Wednesday, June 12, 2013

Adenoid Operation for Sleep Apnea

There's something about being the only one in the house that's awake after midnight, don't you think? Most people seem to hate it. I find it serene. Beautiful. For some reason, this is the best time of day for me, which is why I find it difficult to go to bed before midnight. I usually end up forcing myself to switch the lights off at 1am, else I'm just too tired in the mornings.

So on Monday this week, we took Monkeyman to the hospital for his little op. I have never been as relaxed before an operation of one of the kids, as I was for this one. It wasn't his first anaesthesia. I already knew the recovery would be hard, but the op didn't freak me out. I wasn't stressed, I slept well the night before, everything just fell into place calmly without me needing to think about it much. I even forgot to let my family know the day before, that he's going in the next day. I just didn't think it a big deal at all. It was, afterall, only adenoids! A quick in-and-out thing that's one of those "have to be done things that's just an irritation" kind of things.

So we stood up early, and I gave Monkeyman some cereal since he was the eldest (yes, at 5, can you believe that?!) of all the kids on the theatre list, so he was being done last. Only around 13:30. So there was time enough for breakfast. I was actually grateful for this, because one of the hardest things on these types of days, is dragging a really tired, grumpy, HUNGRY kid out of bed, just to go and sit in hospital for hours and hours, waiting for their turn. So Monkeyman had a huge bowl of weetbix, and some juice. Then he played, while I settled little Peanut and took a quick bath myself. Such a relaxing start to the day. I even left 20 min earlier than planned! And tapped myself on the back for achieving that with the baby not being exactly easy that morning. So I left her (thank goodness, because I did contemplate taking her with!) sleeping, with the in-laws who were visiting us for a few days to help out. Monkeyman was really excited because he got to take his brandnew (overpriced!) pull-along schoolbag (with little wheels) with him. It was his "bribery" prezzie for being a brave little boy. So off we went, booked him in and started to fill out the forms once he got his bed in the children's ward.

Next moment, 3 nurses were standing around us, asking questions, demanding more detail, calling the sister in charge, bringing more bracelets, adding bright red stickers to his file, etc. I started to feel mildly uncomfortable. I mean, I've been through a child of mine having an operation at least 10x before, and this was clearly "off". About 5min later, their questions started to make sense, and I realised they were concerned about Monkeyman's heart condition. It was like being hit with a cold bucket of water in the face. I was so STUPID. How could I forget that children with heart problems are being treated with the utmost care. And for a reason!!

So I tried to shrug the mild worry off, and told myself it's not as if he has a REAL heart defect. Just an enlarged heart, not true? The one nurse came back to us and said the anaesthetyst phoned from theatre, we must go in to see her. She can't come outside to the ward because she's busy in theatre. I told the nurses that it's okay, I've written all of the info down for her, but they said she demanded to see Monkeyman in person immediately. So, off we went to the theatres, where we got to wait about 5min for her to finish up (with an emergancy trach on a baby, how sad? Baby turned out to be fine though.). She came to sit next to Monkeyman and was SO kind to him. Then she had a really good listen to his heart and gave him a quick checkup, after which she told me that his condition makes his adenoid operation a BIG deal. She said, if the adenoids are the cause of the pulmonary hypertension, it's a really big deal taking them out. She said she'd prefer it if he overnights in the hospital after the op for observation, but she'll talk to the ENT about it. She also mentioned that nobody informed her about him in time. She seemed really upset about that. And seemed to think he should've been first on the theatre list, so that they had the whole day to monitor him. I told her that he can't be pushed in earlier (it was around 11am at this point) since he had eaten at 7. So she excepted that and said they'll finish with another patient first before him then. I was kinda in shock, and didn't ask too many questions. Walking back to the ward though, it hit me like a ton of bricks, and I started crying, obviously hiding it from Monkeyman (wonderful excuse is having a cold, LOL). I just didn't expect this easy, risk-free operation to turn into a really big, scary thing so suddenly. A short while later, Monkeyman's daddy arrived, bringing lunch with for me. So I dissapeared with it (so that Monkeyman didn't need to see), and while I ate and drank something, I messaged my worries to my sister. She phoned back and within minutes she had a whole group of people praying for Monkeyman. It meant the world to me.

Around 13:30 the nurses fetched us and told us to wait just outside the theatre with Monkeyman. While there, another nurse came in from outside with some extra heart monitoring equipment, and called some more nurses to come and help out in theatre. Obviously, scaring me even more. Fortunately, Monkeyman was a real trooper. He just sat on the table while the anaesthetyst held him from behind, holding the mask over his nose to gas him. He even leaned into her. I sat in front of him, holding his hands/knees, and talking to him. It didn't even take 10 seconds for him to fall asleep.

The wait outside was obviously stressful. The ENT asked us to not go back to the rooms where the parents usually wait, but to sit just outside the theatre. Which we did gratefully. He came out about 30 min later and told us it went really well (thanks to the Lord!), but they're still busy monitoring him, because of his heart. I think his heartrate was fast. Anyway, so he said that the adenoids were exceptionally swollen. Even he was surprised at how much. He showed with his fingers, describing how there was only a slither of air going past the adenoids. More than 90% of the airway was blocked. So he cut them out. The tonsils were absolutely fine (small and not infected) and the rest of the airways were all unobstructed. He had a slightly deviated septum which was really no big deal. And his sinusses were infected (Monkeyman has been battling another cold). He flushed those and took some blood for allergy testing. He believes the adenoids overreaction was due to a longstanding allergic reaction to something in his environment or foodwise. He also said that his reflux seems to be controlled well enough on his meds (yay!!).

Poor boy was really upset when they pushed him out of recovery. Crying, kicking, throwing his body and head around with force. Nothing new, he always behaves like that when waking up from anaesthesia. So different from our sweet Boeboe who will just open her eyes and look at you with this strange, heart-plucking stare. Anyway, fortunately the anaesthetyst must've kept to her word, giving him a voltaren suppository and valoid during the op. Because after about 10min of thrashing around, he fell asleep. He woke up once or twice again, but all in all, he slept 3 hours straight. Bliss! For him and us. The dr asked us to stay in hospital until very late afternoon/early evening, so that they could check his sats. About an hour after the op, it was 89, and about 93 when we were released. His heartrate also dropped with about 30. I was actually surprised that they didn't keep him until his sats reached at least 96. But I guess they were happy that it was improving.

But, the shocks of the day wasn't done yet. The ENT explained to us that their bodies goes into a kind of shock when there's suddenly this huge influx of oxygen when they breath at night. No obstruction anymore, and this cause them to completely seize to breath. He asked us to check Monkeyman throughout the night. Fortunately, we had Peanut's angelcare breathing monitor, so we put him on that and he was just fine!! I was so so so relieved! I had enough of seeing Boeboe's seemingly lifeless, grey bluish body as a baby when she stopped breathing. I just couldn't face the thought of Monkeyman like that.

So ya, what a day it turned out to be. For such a small, seemingly innocent and risk-free operation. I'm just grateful it's over. The ENT seems to be certain that the adenoids must've caused sleep apnoa, and that must've caused the pulmonary hypertension. He's also positive that fixing the underlying cause, will revert the PH. We'll have to wait 8 weeks for a repeat eccho, but I'm cautiously optimistic, happy and so relieved!!! Oh, and he also said that Monkeyman's upperjaw will catch up with the growth that it lost out on. Yay!!!

I have so much more I want to say, but it's been a VERY long, difficult month since his PH diagnosis. And it's now long after 1am and really time for bed.

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