tonsillectomy

Part 1: the prep.

The very first (and possibly most important) step in preparing Ladybug for her tonsillectomy was to REPAIR HER BLANKET! This faithful friend has gone everywhere with her since birth so I didn't want to even imagine trying to do something so traumatic without it.  But unfortunately it had a few small holes and at least a dozen spots where the fabric had worn through and was literally held together only by a few threads.  It badly needed washing before surgery (especially since she would be so susceptible to infection) and I feared that washing it would result in shredded fabric.

So with my limited sewing experience I got some helpful input from Grammy the seamstress (and original maker of the blanket), Daddy the engineer and Grandma for her creative flair.  We concocted a plan.  I let her pick out some fabric, we cut it to the same size and shape, ironed a hem around it and with a wide zigzag stitched  layered the new fabric onto the back.  It doesn't sound that complicated but I was terrified that the worn fabric would give up or that if I messed it up and had to unpick the stitches, that then the fabric would be even weaker than before.  But success!  Yellow is now a little thicker than before but the new back makes it solid and strong again with the stitching careful placed to reinforce the weak, threadbare spots and the soft crochet edge still sweetly bordering the blanket.  All of this was done to Ladybug's careful (sometimes frantic) coaching, "don't cut the yellow!", "don't cover the soft yellow!" (the edge) or simply "be careful my yellow mommy!"  Soon it was finished, freshly laundered and safely back in Ladybug's arms.

The next step of preparing for surgery was the last hurrah.  Since she would be under house arrest for a week and on a soft-foods diet, we wanted a special day for her.  So in the afternoon, I drove up the canyon to meet Grammy, my two sister-in-laws and a bunch of cousins for lunch.  We met at McDonald's and they ran and played together.  We did a little shopping, picking out fruit, juices, pudding, ice cream, popsicles, etc. Then in the evening, we celebrated with pizza and ice cream followed with a trip to the pool (Ladybug's favorite).  We got home late, already past bedtime but since she wouldn't be able to eat after midnight, we continued the party with a smorgasbord of her favorite foods and snacks: ramen noodles, fruit snacks, chips, goldfish crackers, blackberries and more. And then finally put them to bed.

She ended up in our bed again that night, as she often does.  She's my nighttime Tasmanian devil, tossing and turning, never resting deeply but always troubled by her restless sleep and sleep apnea.  This is one of the major reasons for doing the surgery in the first place.  Her tonsils are so large that she can't breathe deeply and most sleeping positions restrict her breathing.

Part 2: surgery.

We woke up early, grabbed a quick breakfast before Ladybug was awake, and then settled our sleepy Ladybug into the truck.  Butterfly and Lovely stayed home with Grandma so Daddy and I could both be with our Ladybug.  She sat very quietly, her Yellow spread across her lap and an edge pressed to her nose.  Her eyes looked around suspiciously as we drove.  We arrived at the surgical center and she perked up to play with the toys int he waiting room.  Soon we were ushered into a room where she donned a surgical gown covered in Looney Toon characters and delightedly met her "lel-laphant", a small stuffed elephant gift from the doc and his staff.  Nurses came and went, collecting vitals, asking questions, etc.  The doc appeared for last minute questions and eventually the anesthesiologist arrived. 

This is the part I had been dreading.  When she underwent surgery for her eustachian tubes, she was given a dose of a oral medication that was meant to make her relax and forgetful to ease the transition to the OR.  It didn't work.  It made her silly and hyper, running in circles but so unstable that she repeatedly fell over.  The real problem was than when they tried to take her to the OR, she became frantic, screaming and crying and they had to use a mask to put her to sleep.  Then when she woke up from anesthesia  it was more of the same, panicked screaming, flailing against the nurses and monitoring devices and desperate crying.  She doesn't remember it but it was awful for me and Daddy.

Good news! This story has a much better ending.  We told the anesthesiologist of this history and she quickly assured us that they don't use the oral relaxant because of the high percent of kids that respond this way and explained their procedures.  As we talked, Ladybug got to play with the mask that she had brought.  It had been sprayed with the bubblegum flavoring so she kept putting it to her face, smelling and giggling.  She knelt down by Ladybug and asked if she liked to play pretend.  Ladybug grinned as she explained we were going on an airplane and she got to be the pilot.  I was invited to come along to the co-pilot.  She talked animatedly as we went from our patient room to the OR.  She lifted Ladybug up to the computer screen that would be used to monitor her vitals and asked her to push the buttons to start the engine, adding sound effects and jostling her to mimic the movement of the engines starting.  We settled Ladybug into her "chair" and used the heated blankets as the seatbelts to secure her.  She put the mask to her face and quickly hooked the tube onto it.  Ladybug tried to recoil from the smell of the gas, grabbing my hands for reassurance.  I promised her three deep breaths and she would be done and sure enough, after breath #2, she was out.

I was sent back to the waiting room to sit with Husband.  After about 15 minutes, the doc appeared to tell us they were finished and all went well.  And after ten more minutes, we were escorted back where she was just starting to come around.  She was still mostly asleep as I scooped her up and cuddled her for awhile.  She occasionally acknowledged me and eventually roused enough to eat half a Popsicle ("purple please").  After more cuddling, she was coherent enough to get dressed and was released to go home.

Part 3: recovery.

She was sleepy the rest of the day, but calm and very willing to cuddle.  Actually, I have to confess that she was doing so well, we actually stopped for a quick trip to Costco on the way home.  We picked up a few items as she slept in a pile of blanket in the cart (it was adorable  and then continued to sleep on the way home.  Soon she was awake enough to be hungry and quietly but eagerly requested some ramen noodles and milk.  We watched movies through the evening, cuddling and relaxing.

The doc had warned us that the effects of the drugs from surgery wear off in about 12 hours and then she would need the pain medication we had for her.  We saw a noticeable change when this happened and she had become much more uncomfortable in the later evening.  During the night, she began to cry and it was so painful and pitiful sounding that it broke my heart.  I gave her more meds and sent big sister to sleep with Daddy so I could sleep next to Ladybug.  She slept in 20 minute spurts, waking up crying and needing reassurance.  She seemed disoriented and in pain throughout the very long night.  In the morning, I tried to give her another dose of pain meds but by then, she knew the nasty taste and it became a battle that resulted in her gagging it up anyway.

It was a long day.  By the time Daddy got home around 4:00, I was a mess.  Ladybug was in obvious pain and couldn't keep the medicine down and was refusing to eat or drink. I was worried and flustered, Ladybug was crying and Butterfly and Lovely were both desperate for some attention.  Daddy and I came up with an ingenious plan to mix the meds into chocolate pudding, we bribed her to eat it and then Daddy entertained the sisters while Ladybug and I cuddled.

Now with the drugs in her system, comforting her properly again, the world was a much better place.  She ate dinner with us, we played a little, watched more movies and slept much better that night.

Today has been more of the same: cuddling, movies, magic pain relieving pudding, a little food, and playing quietly.  The next few days will probably be long since she can't go to school, ballet or daycare.  But hopefully we will keep her distracted and she will heal quickly.