn't suffer from it. 

We went back to the pre-op room with Dr. Coplen, and he went over Sarah's ultrasounds and x-rays again.  Sarah kept talking about poop with everyone she saw.  She told Dr. Coplen that she doesn't like bladders, and he said, "You're more of a poop girl, huh?"  My friend Jen's parents live in STL, and they came to visit us and brought a teddy bear and blanket.  Such a sweet surprise!  Derick and Jen's parents ended up staying through all of the surgery.  20 minutes before the surgery they gave Sarah some medicine to help her relax so she wouldn't be as nervous about going off to surgery.  It made her very loopy and relaxed.  She was entertained playing with Serina's arm and Robert's beard.  We carried Sarah to the final door and said goodbye.  Robert and I stayed in pre-op for half an hour, and then Dr. Leuder came out to tell us the surgery was successful.  He said Sarah's right duct was actually more clogged even though her left eye looked more teary which happens occasionally but is very uncommon.  His nurse gave us instructions for caring for Sarah.  We're doing a thick eye drop daily for a week, and we never did end up needing to use the nasal spray to prevent nose bleeds.  Her eyes look so clear now!

We went back to the waiting area to join up with the other five and all went down to lunch.  I didn't want to leave the area, but the front desk worker had my phone number if they needed anything.  Eating lunch and talking kept my mind off of things.  We went back up stairs and only had to wait maybe another hour.  Dr. Coplen came out and told us the surgery was successful with no complications.  Her vitals had stayed stable the whole time.  He closed the incision by stitching underneath the skin and putting dermabond on top.  It looks really good! 

Half an hour later we got to see Sarah in recovery.  She was still very asleep, more so than I had expected.  She cried out in pain a few times as she was waking up, so I just snuggled her.  Nurse Sarah took us upstairs to her room.  Because it's flu season, the hospital has been backed to capacity and Sarah had to get a roommate.  The roommate had already arrived and definitely got the bigger half of the room with a couch.  Our side was pretty microscopic.  The roommate was crying a lot at first as she had just had ear tubes, adenoids removed, eye surgery, and tonsils removed.  She calmed down some, and the family was nice.  As Sarah was starting to wake up I was telling her I love her, and her first words were, "I love you, too."  So precious!  Her voice was very scratchy from the breathing tube during surgery.  She also hated the IV and catheter and asked to take them out a lot.  They had trouble getting an IV in for surgery and had had to try three times.  She had dried blood in her hair from the surgery which was kind of pitiful.  The first evening was kind of a blur, but I know at one point Ray and Serina left to get us food, and I know that I spent some time watching Sesame Street with Sarah.  We got to meet Dr. Coplen's resident, Dr. Song, who had helped with the surgery.  He was incredibly nice.

Our tiny half of the room

On Wednesday Sarah had asked that her first meal be Cheerios, and that's what she got and enjoyed when she wanted to eat.  She was good at drinking water which made me happy.  Since we had a shared room the staff said only one parent could stay the night which was for the best because there really wasn't room for a second person.  We decided Robert would stay the night because he can sleep through bad conditions more easily.  I said good night around 8:30 and went back to the hotel with Serina.  Robert and Sarah had a good night, all things considered.  As good of a night as you can when you're being checked every two hours. 

Robert called at 5:30 on Friday morning saying that Sarah wanted me.  When I got there at 5:45 she had fallen back asleep and slept for two hours.  Serina and I went down to the cafeteria to get breakfast.  At 6:30 Dr. Song came by and took out her catheter.  Sarah was so glad!  She peed on the potty three times in the first hour.  It was painful for her because every time she needs to pee her bladder has a muscle spasm.  Her pee had blood in it and still does which is normal for the first week.  When Dr. Coplen came by at 8:00 to check on Sarah she had just peed on me so he said he'd come back at 12:00 to check on her.  We were really bummed because we wanted to leave and go home as soon as we could.  After he left we got Sarah a "ticket to ride" as they call it and pushed her around in a wagon and took her to the play room.  We got back to the room and Dr. Song came by again.  We told him we thought we were ready to go.  He said he'd call Dr. Coplen and ask if he could discharge her.  Just a bit later they both came by.  That really made me happy!  They discharged Sarah, and within half an hour they were taking out the IV.  Sarah got nervous last minute because the tape hurt when it was getting peeled off, but she was glad to have out the IV.

We wheeled Sarah out to the car in her wagon.  I picked up a muscle spasm medicine and a pain killer at the hospital pharmacy, but Sarah hasn't needed them.  So thankful!  Even since the first day Sarah has only needed Tylenol and Motrin to manage the pain.  Who else could have an abdominal incision and eye surgery and only need OTC pain relief?  Wow! 

Happy girl with her tots

I had been nervous about the drive home, thinking that the car seat would be uncomfortable, but it went really well!  She slept for an hour and a half, and then we stopped for lunch at Steak n Shake.  While we were there Sarah asked to walk around which was her first time to walk.  She enjoyed saying hi to other guests.  The last two hours of the drive home Sarah was awake and happy.  When we got home Ray headed out, and we had about an hour before my parents got to our house.  The three of us all took a nap together.  My parents got here, and the second she woke up she told her Grandpa, "I need my Andy's ice cream!"  He had promised it to her before surgery. :)  We ate dinner together and did lots of holding and snuggling the first evening.  My parents spent the night, and I'm so glad.  We tucked Sarah at 8:00.  She went to sleep well.  I had set my alarm for 1:15 to give her more medicine.  When I went in to wake her up she was burning up.  I took her temp in her armpit and it was 101.4 which is like 102.4 in your mouth.  I woke up everybody and was kind of freaking out.  I called the 24 hour urology nurse line, and two minutes later Dr. Song called me.  He said to let the Tylenol and Ibuprofen work for an hour and take her temp again.  Half an hour later she threw up all over Grandma, but 30 minutes after that her fever was almost gone.  Dr. Song called me back at 8:00am and asked how Sarah was doing.  She had taken a couple of little naps after throwing up but hadn't slept a lot, but I told him the fever was gone.  He said sometimes people get fevers after surgery, but that as along as it goes down it's okay.  He also said she probably threw up because she had Ibuprofen on an empty stomach.  There's still a chance of a UTI the next few weeks as her ureters heal, so that's why we really need to keep an eye on the fever to make sure it isn't indicating a UTI.

 Saturday we all hung around the house.  Sarah mostly wanted to be with Grandma, so Robert and Dad went grocery shopping, and I picked up and did laundry.  Saturday evening my dad went home so he could go to church on Sunday.  Saturday night was quite a bit better.  She woke up twice but didn't have a fever or sickness.

Quick ride up and down the street to get some fresh air

On Sunday we stayed home and watched church online.  My dad came back over after church, and then Robert went up to church in the afternoon for student activities.  Dad left after dinner, and Mom spent the night again.  Sunday night was really good.  Sarah slept from 8:00pm-8:00am with one wake-up from 10:00-11:00.

Robert went back to work today.  Sarah's appetite came back yesterday I'd say.  She's still wearing a diaper just because she's peeing so often as she heals, and she can't hold it well.  It seems to comfort her to know she won't be having an accident.  My dad came over after work today for a bit, and he and my mom just left.  I want my mommy! :)  Sarah really is doing well, but it's been so great to have them here.  We're supposed to stay in away from other people for the first week.  We don't want other children to accidentally injure Sarah. 

As far as recovery goes, bladder spasms should be done soon.  She should be feeling like herself in the next few days.  The stitches and glue are starting to dissolve and should be gone in the next week or so.  She has a renal ultrasound on February 16, and a post-op appointment with Dr. Coplen on February 19.  Both are in Springfield which is fantastic!  At the appointment we hope to get the all clear so we can stop giving Sarah her daily medicine.

Through this whole experience I have been so thankful for the support of our friends and family.  They have been so thoughtful through praying for us, bringing Sarah gifts, giving us food, and checking on us.  We're thankful that Sarah could have these two surgeries to get her healthy and improve her quality of life.  We're thankful that she made it through the surgery well.  We had such great medical care.  The doctors are excellent and kind.  Besides Sarah's health, I'm most thankful for the peace and calm that I felt during Sarah's surgery and hospital stay.  I had been concerned that I would be very anxious and a nervous wreck the whole time, and I know that the peace came from the Holy Spirit.

Thank you very much for your love and support!