Sunday, April 21, 2013

A somewhat rough recovery: s/p tonsil-and-adenoidectomy

I shall not keep you in suspense.  No, we have not needed to take the Bear to the ER status post tonsillectomy, adenoidectomy, and ear tube insertion. . . but we have come very close as a certain little Ellie Bear does not want to consume her fluids.  Or take her medicine.  Or stay awake long enough to drink her medicine or any liquids.  The oral syringe is my best friend and Ellie's biggest enemy right now.




In the past few days, I have given my daughter sugary concoctions and food items that I swore I would never keep in the house let alone beg her to take.  She now has reason to believe that we have cupcakes in the pantry and that ice cream is an acceptable food for breakfast.  That several types of juice and Gatorade have a home in our fridge.  Swirly straws and various drinking apparatuses have been introduced to my stubborn toddler.  The thing is, they are not enticing enough.  Even the Capri Suns were purchased in hopes of enticing her to drink.  Capri Suns--a treat only at birthday parties.


She is holding her own face mask.  The Child Life Specialist got it out to show her and Ellie just yanked it from her hands and put it on her face with the attitude of "uh huh!  I know how this thing goes, girl!"


My little bundle-of-energy isn't behaving like my Ellie.  The spider monkey has disappeared.  She has not tried to climb onto the kitchen island once.  I know!  She is a different child.  Plus, she watched a movie.  An entire movie.  While sitting.  The whole time.  Snuggling with me.  Did I mention it was a whole movie?  As in more than 5 minutes? I would say it is glorious to snuggle with my little Bear, but I am sad because I know that she is behaving this way due to pain. . . and I cannot make it better.

How do you explain to a child that you put them through this pain to make them better?





On Tuesday, the day of her surgery, Ellie tricked us.  The little turkey led us to believe that she was fine and dandy.  Good to go.  Chugging apple juice to the extent that I was a bit worried about the contents of her next diaper.  Scarfing down ice cream like there was no tomorrow.  Attempting [and succeeding] to climb over the railings of the hospital crib and trying to escape her hospital room--with her diapered tush hanging out of her gown.  Ta-ta Dell Children's!  The Bear is on the loose!

Ellie tiredly sat in that post-anesthesia care unit trying to sign along to Signing Time and the Wiggles.  Shouting to everyone that her name was "Eeeee!" when asked.  She charmed the pants off everyone!  She was my Ellie.  A little drunk, but still my spunky Ellie Bear.




Then.  Suddenly.  The Scream.  Not an "I'm pissed off. Give me M&Ms" scream, but an agonizing scream.  Pain.  Severe pain.  From my baby.  Full body tensing.  Panicked look in her eyes.  The Scream of Agony.

Though not because pieces of her upper airway were scraped out, but because of pain from her bladder/ureter.  Yes, she was grabbing the diaper area.  She would scream for 10 minutes, then urine would gush out into her diaper and she would calm.  Repeat.  Repeat. Repeat.  The vicious cycle finally slowed to twice an hour. It was so horrendous that the nurses finally requested the docs to come and look at her and were begging for a PCA pump [patient-controlled-anesthsia aka IV pain med pump].

Was it a UTI?  Was it a bladder spasm caused by the anesthesia?  An over-distended bladder? The doctors and nurses seemed clueless.  I googled.  I Facebooked.  I tapped into my previous nursing experience.  Mostly, I tried not to cry in front of my baby.

Ding ding ding ding ding.  As it turns out, Bear's IV fluids should have been discontinued once she demonstrated that she could maintain her oral intake of liquids.  As in, the IV fluids should have been shut off the moment we reached her hospital room.  Once the IV pump was off, the excruciating pain decreased and the screaming ceased, but my Ellie wasn't the same little girl from earlier that day.  She was cranky.  Irritable.  Hyper.  An overtired type of hyper.

I was also puked on.  Dried, coffee-ground-blood puke all over my clothes. The clothes that I changed into for sleeping.  Yuck.  Zofran was given which helped the vomiting, but caused the hyperactivity.  Oh yes, FYI Zofran hypes up a child like crack.  




Finally, around Midnight, Ellie calmed enough to fall asleep.  Only to be woken up by loud beeping.  I spent 2 years working in a PICU and I know my alarms.  I also know that a lot of times they go off because the battery is low, the wire is kinked, or the child removed the lead.  This alarm was none of that. Apparently, Ellie couldn't keep her oxygen [O2] sats up while sleeping and was dipping pretty low once in a deep sleep.

Introducing, the nasal cannula.  Ever try to keep one of those bad boys on a little toddler?  Yeah, even with the little sticky dots and tagaderm and even more tape, Little Miss had the cannula ripped off in record time.  Fortunately, her skin remained in tact.  I spent the remainder of the night vigilantly [in panic mode] watching her monitor and holding a face mask in front of Bear.  If she turned, I chased her with the mask.  With the mask, she would sat in the low 90s.  Without the mask somewhere in the 80s. Typically, the upper 80s but everyone once in a while she would slip to 80%.  

My persuasive powers allowed the ENT surgeon to feel comfortable discharging Ellie into our care.  Who knew that batting one's eyelashes could go so far!  In all seriousness, Ellie's surgeon and I go way back and she knows that I tend to be hyper vigilant [aka worry-wart /  obsessive].  Yes, Ellie's O2 sats sucked while sleeping but chances are, they were low prior to the surgery--you know, obstructive sleep apnea and whatnot.  When awake, The Bear was rocking at 96%.  She has no signs of respiratory distress and everyone knows the best healing happens at home.



Since discharge on Wednesday, it has been a battle to keep fluids in her.  We have tried various sippy cups, straw cups, dixie cups, swirly straws, regular straws, and the dreaded oral syringe.  We have tried foods that count as fluids--yogurt, ice cream, applesauce. I even did the reverse psychology of "this is mommy's drink, not Ellie's".  Five days of obsessing over every sip and every diaper. Five nights of laying with my daughter cuddled up against me, nearly kicking me off the bed as she moaned in between doses of pain meds.  Five days and I believe she finally turned a corner.

Ellie woke up and drank 3 ounces of a Capri Sun without any coaxing.  She also only took a 3 hour nap as opposed to a 5-6 hour one.  She put together a few puzzles and she ate part of a donut.  She signed along to "Signing Time".





I know that you all are thinking that I should have been prepared.  The hospital discharge papers warn of a 10-14 day recovery.  Yet, this was the Bear's 5th surgery and she has always bounced back quickly, even after her GI procedure.  Even when ill with a high fever, Ellie tries to climb into the sink or escape through the dog door or demands a "sandwich" from Quiznos.  My little Bear has proved to me over and over again that she is a little trooper and with this surgery, she has proved the same.  She is strong.  She is resilient.  She is a trooper.   While at times I felt helpless, I also knew that I could give her the only thing that others could not--I could be her mommy.

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11 comments:

  1. I am so glad that Ellie Bear is returning to her ol self! What a hard thing to go through for her and you and your hubby! Sending kisses and hugs to you and Ellie!

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    1. Thanks, Anna. One of Bear's friends had the same surgery a few weeks ago and bounce right back. I sort of thought Ellie would be the same way! I was wrong :-(

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  2. I'm sorry that it has been rough-going. Owen's surgery was 2 summers ago and it was the absolute worst for us; I hate thinking about it and I hope I never have to go through it again. His recovery period was more like 5 weeks--he was a cranky, angry, totally not himself child for that whole period. We had to do everything but dance on the ceiling (and believe me, I thought about it!) to get him to drink anything and eating was nearly non existent and if it happened, it was usually Gerber puffs!

    I hope that Ellie has turned that corner and gets a little stronger and more like herself everyday.

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    1. Poor Owen! He was young when he had his done. Gerber puffs--good idea. I need to pick some up. She will ask for food and then just hold it. Not eat it. We started going on car rides and that has helped a bit. She likes getting out but not having to be active. I would give anything to see you dance on the ceiling! :)

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  3. oh poor baby. it's not an easy recovery even though it seems like everyone has one now. glad things are starting to look up and so glad you got to take her home. i really hope thus helps her but can't imagine it not with the status off those pesky t&as

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  4. Wow! What a ride! We meet with Levi's ENT next Thursday to see if she wants his tonsils out. At least I'll know about what to expect! Hope she improves quickly!

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    1. April, keep me posted on Levi. I hope that he doesn't need them out but it seems as though there is a sale on T&As lately.

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  5. I know that has been hard for you to see her so puny, and to know that she was miserable and all you want to do is wave a wand and make everything all better. Thank goodness for your background. I hope she truly starts to recover from here on out, and that she will be dancing on the table in no time. Prayers continue.

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    1. Thanks Donna! She is slowly improving. Those nasty scabs have fallen off and now she has turned a corner. Soon ya'all shall here me say " Ellie! Feet on floor!"

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  6. I haven't been on line much lately & missed a lot of this - so sorry she had such a rough time! Big hugs to you both.

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