Sunday, April 14, 2013

Surgical Suite: Adagio*

We had been greeted the previous day with a snowstorm;  it had cancelled buses and generally depressed the hell out of everyone.  The sidewalks had been slick with a layer of slush in Toronto, but points farther north had ice storms, wind and damage.  This morning dawned rainy instead.  I woke up early to a torrent outside my window and I drank my first cup of coffee in front of the laptop, wrapped in a blanket against some imagined chill.  

If there is one thing that I enjoy at Sick Kids it is the little loaves of banana bread that they sell in the cafeteria.  I had purchased one the day before and ate half of it with my first cup of coffee.  A quick call to the unit let me know that Wyatt had slept well and only required morphine once.  He had gone for his sedated echocardiogram and was still sleeping from the chloral hydrate.  I skipped breakfast otherwise, in an attempt to make it to the hospital in time for rounds.  As I cursed myself for forgetting my umbrella in the van, I made my way to the hospital.  I am very lucky that my hairstyle involves mainly being rubbed with a towel as I was a soggy mess by the time my shoes squeaked up to Wyatt's door.

The door was closed for rounds.  As there was another patient in the room, for confidentiality reasons I had to stay outside.  When it was Wyatt's turn, the other parent left and I went in and stood beside my son's bedside, where he was still sleeping.  I stroked his forehead through the crib bars as the NP (Nurse Practitioner), Charge Nurse, Floor Manager, Pharmacist,  Social Worker and a few other solemn looking people evaluated my son's progress.  The NP woke him up to listen to his chest and stated that he looked good on paper and in person.  It was the team's agreement then that he would have all his tubes and wires pulled (with the exception of the saline lock in his foot as he had one more dose each of ketarolac and antibiotic left to go) and that the plan was to get him up to the playroom and "let him be a boy".  I was very happy with this as that is exactly what I had hoped would happen.

The IV in his hand was taken out first.  He hated it.

Then we took out the central line, including the two stitches that held it in. He hated that more.

The pacing wires were next.  They were knotted and stitched in.  He hated the world after that one.

He was so inconsolable in fact, that he cried himself to sleep in my arms again.  After our unsuccessful holding the day before, we found that it was easier for me to lean into his crib and have him either lean into me with his arms around me or to lean on me (like a back rest), especially since he was so tired and apt to keel over.  That way we could have contact and still remain comfortable and without putting pressure on the tender bits.  I laid him down, put up his side rails and got out the laptop to keep myself busy.

He would nap for an hour and then be awake for an hour and then fall asleep again.  All the crying wore him out; he cried every time somebody took a blood pressure or approached him with a stethoscope.  By lunchtime our room was filling up.  Despite the increased level of noise (and each new set of parents complaining about having a shared room), Wyatt still slept through it all.

Wyatt woke up about 1 p.m. and I tried to coax some milk or juice or even a chicken nugget from his tray into him.  He ate one chicken nugget slowly and only took in 20-30 cc of liquid at a time.  He was still getting lasix due to his puffiness and he had to drink.  I offered him juice and milk and water over and over again.  He was happy to chew on the bottles mostly;  without warning, he would suddenly fling them across the room before falling asleep again.

Most of the afternoon went by with Wyatt sleeping.  In a brief period of wakefulness his nurse brought him additional toys from the play room.  One was a musical caterpillar that he had at home which provided a sense of familiarity, while the other was a type of activity centre with all sorts of lights and buttons and sounds.  Except this one was completely in French.  The rest of his waking hours while in hospital would be peppered with "coo coo bébé!" and a smattering of French ditties that I couldn't quite follow.

I ordered a variety of things for his dinner that I thought he might be able to pick at.  I had to admit, I was impressed not only with the nursing staff, but also with the actual workings of the hospital.  Wyatt's nurse called in his dinner order and less than 10 minutes later, it appeared at the end of his bed.  Need a bed cleaned?  Boom.  Done.  Need a crib swapped for a bed for an admission?  Done, less than 5 minutes.  They may not be able to schedule clinics worth a damn, but the people that actually work there, work.

Vocalizations were pretty minimal with Wyatt, possibly due to a sore throat that would have been caused by the breathing tube.  He was also into really long hugs or kneeling for a few seconds, before drifting off back to sleep.  At dinnertime, I was able to get some applesauce and three french fries into him along with a small amount of juice.  Sean arrived shortly afterwards (Quinn and Zoe were on an adventure with relatives).  Wyatt immediately began to smile and was suddenly up to a lot more, including a lot of peekaboo and goofiness.  He also suddenly developed half an appetite by eating half of the remaining fries and several strawberries.  His evening nurse was impressed as she mentioned that most kids don't eat for 2 to three days after surgery. That settled me down a bit as I was getting really concerned.  This kid would normally eat a dead frog if you gave it to him.  Wyatt not eating or drinking was really out of character and it concerned me.

When he was asleep, we pinned his drains to his back in order to let him sleep on his tummy (which he did and quite happily).  Although parents are cautioned about tummy time with babies that undergo heart surgery, it is okay with bigger kids if they position themselves that way.  If it hurts, they will stop or reposition.  When he was awake however, he would scoot around his crib and generally get tangled up in his drains, regardless of where they were positioned or pinned.  I was really looking forward to their removal, to be honest, as I was afraid that he would pull them out by accident (which would cause a pneumothorax, a medical emergency).  His drainage had slowed to almost insignificance and it was determined that they would be removed the next day.

In his own Jammies, tangled in drains and yet, contemplating his toes.
His dinner eaten, he fell asleep again at 8:30.  Sean and I took our leave;  he to go collect the kids and put them to bed and I to go back to the hotel and get some sleep.  I was exhausted again.  On the surface, it seemed that I hadn't done much all day, but the sitting around, distraction and constant worry does take a toll on you. I had a bath and was in bed, asleep by 9:30.
On a Friday night.
In Toronto.

Pathetic, really.

Getting all his IV lines and wires out was big news, for sure.  Compared to the day before however, his progress had slowed a bit.  He was tired and now that there was less things poking him, he could get some much needed healing rest.  It had been a rainy day, a sleepy day.  After the wailing despair that had a accompanied getting the gear removed, it was wonderful to see him sleep comfortably on his tummy, his little feet crossed at the ankles.   I was moving out of the hotel in the morning, Wyatt would be getting his own room and Sean and the kids would visit in the afternoon.  These things helped me sleep too.  Which I did, like a stone, in my last night in the Fortress of Solitude, listening to the rain.

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*Adagio - A musical term meaning slowly, "at ease".


The Surgical Suite:
Prelude - Grave - Allegro con brio - Adagio - Allegretto con moto - Finale - Coda

12 comments :

  1. I'm so glad Wyatt's back to being the boy he is! And I can't get over how pink he is!

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    1. He's pink. He's alert. He's awesome. :) Thanks so much.

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  2. Sounds like Wyatt is recovering amazingly! I used to work on the cardiac unit at the Montreal Children's Hospital, and we usually didn't get the kids from the PICU for a couple of days post-op. And they definitely were not so into eating!! Glad it's going so well :o)

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    Replies
    1. Thanks! He was picking at that point, the real eating started when the drains came out. He's a trooper, my kid. :)

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  3. Good work all of you, Wyatt is looking good and I'm glad you are getting some rest too.
    H x

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  4. Oh, Congrats on the SWAN Award too ;)

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  5. Replies
    1. He still has a bit of a teething rash too.

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  6. You did a great job of capturing those moments. I love that photo of Wyatt. Love it.

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