Sunday, July 10, 2011

July 5-Aaron’s pre-op

I don’t have any pictures for today, but I do have info to share about Aaron’s pre-op. The morning of July 5th, Aaron and I headed to the soldier hospital for what we were told would be a half day appointment. That ended up pretty close to true…we were there for five hours. Unfortunately for both me and Aaron, Chris was not able to come because it was the first day of summer school and he had to give a morning orientation. I know Chris’ presence is very reassuring for me and Aaron, and I was worried about how Aaron would do with one part, the blood draw, in particular. The majority of the five hours was sitting and waiting and being talked to by different departments. It is really amazing how much has to be coordinated for any surgery, and there certainly was a lot of information to digest. I will describe some of the things we learned about surgery day at the end of this post.

The blood draw turned out to be worse than I imagined it could be (which is pretty rare, something being worse than we worry it will be) because Aaron was very scared. He needed to have three tubes of blood drawn and he was so frightened that he became hysterical. We got a glimpse of this when he came out from his first sedation, but this episode was that horror doubled. Basically the issue was that we were not in a pediatric wing, it was just a row of chairs with no resources to handle a little kid that was screaming and flailing in terror. After 45 minutes of hysterics with only one tube of blood and two poked up arms to show for it, the poor nurse suggested that we take a break. I was exhausted from trying to physically restrain Aaron all by myself for all that time, and Aaron and I were both very emotional. I got the idea to call the pediatric sedation ward where he has been before and ask if they happened to have a spare bed and if they had time to draw the rest of the blood. They have beds there, not upright chairs, so it would be easier to restrain him, he knows them, and there are the little TVs at each bed. He has had a needle in his arm for both MRIs but it never went anything like what happened on the pre-op floor. So they said we could absolutely come down there and they would do it for us after the other parts of our pre-op appointment were done.

When we got down there, Aaron was totally at ease with them and the played with him while the peds anesthesiologist, Naomi, who is great with Aaron, talked to me about what had gone on on the pre-op floor. Even though he was having a fine time at the moment, once Naomi got out the needle, he freaked out again, which I think is because he was so traumatized this morning and by now his arms were both actually hurting. Luckily, they are prepared for kids who freak out there and one nurse wrapped up his legs in a sheet and held them while I held his right arm and cradled his head. He became enraged and screamed all kinds of horrible things at me, he hit me in the face, told me he hated me, all the while screaming himself hoarse. But quick as you could tell him to calm down; they were done and had three whole vials of blood, just one shot, just like that. As soon as that was over, he was completely fine and calmed right down. Then Naomi told Aaron, “When you were scared and upset you said things to Mommy that were not nice at all, that you would never say any other time, and now you need to give your Mom big hugs and kisses.” Which he of course did, right away, but you could tell he already had no idea what she was referencing and had totally become himself again. They gave him a toy, he was perfectly fine and we headed home.

The other parts of the appointment included:

- meeting with a finance/signature kind of guy who told us the entire procedure will cost us $18.65 a night. Can you believe the care and treatment our son is getting for that price? Our military healthcare was hard earned by Chris’ career of service, but it is TRULY amazing and we are so grateful for it.

-meeting with Dr. Lehman (remember this is Aaron’s surgeon), who gave us more information about surgery day. Aaron has to report for surgery at 5:00 am. We also learned from Dr. Lehman that we will most likely get to be with Aaron until he is completely asleep. He will be taken away from us about 7 AM and the surgery won’t start until 9 AM, so the hours of counting don’t get to start until then. He may need a blood transfusion if he has excessive blood loss. He will have two drains in his back (don’t know how long those will be in there) and he won’t have food or drink for about 2 days after the surgery. He will spend on night in the pediatric ICU and the move to the pediatric inpatient ward. The goal in this surgery is to fuse as few of his vertebrae with the rods as possible, because that preserves the growing ability of more vertebrae. Vertebrae with rods inserted into them will not grow. It may be necessary once they get in there to do a bigger fusion that includes more of the vertebrae, and that would pose a challenge as Aaron gets bigger. We won’t cross that bridge unless it becomes necessary.

-meeting with an anesthesiologist. Luckily, the woman who talked to us was present for Aaron’s hysterics, and she said that he plan for surgery would be to drink a liquid sedative first thing that would make him sleepy and help with his anxiety. When he gets taken back, he will be given gas anesthesia that will put him all the way to sleep, and then they will put his IV lines in and draw more blood after he is asleep. Thank goodness for that. She warned me that because he will being face down for all those hours and receiving IV fluids, he will come out of surgery with a swollen face, and that we needn’t be alarmed by that. He may also still have a breathing tube in, and she wanted us to know all the possible things we may see on him so we wouldn’t get freaked out, which I appreciated.

-meeting with a surgical nurse who gave us basic procedural information.

So now…I am even more freaked out because it’s so real, and happening really soon. There are even more things to think about now than before we had this appointment. I just have to work to keep my calm (as least while Aaron is awake) .

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