Thursday, March 1, 2012

Alexandra's Surgery

I have no idea where to start this post, so I guess I should just start at the very beginning. About two weeks ago (On Christmas day to be exact) Alexandra developed a terrible case of constipation. It was so painful for her and she couldn't go not matter how hard she tried. My normally quiet as a church mouse baby was squealing for everything she was worth. I found myself talking to David about the problem and what we could do at home. Nothing we normally did was working for her. We finally decided to make the trek to the hospital to see if there was anything they could do for her.

When we arrived at East Tennessee Children's Hospital we were immediately whisked into a room where everything seemed to happen at record pace. We knew it would happen pretty quickly given her medical history and the fact that if her bowels weren't emptied soon it could hit the point of critical very quickly. Her doctor (who truly was an ANGEL) came in and did a quick exam. She found that Alex didn't even have an opening large enough to put a suppository in to aid in passing stool. For the life of me I wish I knew this woman's name! She was so sweet to our very upset and sick baby!

After her exam Allie started to pass some stool on her own, but it was tough going. She showed me some tricks her pediatrician did not show me and ways to help the rock hard stool pass. Alexandra cried for quite a while, but she was able to empty herself out enough to be semi-comfortable until the emergency room doctor could get an x-ray to see how far she was backed up and if we needed to do anything else. After the x-ray she still was backed up into her small intestine, so the doctor proceeded with an enema. It was excruciating to watch my little girl be in so much pain, but it had to be done. The last thing we wanted was a ruptured intestine, something that is deadly in both adults and children. I knew a little bit of pain temporarily would do wonders for her in the near future, so we agreed despite knowing how uncomfortable it would be for her.

Alex started moving again and the doctor felt confident enough that she was moving plenty of stool to send us home. She called the surgeon on call with the practice we went to and asked what our next steps should be. Dr. Fowler (the doctor who also did the surgery) suggested we follow up as soon as possible with the surgeon to find out what needed to be done. We made an appointment with Dr. Jensen, her original surgeon, and he felt that it was time to do the surgery, in spite of telling us just weeks before that everything looked good for the time being. David and I were very unsure about letting Dr. Jensen operate on our child, so we did some asking around about his reputation. We found out that he was fairly new out of medical school and not very experienced at doing the imperforate anus repairs. This left me feeling ill-at-ease and I felt that we needed to get a second opinion. We called and scheduled with Dr. Fowler, who I had heard WONDERFUL things about and who was VERY competent in the repair she would be doing. She agreed with Dr. Jensen's assesment, but also felt that we needed to be further informed about the process from admitting to surgery and beyond. In doing so we found out that Dr. Jensen, who felt it should be an outpatient procedure, was wrong. The surgery was going to be a lot more involved that I initially thought, but Dr. Fowler assured me that it was important that we do it soon since Alexandra had developed a prolapsed colon.

The week leading up to her surgery was terrible. I was full of anxiety and fear. I did not want to put my child through a painful procedure, even if it meant a better quality of life for her. I was torn and I didn't sleep much. The night before her surgery, when we were admitted for bowel prep I laid in a ball praying fervently that God would protect my child and guide the hand of the surgeon and her assistants. The fear was terrible, but in spite of the fear I also had a peace about the decision that we had made. I can't tell you how many times I cried and asked what I could have done while I was pregnant to keep Allie from having been born with the problem she had. I know logically that it wasn't my fault, but there is still a part of you as a mom that blames yourself. Its hard to explain, but I kept feeling like I did something wrong.

The next morning our dear friend Kara came to sit with David and I while we waited for Alexandra to be wheeled down to surgery. My heart was full of anxiety, fear, relief, love for her, and prayers. I mostly prayed that nothing terrible would happen to her while on the operating table. I know this is me having knowledge of what CAN happen on the operating table and of course watching too many medical dramas play out on TV. I honestly think that if Kara and David hadn't been there I don't think I would have made it through surgery day with my sanity intact.  I cried a little bit, but I also spent a lot of time in prayer that day. It seemed to be the only thing that could calm my anxiety.

The two hours that she was under the knife were the worst two hours of my life. A few times I literally SHOOK with fear. I was terrified for my daughter, but the doctors were amazing. With each phase of surgery, I received phone calls with updates of her progress. I was told how long each part would take and when to expect another phone call. That helped with my anxiety too. I was able to walk around the hospital a bit to clear my head and David took a shift waiting on updates. It helped me to think and to not worry as much.

Shortly after surgery was over and the doctors began to wake her up, we were allowed to head back to her room. Within about a half an hour she was with us and I was able to hold her. Allie was in a little bit of pain, but nothing that wasn't manageable with pain medication and some snuggling. I was able to do skin to skin contact with her and that seemed to do wonders for her pain management. I wanted to nurse her so badly, and I can't even begin to say how hard it was not to have my baby close to me in that manner for an entire week!

Pain medications continued at regular intervals for three days after her surgery in order to keep her from having any bowel movements. This didn't work, but it did delay her first stool a whole day, giving the fresh wound time to seal a little bit. She was given IV antibiotics every six hours until she was discharged in order to stave off any infection that could have happened. With LOTS of prayers and the hard work of Dr. Fowler and her team, this never happened. I will be ever thankful this did NOT happen, as it would have required an other surgery right away to give her a colostomy. (Something NO ONE wanted to learn to care for!)

After five days of not being allowed to nurse Alexandra was allowed to eat. There is simply no way to describe how relieved I felt to be giving my daughter the milk she needed. Having her body close to my breast was like nothing I can ever describe. Allie seemed just as eager to be nursing as I was to have her nursing. She knew right away what those cues meant and she took to it like one takes to a bicycle after years of not riding. She was a little clumsy at first, but she soon remembered the basics.

After 24 hours of nursing and one good bowel movement later, Dr. Fowler checked her wound, gave her the thumbs up and scheduled an appointment for a week later to check that everything was healing well. We were allowed to go home, and I was praising God the whole way home, knowing that he was faithful to our family the entire time. An added bonus was we made it home in time to celebrate Christmas together as a family in our own home!

I can not say enough positive things about Doctor Fowler and her team. I also can not say anything negative about East Tennessee Children's Hospital.  All were very positive experiences given the circumstances and EVERYONE took excellent care of our little girl. A huge thank you must be made to everyone who helped our family and prayed for Alexandra and has continued to pray for her. She is doing amazingly well now and is growing and thriving. She continues to be under the care of Doctor Fowler, however if all goes according to her treatment plan, she should be through with regularly scheduled visits as of next week. Our journey through this has, at times been challenging, but certainly worth all of the pain and work.