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!

Sarah's Upcoming Surgery

A few weeks ago I wrote about all of our health battles we've been enduring.  I'm happy to say that I've gotten a custom mouth guard to wear at night and have noticed a great decrease in my discomfort.  So thankful!

On December 15 Sarah had her renal ultrasound and VCUG.  We had to wake her up at 6:30 which wasn't great, but she got moving quickly.  She wanted to leave on her pajamas which worked just fine.  We got to the radiology department at the hospital at 7:30.  My parents met us there which was very kind.  We didn't have to wait long which I was thankful for.  Sarah, Robert, and I went back to a small, dark room for the ultrasound.  She wasn't a huge fan, but she cooperated and stayed pretty quiet.  The ultrasound tech was nice and worked pretty quickly.  He checked out her bladder and kidneys and only took about five minutes.  When he was finished we waited in a different waiting room.  Sarah wanted my mom to come back and join us.  Shocking. ;)  They're two peas in a pod!

The room for the VCUG was much larger.  We'd been in it a year and a half ago, so I knew what to expect.  There were two radiology techs that got the area ready.  They had Sarah change into a hospital gown and gave her a doll that also had a hospital gown.  She got to take it home which was sweet.  Then a pediatric nurse came in and placed the catheter and emptied her bladder.  The placement of the catheter wasn't fun but not horrific.  She's had a catheter six times so it's sort of familiar.  My mom, Robert, and I were able to hold her hands and stay close to her face to talk and reassure here.  They lowered the x-ray machine, and her torso was basically in a tunnel.  Then the radiologist came in, and they started pushing the contrast dye.  That part was a bit uncomfortable, as you can imagine.  The radiologist watched a live feed of the x-ray, and we could see the monitor as well.  He watched her ureters and kidneys as her bladder filled, and the instant the contrast dye started up her left ureter started refluxing.  I was immediately disappointed.  Honestly, I had been hoping and praying so hard for 18 months that I just thought surely something would have improved.  I knew there weren't great odds, but I just had such high hopes.  After seeing the reflux I just switched my focus to soothing Sarah and cheering her on.  The left ureter continued to reflux, and then the right one started up two.  Both backed up into her kidneys.  The left ureter is just as misshapen as before.

So then they pulled out the catheter and needed her to pee to watch the reflux as her bladder emptied.  When she'd had the last test at 7 months old they just removed the catheter and she immediately started peeing, but since she's potty trained now I knew it wouldn't be that easy.  We'd talked about it beforehand.  "Sarah, the doctor is going to ask you to do a funny thing.  He's going to ask you to pee on the bed, and it's okay to do it this one time even though it seems strange."  She'd told people for days that she was going to pee on a bed, but unsurprisingly, when the moment came she wouldn't do it.  I really do understand.  I mean, I wouldn't want to pee on myself and then lay in it on a bed.  So she got squirmy and was crying because she had a super full bladder but didn't want to pee on the bed.  The kind nurses brought out a pink bedpan and called it a princess potty.  They held it under her, and she peed immediately.  I'm not sure why they didn't offer it to begin with, but at least it worked once it was offered.  She peed, and the radiologist noted that she continued to reflux as her bladder emptied.

Once she peed we got to clean her up and get dressed.  She got sent home with a diaper for her baby and lots of band-aids.  We went to Chick-Fil-A to let her celebrate her bravery.

As a reminder, or maybe just for your information in case you haven't become a novice urologist over the last year a half (haha), when a healthy person is processing urine, it goes from the kidneys, to the ureters, to the bladder, and out of your body through the urethra.  Sarah's goes to the bladder but then goes back up the ureters and into the kidneys while your bladder fills up.  Then when she pees some urine also goes up into the kidneys.  The urologist likened the urine being back in the kidneys to being like a pond with stagnate water or a pool without any chlorine.  So obviously, that's a prime environment for an infection to occur.  So that's how Sarah gets UTI's.  It has nothing to do with external factors like wiping wrong, sitting in diaper, or peeing in the bath tub (as some people have tried to suggest to me.  Uh, thanks?) The last year and a half she's been on a medicine that doesn't prevent reflux (no medicine can), so her body has been refluxing, but the medicine has been preventing infections.

Anyway, we went home happy that Sarah had been so brave and didn't seem to be permanently traumatized from the day but also fairly disappointed that we didn't have better initial results.

Three days later on Monday, December 18 we saw the pediatric urology nurse practitioner.  Springfield doesn't have a pediatric urologist so a team comes down from the St. Louis Children's Hospital once a month.  From my understanding, the doctor comes down to do outpatient procedures, and the nurse takes the office visits.  So we've seen nurse practitioner Mary both times now.  She confirmed what we suspected - grade III for her right and grade IV for her left - just like a year and a half ago.  She said we could continue to give Sarah her medicine and wait another 12-18 months, but things most likely wouldn't have changed.  She kind of beat around the bush for a bit while I asked her questions like, "How likely is it that she'll improve?" and, "How long do people usually try to wait it out?"  Finally I just asked her, "What would you do if Sarah was your daughter?"  She was finally straightforward and said she'd have the surgery.  As a reminder, for kids with lower grade reflux like a I you often outgrow it.  Grade II can be fixed through a laparoscopic outpatient procedure called deflux.  But grades IV and V have to be fixed with a procedure called open anti-reflux surgery.  She asked if I'd like the doctor to call me later that day, and I said yes.  At the end, they had Sarah pee on a super high-tech toilet that observed her peeing and printed out a receipt with a graph showing her flow and information about her duration, quantity, and peaks.  Crazy and super cool!

The doctor called me a couple of hours later.  I was very thankful that he took time to call me and answer my questions because I know not all doctors do that.  The synopsis of the phone call is that he doesn't believe that Sarah will get better on her own, and that surgery is necessary and the only way to resolve her issue.  Robert and I feel very confident that this is the right decision for Sarah's health.  The doctor says this surgery is the gold standard for fixing VUR, and that it was a 98-99% success rate with a very low morbidity rate.

So here's what else I learned from the doctor.  The surgery will be at the St. Louis Children's Hospital on January 25.  We will go up the day before so that we can get settled and not have to make the 3.5 hour drive the same day as the surgery.  They schedule surgery in age order, so Sarah should be toward the start of the day, but we'll get the exact time the day before the surgery.  We get to be with Sarah while she gets her catheter, and then they'll take her back for the TWO HOUR surgery.  Does that seem long to anybody else?  After the surgery, the second she wakes up Robert and I get to go back and join her.  She will spend the night in the hospital and will have in the catheter overnight.  I'd imagine she'll also have an IV overnight, too, but I forgot to ask.  I'm also thinking that if she has a catheter and an IV then they won't want her walking.  How do they keep a two year old from walking?  Will she be heavily medicated?  I should have asked more questions!  They need Robert and me to spend the night in her room with her on a little pull out bed.  We're already bracing ourselves for a very long night with little sleep.  In the morning they will remove the catheter, and they will need her to go to the bathroom.  Then we'll get discharged.  The doctor said patients usually stay 24-36 hours after surgery.  I'm curious to see how miserable the drive home is.  The incision will be like a c-section incision, so I can't imagine riding in the car in a carseat is super comfortable.  He also said that Sarah's left kidney is 15% smaller than her right kidney which is pretty common for people with reflux.  Her kidneys aren't scarred at all, and both are growing proportionately, so he feels comfortable saying this is just a birth defect.  He also said that Sarah's bladder is the size of an adult's which is also common for kids with reflux.  That really makes sense because I've always thought it's impressive that Sarah can hold her bladder for six hours from time to time.

The doctor says she should be back to her normal self in a week and to expect blood in her urine for about four days.  The reason for that is because for the surgery he cuts open her bladder, removes the ureters from it, straightens them, and reattaches them in a stronger position.  He will close the incision with stitches and glue.  I need to ask, but I'm not sure if the follow-up will be in St. Louis or if we can do it when his team comes down to Springfield.

Anyway, here's our current mindset: We feel confident that this is necessary and the right decision for Sarah even though we wish this wasn't our reality.  We feel confident that this is the right doctor to do the procedure.  St. Louis Children's is a great hospital, and he's one of only 150 people in the country with his certifications.  We're sad that our daughter will have to go through being scared and being in physical pain.  We're sad that she'll have a large scar on her beautiful skin.  We're thankful for modern medicine that can prevent her from needing a kidney transplant.  We're thankful for family members who are supporting us and sharing this burden.  But I'd imagine that we're as nervous as just about anyone would be who has a two year old about to have a two hour surgery and an overnight stay in a hospital.

We would greatly appreciate your prayers.  We're praying that God would use this surgery to heal Sarah and to help her lead a healthy life, that He would keep her safe through the surgery and recovery, that God will calm our anxious hearts as we anticipate the surgery and wait through the actual procedure itself, that God would use this part of our story to bring Himself glory, and that we could be witnesses to all we encounter because of this situation.

Would you join us in doing the same?

This Fragile Life

As a lot of you know, Robert had surgery yesterday.  It had been a long time coming.  He has had a sensitive back for his whole life - scoliosis, slipped discs, etc.  In January he was playing intramural basketball and took quite the spill.  We've been dealing with it ever since - chiropractor, physical therapy, pain management doctor, x-ray, MRI.  It's been a long process, but it seems to be coming to an end.  About two weeks before we got married Robert found out that he did indeed have two herniated discs.  Since it was just two weeks before our wedding and three weeks til the big move we decided to just ease the pain and work on actually fixing the problem later.  He got three epidurals (yes, like ladies get during labor and delivery) and felt significantly less pain, but still had two herniated discs.


Once we moved to North Carolina we decided to get the ball rolling.  He knew he need to find a neurosurgeon, per the pain management doctor's request in Bolivar.  After searching around to see which doctors would accept Robert's insurance we came across Dr. Eldad Hadar.  Per usual, it took awhile to get in to see him as a new patient.  When Robert got to see the doctor he confirmed the herniated discs and said surgery would do the trick.  Apparently when a back problem is causing problem in your back the surgery isn't usually very successful, but when a back problem is causing nerve problems in other parts of the body the back surgery is 93% successful.  Well, Robert's back problem was causing nerve pain on his left side - hip, knee, shin, foot, toes.  He had sharp pain, numbness, and tingly-ness.  We scheduled the surgery for September 12, and he had a pre-op appointment last week.  That all went very well, and we thought we were good to go.  Unfortunately, the MRI images that we mailed to UNC Memorial Hospital got delayed and weren't there as of 9/11 a.m.  The secretary said they wouldn't be able to do the surgery if the mail didn't arrive by the end of the day.  Robert began to get a bit panicky as he had already waited so long for surgery.  The images arrived in the mail Tuesday afternoon, so we got the go ahead.

We woke up yesterday morning at 5:00 so we could hit the road at 5:30 and arrive at UNC Memorial at 6:30.  The surgery wasn't scheduled til 8:30, so we had some down time for about 2 hours while nurses came in and out to get him prepped.  I said goodbye to him at 8:30 and was told the surgery would be 3.5 hours - he'd be out at noon.  I still hadn't heard anything at 1:00 so I asked the secretary what was up.  She assured me that if anything was wrong they would have contacted me.  A little while later the nurse called in and asked for me.  She said she didn't know why, but the surgery was going to take extra time.  How much longer?  Two more hours.  I decided to go exploring and found a farmers market in the hospital (It's a HUGE hospital) and Starbucks.  I picked up a salted caramel mocha frapappuccino and enjoyed the sun and breeze for a bit.

When I got back to the waiting room I was notified that the surgery was over and I would be able to see him in about an hour.  I finally got to meet Dr. Hadar and found out why the surgery lasted 6 hours instead of 3.5  He said nothing went wrong, but it was more intense and detailed than they had expected.  Robert had two herniated discs - One between L3 and L4 and one between L4 and L5.  The top one was "massive."  I don't know exactly how big a "massive" hernia is, but it sounds crazy.  Both hernias had a ton of scar tissue around them since they had been irritated for nine months.  This caused the hernias to be really latched on to his discs.  Because of this he couldn't just take out each one in a big piece.  He had to chisel away at them and got the top one out in 40 pieces and the bottom one out in 30 pieces.  This obviously made the surgery last a lot longer.  It also caused the incision to be significantly larger.  It was supposed to be a pea-sized incisions that was to be closed with glue.  I would say the incision ended up being 4-5 inches with several stitches.

Once he came to I got to visit Robert for five minutes.  He was shocked when I told him it was 3:15.  It was also shocked to see that he had an IV in both hands as he had gone to sleep with one in his right hand only.  He was also surprised to learn that he had a catheter as that was not planned.  The doctor told Robert he had to spend the night in the hospital since the surgery was more intensive than expected.  He knew Robert's body would be very tired and sore.  Because we hadn't planned to spend the night the hospital had not reserved a room for Robert.  He had to wait in the recovery room for three hours while I sat in the waiting room because visiting hours were over.  He finally got a room at 6:30 - twelve hours after getting there.  He had a semi-private room on the 6th floor of the neuro department.

I got him set up with dinner and his very own scrubs - he was pumped to pretend to be a doctor.  I headed home at 7:45 and got home right as Serina pulled in from DC.  I'm working today and Serina is taking care of him.  He got to leave the hospital about two hours ago.  He should be better than ever with some medicine and rest.

Thank you, Jesus, for reminding us that this life is fragile and you are always in control even when things don't go as we had expected.

Happy New Year!

Robert and I rang in the new year with a few of our dear friends.  We've gone to Elise's house the past few years, but she was out of town this year.  We celebrated by going to Michael's house and playing Scattergories Categories.  The new year doesn't usually mean a ton to me.  I'm not much of a new year's resolution gal, but this new year represents the start of many changes and new experiences.  This year I will complete grad school, Robert will complete his undergrad degree, I will get married, I will move 1,000 miles away, I will live with a man for the first time ever, I will have my first apartment, I will start my first adult job, and I'm sure there will be plenty of other firsts and new experiences.  It's exciting and scary.  Sometimes I want it to come faster.  Other times I try not to think about all the changes that will be rocking my world in the coming weeks.  I have to remind myself that these changes and new experiences are all happy, good things.  It's exciting!  But it's my natural inclination to allow my thoughts to churn and think too much about the future. 

Here's an updated version of "the list" -

1. August 22 - Drury starts, 4 days til... DONE
2. August 26 - Mom's birthday, 8 days til...DONE
3. September 3 - Bethany gets married, 2 days til... JUST 4 MORE DAYS
4. September 5 - Dad's birthday AND Labor Day, 3 days til...
5. September 8 - My birthday, 34 days til...
6. October 12 - Organizational Communication ends, 2 days til...
7. October 14-23 - Fall break, 1 day til...
8. October 24 - Organizational Change starts, 6 days til...
9. October 30 - Saints game in St. Louis, 1 day til...
10. October 31 - Halloween, 22 days til...
11. November 22-26 - Alabama for Thanksgiving break, 18 days til...
12. December 14 - Organizational Change ends, 1 day til...
13. December 15 - Public Relations ends, 3 days til...
14. December 18-December 23 - Pennsylvania trip, 2 days til...
15. December 25 - Christmas, 8 days til...
16. January 2- Winter project begins, 15 days til...
17. January 17 - Spring semester starts, 10 days til...
18. January 27- Winter project ends, 49 days til...
19. May 16-26 - Spring break, 11 days til...
20. April 6 - Good Friday off, 1 day til...
21. April 7 - Jim's birthday, 1 day til...
22. April 8 - Easter, 29 days til...
23. May 7-12 - Finals, 3 days til...
24. May 10 - Graduation rehearsal, 1 day til...
25. May 11 - School ends, 1 day til...
26. May 12 - My graduation, 7 days til...
27. May 19 - Robert's graduation, 1 day til...
28. May 20 - Our wedding!

My holiday break is officially over.  For the next three weeks all be working on a service project for my grad program.  In the accelerated program we need a "project" in order to make up for the fact that we only take 30 hours instead of the normal 33 hours.  33 hours simply cannot be completed in 11 months.  To satisfy that requirement we are doing a service project for 0 credit hours.  We're teaming up with Ozarks Food Harvest in Springfield.  My three organizational leadership and change cohorts and I will be conducting a communication audit and analysis.  My integrated marketing cohorts will be working for OFH in various ways as well.  The spring semester officially starts January 23.  I can't believe I'm just four months away from graduating.  It's incredible that I started this journey seven months ago.  So much has happened since then.

Robert had surgery today.  Approximately two years ago he injured his left knee playing ultimate frisbee on the forum.  He was able to endure the pain as it only flared up every once in awhile.  However, since the start of the school year the pain has been rather debilitating.  He went to his primary care physician, and the doctor said from looking at Robert's knee he thought it was a frayed lateral collateral.  He referred Robert to an orthopedic surgeon.  The surgeon agreed with the physicians assessment.  The surgery was here in town this morning.  Both of Robert's parents were able to come down which was very nice.  The surgery took about 45 minutes.  Then we had to recovery for a bit.  I'd say we were there a totaly of two and a half hours.  We got to come home with some pretty sweet pictures of the inside of Robert's leg.  It turned out to be a frayed lateral collateral/frayed meniscus.  He also had bursitis.  The doctor removed some fluid which should help with the pain and inflammation the bursitis was causing.  We have him all set up with medicine, food, ice packs, and pillows.  He seems to be doing very well currently.  He should be back to normal pretty soon!

We're planning to visit Robert's parents, sister, brother-in-law, and daughter this weekend.  We'll celebrate Christmas together and go to Ray's new church's grand opening.  Robert needs to heal quickly so he can cheer on the Saints with his family on Saturday!