Friday, February 6, 2015

the surgery before surgery

It's been a little over two weeks since Mary-Kate's dental surgery.  I find it ironic that by the time it was over, our family count was 26 lost teeth.   Just days before MK's surgery, our 19-year-old Abi had her four wisdom teeth removed.   A few days after her surgery, our 14-year-old poodle had his own surgery to remove a good number of his bedraggled canines, among others.

But, really, the day of Mary-Kate's surgery was way more traumatic than humorous, for us just as much as her.   A few days of healing have allowed us a lighter perspective and even a few jokes.  That Tuesday, though, we were anything but laughing.  Jon and I both felt an inexplicable angst watching Mary-Kate struggle through that day.  Maybe it's because we couldn't explain the why to her.  Maybe it's because we knew the bigger surgery was just a few short weeks away.  Maybe it's because she's just a baby, and it's hard to think about this happening to her on top of everything else she's been through.  Maybe it's just because she's OUR baby, and it's a miserable feeling to watch your baby go through a day like this.

Following our dental consult on January 12th and the news that Mary-Kate's heart surgery would have to be postponed, our baby girl was swiftly worked into the surgery schedule, and we found ourselves on  our way to Riley on the 20th at the unmerciful hour of 5:00 am.

We checked in, weighed in and waited.

We almost found ourselves rescheduled for this surgery when they found out she was being treated for an ear infection.  The anesthesiologist was hesitant to put a heart baby under if there was any chance at all she would have any respiratory issues.  At our insistence, he looked her over and determined that it wasn't worth postponing yet another surgery.

One of the hardest parts of any surgical procedure with a little one is keeping them from eating and drinking. I haven't shared much about this, but nights can be pretty rough with MK.  She hasn't "slept through the night" once since we've had her.  And we're over the 90-day mark.  We've had some exceptionally good sleepers in our family, and this baby has put our parental mettle to the test, for sure.  I'll share more later, but suffice it to say that every night she wakes up several times a night.  While we've had numerous night terrors, most of those times are comforted with an ounce or two from her bottle.  Whether it's a security or attachment issue or whether it's because she's a heart baby and never takes more than two or three ounces at a time anyway or whether it's a little bit of both, we give her what she needs. It's something we're just working through one night at a time.

See where I'm going with this?  By the time we got to the hospital, she'd abandoned words and was just looking at us and pointing to her mouth.  By the time we'd done all of our pre-op procedures, she was clearly convinced  we'd lost our minds. We were more than grateful when they finally brought her dose of Versed around 7:30 am and carried her back to surgery twenty minutes later.  We stumbled down the long hallway to the surgery waiting room where both the grandmas were waiting for us.  I could not compose a thought or even force a conversation.  Beyond my tired, I was just a mess, frustrated with myself because I was struggling to interact with the company for which I was so infinitely grateful.  I finally dozed off in my chair about an hour later, and shortly after the 90-minute mark, the nurse who makes the surgical update rounds informed us that Mary-Kate was in recovery and that the surgeon was ready to speak to us.  The outcome was more harsh than expected.  Our sweet baby girl lost a total of 10 of her 16 teeth, including all of her front teeth, top and bottom.  I couldn't help it.  The tears just overflowed.  It was hard.

x-rays taken during surgery
healthy teeth are solid white

Our very kind doctor explained to us that every one of those extracted teeth was soft all the way through the gum.  There was no way to save them.  We were very fortunate that her permanent teeth are now, at this point, protected from further decay.  But still.  My poor baby will have no front teeth until she's six or seven years old.  There is the possibility that they will be able to mount a pediatric partial once her two-year molars have come in.  If not, she will definitely struggle with speech. Wrap your mind around what all this baby has endured even before her two-year molars.

Shortly after, we were escorted to the open bay recovery.  While I've had experience with several oral surgeries with my older kids, I was wholly unprepared for what awaited us.  Mary-Kate was on her side with her face in a pool of blood.  The recovery nurse had waited for us to be present before waking our girl.  I am grateful for that because we were immediately able to comfort her.  If you've ever had a child come out of anesthesia, though, you know that comforting is a relative term.  We were able to hold her, but that also meant confining the bleeding.  And we were told that in order for the necessary clotting to occur, she couldn't have a bottle for the next 24 hours.  I'm really glad I hadn't thought that through because that would have just upped my anxiety level.  We made the attempt to offer her some Pedialyte straight from a cup, but that turned out to be a messy effort, to say the least.  She was expectedly miserable. And as she came out of the anesthesia, each crying fit resulted in her oxygen level tanking in the 40's and 50's, which meant a bit of supplemental oxygen.

We were eventually moved to a private recovery room.  I can't say enough about the nurses at Riley.  The right nurse really makes a difference in your experience.  And the ones we've encountered so far have all made every effort to meet our every need.  They made sure our baby girl was as pain-free as possible before we were sent home.  That extra effort in medicating her really made the difference in her state of agitation.  Once the bleeding was relatively under control - not an easy milestone with a heart baby on aspirin therapy - we were able to take her home.  She slept fairly solid all afternoon and evening while the anethesia worked itself out of her system.  The rest of the night wasn't so smooth.  Let's suffice it to say we went through a lot of clothes and towels, and we had a very unhappy baby without a bottle.  We were able to pacify her some with popsicles and pudding, but we also struggled with limiting her sucking on her beloved tan je.  It was a long, long night.  The wheels started to come off for me about 3:30 am.  I'd begun to lose all rationale and was ready to book a flight to Jamaica - ALONE - when Jon rescued us, scooped up his baby girl and sent me to bed - ALONE.  It was a blessed few hours of sleep.

Even the next day was rough, with continued bleeding and an out of sorts baby.  Can you imagine the thoughts running through her head?  Every day since then, though, she's been a little more her funny little self.  Nights continue to be her struggle and where her heart and mind continue to work through all that she's endured so far in life.  As frustrating as it can be, any irritation I feel melts away when her cries turn to the sound of a newborn, when her mouth takes the shape of tiny baby that only knows the instinctive desire of a mother's touch and comfort.  It's as if all those months of not receiving that have awakened a deep, deep need in this tiny little girl.  How can any need of my own come close to hers? 

If this alone were our battle, it would be one thing.  But our knowing what looms ahead gives me an entire new level of angst.  I cannot put to words how grateful I am for the peace I find in knowing our God goes before us, knowing that this is His plan.  Because in a few short days, we will place her in the arms of a nurse who will carry her to the skilled hands of a renowned surgeon.  We know to the depths of our souls, however, that we nurses, doctors and parents are all just vessels of HIS healing.  Ultimately, our Mary-Kate will be in the hands of the Great Healer.

*We spent the afternoon at Riley today for Mary-Kate's pre-op appointments, bloodwork and testing. She is cleared for surgery, and we are scheduled to arrive at 5:30 on Monday morning.  She should be taken back between 7:00 and 7:30 am, and the surgeon expects to be in surgery until at least mid-afternoon.  I will be updating general information on my personal Facebook page, but I will share more details on Mission: Mary-Kate's page.  We are so very thankful for all of you who will be lifting our baby girl up in prayer as we put our trust in Him.