Girl Child slept ok last night, though only for 45 minutes or so straight with the 4am valium. She was having some pain closer to surgery time that I suspect might be due to not being able to take the oral muscle relaxer after midnight. Nurse K. came in to do her thing at various times, and at one point, Girl Child told her she was her favorite. Even when she’s had to do things that don’t feel comfortable, she’s been obviously caring about her and joked around with her (and with me) a lot.
Around 4:45am Dr. B. The Resident, son of Dr. B. The Thoracic Surgeon came in to check on her. He’s followed her the last several days, and he’s been very kind. I talked to him about whether or not the incision drain tube from Tuesday’s surgery would come out today (he thought that was the plan), and about her general respiratory stuff (using the spirometer, respirations per minute, oxygen levels, etc).
Around 6:15, DH arrived as they were starting to prep Girl Child to head to the surgical floor. An anesthesia nurse came in to go over consents, and on the paperwork I flagged that they had Dr. C. doing the anterior thoracic release from T2-T10. The overall plan all along has been to fuse from T4-L4 or L3 if he can work some spine magic, so this was the first we’d seen anything about T2. The nurse looked through the records and could see the final pre-surgery plan of T4-L4, but the consent for whatever reason said T2-T10 for today’s procedure. We decided to hold off on the consents until we could discuss with Dr. C.
Next up was a chest x-ray that Nurse K. wondered if they were supposed to get earlier than this last minute affair. Having heard of our experience with the fluoroscopy test yesterday, apparently Nurse K. said to the x-ray tech who showed up this morning, “PLEASE tell me that’s portable and she won’t have to transfer!” Thankfully it was. Unfortunately, it still required rolling Girl Child to put the x-ray plate under her, and that did hurt, but it was still infinitely better than the trip to the bowels of x-ray hell yesterday.
The last of Girl Child’s tubes and wires and lines (oh my!) were unplugged and moved to her bed in preparation for transport. Her pain pump was turned off about 30 seconds before the surgical floor called to tell them to leave the pain pump attached. Too late, and it had been nearly empty as it was. Girl Child was going to be needing another dose soon, and we were going to be dealing with another transport, so I let the nurses handling that know that yesterday’s transport did NOT go well and to please be careful with bumps. Thankfully, these ladies handled things much better and we were soon in pre-op.
We spoke first with the anesthesiologist, a different Dr. S. from Tuesday’s surgery. She had a very laid back yet take charge manner. We talked about what would be different going into surgery already with narcotics and other meds on board, and whether we’re already seeing habituation on her meds (we are, at least on the valium, in the sense that she’s not as sleepy on it as she initially was). We mentioned she didn’t get her pain pump with her and she’s hurting from being moved for the x-ray, and she said, “Well, I’m planning on giving her a handsome dose of dilaudid in here before she even goes back so she’s out of pain.” I don’t know why the phrase “handsome dose” struck me as perfect and funny, but it amused me. Apparently Dr. S. was an adult anesthesiologist for years before deciding she wanted to go back for a fellowship in pediatrics because she loves kids. It was pretty clear in the time we spoke with her that she knew her stuff and loves what she does. Girl Child mentioned her belly is uncomfortable, and she did get 2 doses of colace in yesterday, but there’s just not much else to do for it heading into surgery other than the pain meds taking care of it. While waiting on her “handsome dose of dilaudid”, she experienced one of the “I feel like I’m standing up” sensations, and we brought that up to Dr. S. She wasn’t concerned and said we should expect odd things like that with the meds she’s on.
We got a chance to check in with Dr. C., and I mentioned how badly the transport and fluoroscopy test went. It was hard to tell him without getting upset and teary again, but I kept it together. He didn’t like hearing that and apologized, but the good news was her test showed her diaphragm is working just fine. The even better news is that she won’t have to go down to fluoroscopy hell again after this surgery. We also clarified the T2 vs T4 thing and confirmed it was a typo. The proper level was noted on the consents, and DH signed them.
Spinal Cord Monitoring Nurse E. stopped by; we were glad she was back on the case. She spoke to Girl Child again and reminded her that she’d be smiling at her from behind her mask just like she was last surgery. It again brought a smile to Girl Child’s face.
As Girl Child received her “handsome dose of dilaudid”, the recovery nurse, Nurse L. told us that she’ll probably turn the corner with this surgery and that Monday’s posterior surgery should be a breeze. Hearing that things might start getting better after today surprised us, given she’s going to have yet another rib removed, and I’m not sure either of us believe it yet, but we’ll see. Dr. S. set about listening to Girl Child’s heart, and she asked how much of the dilaudid dose she’d gotten. Apparently she’d only gotten the first bit and was already out of pain and fairly sedated with it. That worried me cause I thought that meant she was overly sedated on the first bit, but Dr. S. was really pleased because it meant she didn’t need such a “handsome dose” after all. We gave her some hugs as they gave her some versed and she got pleasantly loopy. They wheeled her away from us. Again.
I’d thought I’d do better with this one. I handled the first ok, I knew what to expect, and I know she’s in good hands. But this was harder. Thankfully she was pretty much sleeping as I was breaking down. DH went to hug me, which really opened the flood gates for both of us. Nurse L. was very kind and talked to us a good long while about what to expect today. I told her I was a little concerned that they waited a long time before we got to see her Tuesday, to the point where she had to ask when she could see her mommy. When we were ready, she showed us to the waiting room to camp out.
