One of the scarier words of my life

Surgery.

It’s something I’ve never had to go through.  I think that’s why it scares me so much.  It’s unknown.

On Monday, September 26th Peanut had surgery.

She has bilateral clubbed feet (fancy way of saying both of her feet were clubbed).  We began treating them with serial casting.  Serial casting is when you put someone’s legs in casts every week for approx 8 weeks.  Each week they remove the cast, and stretch the feet out a little more and put on a new cast in the stretched position.  They keep changing casts and stretching until their feet are over corrected (pointing slightly out).  They will eventually turn back in to what would ideally be pointing straight forward.

We were three weeks into casting and it was going well.  But on the third week they already saw that her Achilles tendon was far too tight to stretch out.  They said she’d need surgery.  It’s called an Achilles tendon release.  The Orthopedic surgeon explained to me that they were going to put her under general anesthesia.  Then they would cut around the back of her heel, push the artery off to the side, snip the tendon and pull her foot up into a neutral position.  If the tendon cut alone doesn’t do it, they’d need to do some soft tissue release as well.  The only reason they’d need to do soft tissue is if there’s a lot of extra scar tissue from the malformation that needs to be cut.

If I’m going to be completely honest with you, I didn’t hear most of what he said the first time.  All I heard was ‘general anesthesia’ and I went deaf.  I felt the world close in on me.  I was so scared for Peanut.  When he told me this, she still wasn’t even ten pounds.  She was so tiny.  I was terrified that something would so easily go wrong with the anesthesia.

Surgery.  I wasn’t sure what to think.  I really didn’t want to do it, but I knew it was her only option to have her feet corrected.  I didn’t have a choice.

Surgery.  I’ve gone 26 years surgery free, and Peanut didn’t even make it one.  I was so sad.  I still am a little bit.

I had known about it for about 6 weeks prior, but I never really thought about it because it was so far away.  I was in the midst of B12 injections, blood draws, leg splints and many other ordeals with her.  Not to mention just trying to survive the regular daily life that is twin babies and a 1 1/2-year-old.  *Surgery?  Oh yeah… sure sure that’s awhile away though.  I’ve got other things on my plate.*

We had a wedding coming up, we had a baby shower coming up we had birthday parties coming up and everything else in the world.  In hindsight I’m very, very thankful I was kept so busy for so long.  Why?  Because about two weeks before her surgery date, I was suddenly very aware of the 26th.  Very, very aware.

I started hounding husband to make sure he had off of work so he could watch the other two kids.  I started making lists.  Lists of clothes to bring.  Lists of food to bring.  Lists of things to bring to keep me entertained while I’m waiting.  Lists of questions to ask.  Lists on top of lists.  I had to do something and this was the only thing that made me feel like I was being proactive.  Like I was doing something to get me to an end.  What end that was, I don’t know.  I was just moving for the sake of moving.  I was moving for the sake of not thinking.

If I started thinking, the word ‘anesthesia’ came into my head.  I would get so worried I’d lose sleep.  I have enormous bags under my eyes to prove it.  I’ve had to start wearing my glasses regularly again to cover up the enormous dark circles.  They still haven’t entirely gone away.

When the weekend before the surgery came, I got really sick with a chest cold.  It got to the point where I could hardly breathe and I was coughing so hard my throat was raw.  I was so congested I had terrible sinus headaches.  If I tried to sleep my nose would literally pour on my pillow if I didn’t position myself right.  My eyes were even puffier, my skin looked sallow and my voice was hoarse.

I was so scared to go near Peanut.  Thankfully husband took on the brunt of Peanut’s daily care for me.  I was terrified I’d get her sick and she’d get congested and suffocate while intubted.  That, on top of everything else about the surgery and anesthesia had me in a worrying fit.

Finally, Sunday night came.

I didn’t know if I’d feel good enough to take Peanut to the hospital.  This had me more upset than anything previously stated.  I absolutely had to go.  I don’t think I’d have been able to stay away from the hospital that day without going crazy with anxiety.  But still, I have enough common sense to know when to give up.  I told husband I wasn’t sure if I could go and to prepare in case he would have to go.  He didn’t want to go, and I didn’t want to stay.  We were both equally tense about the situation.

We went to bed and didn’t really talk.  We both just layed there awake for one hour… two hours… nearly three hours.  Finally we fell asleep around midnight.  After that I woke up at 1 AM, then 3 AM, then 4 and 5 AM.  Each time I laid there awake, my imagination buzzing 100 miles a minute.  Not even just about the surgery.  About anything that came into my head.  Surgery, dinner, gardening, Harry Potter, sewing, sickness… anything.  I was too wired to stay asleep.  I felt like right when my eyes closed, they’d fly open again with another thought.

Finally my alarm went off at 6 AM.  Normally I’m not at all a morning person.  But when it went off I immediately sat up and just sat there and felt my stomach harden.  I felt like there was a boulder in my stomach.  I sat there trying to convince myself to get out of bed.  Not because I was too tired, but because I felt like the second my feet touched the floor I was accepting my daughter’s fate that day, good or bad.  *ok.  Today’s the day.  She’ll be fine.  She’ll be fine.  Ok… just get her there.  Stay positive.  It’s going to be fine…*

It felt like I sat there forever, but when I finally took that final breath and got out of bed I looked at the digital clock in the darkness and it said 6:02.

I realized that my sickness had abated somewhat overnight and rejoiced!  I could go now without worrying.  I ran and took some medicine for good measure.  I mechanically got dressed, brushed my teeth, did my hair and grabbed the bags I had packed the night before.  I went through my lists in my head, making doubly sure I had Peanut’s blanket, stuffed animal and a book to read to her when she gets out, healthy and well.  I wanted to make sure I had everything to make her feel comfortable and secure.

I went in the girl’s room and looked at her little face.  She looked so sweet and gentle.  I stroked her cheek and she FLEW awake with a happy squeal!  She started flailing her arms around and chattered away a little more exuberantly than usual.  I laughed so hard at her.  That little goof.  It was just what I needed to chip that boulder down into  rock.  *Ok… yeah, she’ll be fine.*

I got her in her car seat and grabbed up the bags I needed and headed out the door with a swift kiss and good luck wish for Peanut from an equally tired looking husband.  We loaded up and were on our way with 15 minutes to spare.  Thank god for that because the weather was godawful on the way down.  I ended up getting there ten minutes late despite my best efforts.

We checked in to day surgery, headed back to her room and Peanut got dressed in her hospital gown.  I don’t know what it is, but I just love the gowns on her, they’re so tiny! In the meantime she was still chatting away with anyone who would listen.  All the nurses in our pod were immediately in love with her and kept laughing at her squeals and smiles.  I secretly hoped that meant they’d take extra good care of her if they thought she was so cute.

Peanut's cute little hospital gown

About half an hour before the scheduled surgery time they gave her some sedation that calms her (doesn’t put her to sleep) since she was beginning to start stranger anxiety.  Even though she was being so friendly we all figured it’s better to give it to her so when we’re separated she doesn’t get upset that she’s with strangers.  We headed down to the holding room.  (Keep in mind I’ve never done this before.  Although I’ve been to children’s many times, this was so official.  I was very intimidated by this whole process!)

The holding room is a room with six curtained off areas similar to cubicles.  A child is rolled in on their bed and each of the surgeons, anesthesiologist and OR nurses meets with the parents.  The nurses came in first to ask health related questions which, again, is very intimidating.  Mostly because now I know for a fact that these questions will directly affect Peanut’s surgery. (Which at this point is not T minus ten minutes!)  Then the anesthesiologist Fellow came in with his Attending and started asking me some questions.  After that the Orthopedic surgeon Fellow came in, introduced himself, and explained the surgery in full and asked if I had any questions.  I listened smiling.  I was ecstatic!  They both introduced themselves as a Fellows!  *Yes!  YES!*

I was so so happy that it was fellows and not residents doing the surgery!  I knew that since it was a teaching hospital, that a student would be performing the surgery.  At first I was so worried that something would go wrong, but then I knew that the Attending would be standing right there ready to intervene at any time which is a comfort.  My only wish was that Fellows would be doing it because I was positive that this wouldn’t be their first time performing this surgery then.

By the time I finished talking to all six of the doctors and nurses that would be taking care of my little peanut, I felt like that rock in my stomach had turned into a pebble.  My biggest fear had been the anesthesiologist, and not only was the fellow extremely confident and capable, but the attending was so casual and friendly that they really made me feel comfortable with their ability.  their bedside manner was honestly the best I’ve ever dealt with.

They all left periodically and I was left alone with Peanut.  I realized that I hadn’t really looked at her for the past ten minutes.  the last time that I had looked at her she was for the most part with it.  When I looked at her this time, though, I had to literally choke back a laugh.  I realized that I was so distracted by all the background noise I didn’t hear her singing groggily to herself this whole time.  It was somewhere between a groan, a gurgle and a sigh.  Not only that but her eyes were half drooped and she had this odd little confused smirk on her face.  In short, she looked drunk.  She was staring up at the ceiling and she’d raise her hand unintentionally and startle herself.  She’d hold her hand over her face and rotate it round and study it so intensely.  Then I’d say her name and she’d startle and throw her head in the direction of my voice.  It took her a second to focus on me when she finally realized where I was then she’d stare at me.  Hard.  Almost like she was trying to figure out if it was really me or not.

'drunken' peanut

When she wasn’t studying my face or her hand, she’d look at the nurses that popped in and out.  She’d stare at them, then almost smile at them like she recognized them, then go back to serious in an instant.  It was like she was always just short of coming to a realization and was always lost in thought.

She had me laughing so hard I didn’t realize her surgery was late.  When all six of the doctors and nurses came to get her, I was shocked to see so much time had gone by without my noticing.  Peanut’s goofy half-drunken state was just what I needed to relax.

Then, the final kicker.  When they announced “it’s time.” I felt a rush of emotions come back again.  I snuggled Peanut close for a couple of seconds and gave her one, or ten, final kisses and backed away watching her almost smile before going back into contemplation mode about whether she recognizes me or not.  I chuckled.  The nurse wrapped her body up in the blanket I brought and picked her up.  Immediately, as if Peanut’s consciousness was an arrow shooting through the fog, she seemed to get the spark back in her eyes.  She threw her hands out of the blanket, braced them against the nurse’s shoulder and reared her head back while giving one of the dirtiest looks I have ever seen.  Her eyes bore into the nurse like lasers.  Her eyebrows nearly met in the middle.  Her nose was wrinkled up like she smelled dead fish.  Her frown looked absolutely disgusted.  For a good five seconds she glared at the nurse with this look of absolute hatred.  Then, slowly, she drifted back into a state of indifference and started singing to herself again.

I, and the whole team of doctors, laughed.  We laughed so hard that all the other patients and their parents and their doctors looked our way.  Soon, they were all smiling too.

That pebble in my stomach turned into a grain of sand.  What a personality…  I will never, ever forget that face.

I watched them walk away with my baby.  All smiling and laughing about what she just did, and she was indifferently observing her surroundings as she went.  Somehow, at the moment that I feared the most, I was feeling my best in the last two weeks.  I was scared that watching her go would be so hard for me.  I kept thinking of all the bad things that could happen to her.  Yet here I was, smiling and chuckling to myself.  I was completely comfortable with the doctors that were walking away with her.  I was completely comfortable with the day now.

I headed out of holding, and made my way to the family surgery waiting room.  They said the surgery would take about two hours so I brought some knitting and a book.  I considered bringing more, but I knew I could easily just read for two hours and be fine.  I brought a neck pillow in anticipation of a crappy chair with plastic arms in a crappy small room with crappy lighting.  To my complete surprise the waiting room was in a new wing recently built on the hospital.  It was huge.  There were two receptionists there, there was a mini kitchen with so much free food and even more drinks, there were tens of couches and recliners with their own coffee tables and ottomans and there were three big screen TVs.  Phones were even spread through the room for free outside calls if you didn’t get cell phone reception.  The receptionists were there to call the OR at any time and check on the progress for parents and answer any other questions in the meantime.  *Thank you Children’s, yet again, for exceeding my expectations!*

I went straight back to an empty corner in front of one of the TVs and set up camp on one of the couches.  I went to the kitchen straightaway and found the coffee.  Now that Peanut was gone, I was beginning to realize just how tired I was.  After the first coffee I got creative and started mixing coffee and hot chocolate and creamer.  It was delicious.. and effective.  I was happy to see other parents brought book, puzzles, music players and one Mom even had a yoga mat laid out.  Some other parents were napping with blankets and a pillow and had their shoes off, so I felt it was only appropriate to take my own shoes off.  It was like a bum’s paradise.  We were eating free food and napping on furniture that wasn’t ours.

Two short hours later The attending surgeon came and found me to let me know Peanut was out of surgery and already woke up in recovery.  I don’t know if it was the enormous amount of caffeine pumping through my body, or the immense amount of relief exploding from my body, but I was absolutely happy and wired to the max.  (probably a little bit of both)  He told me that they had a minor issue with the anesthesia at first.  They originally put her on her belly so they could get to her ankles easier, but the weight of her body was too much for her lugs to handle so they had to flip her over.  I honestly don’t know if she want into cardiac arrest, or if her heart rate just got too low or what.  I didn’t ask.  I didn’t care.  I knew she was fine now, and I knew it’d only make future surgeries scarier for me if I knew she had something serious happen.

The surgery itself went very well.  He said the tendon release wasn’t enough to bring her foot up so they had to do a soft tissue release too.  I guess she did have a lot of scar tissue around her tendon.  Now because they had to cut more she’ll always have a little gap in the back of her ankle, but I figure it’s better that than being tippy toed all her life!  In the meantime we put her in casts and wait for the tendon and tissue to heal itself back together where it was separated.  That could take anywhere from six weeks on.

I was led back to the recovery room to see her.  The room had approximately ten bed around the left and back perimeter with an island of computers and desks in the middle for the nurses and staff.  The right side had a bunch of door for what I imagine are supplies.  It was a long skinny room.  Right when I entered I heard her.  At least I thought it was her.  It sounded like her, but the little voice sounded so dull and tired and hoarse.  All I heard was “eeeeeeh… eeeeeeeh…”  I was led to the farthest back corner and saw her.  She was in casts up to her hips, sprawled on her back on the nurse’s lap and her head was draped over her arm, completely limp.  Her eyes were closed and her arms were limp at her sides.  She was letting out the saddest little cry I have ever heard.  But the hoarseness is what shocked me.  She sounded like someone who had lost their voice.  I mean it was really really bad!  I asked why her voice was so scratchy and the nurse said that some kids that are intubated get really dry throats from the gas that’s blown in their throats.  I felt so bad for her.  It must have hurt so bad!  I got her in my lap and held her tight.  After a few minutes she stopped crying and she opened her groggy little eyes and looked right at me.  She didn’t smile and she didn’t reach up to touch my face like she always does.  Her eyes were so tender and trusting like she knew I was here for her now.  She snuggled into my chest, closed her eyes and let out a little sigh.

Peanut right after surgery. Still groggy.

I finally felt that little grain of sand I had been holding on to disappear.  It was finally ok.  She was finally ok.  It was done.  I think she sensed that too when she snuggled in.  It was like she had been smiling and laughing for me those last two weeks to keep my spirits up, but now that it was over, she stopped trying to be happy for me and just wanted to be comforted and held tight.  We sat there for a long time quietly.  It was so peaceful.

We eventually were roused from our mental slumber and were taken back to day surgery for recovery time.  We had to wait until she showed signs of being “back to normal” and that the anesthesia was completely out of her system before we could go home.  I snuggled her tightly in her blanket and went to get her stuffed animal.  I realized I forgot to bring one!  I was bummed, but glad she wasn’t attached to any one in particular yet.  I grabbed out “goodnight Moon” and snuggled her up in my lap.  We didn’t even start it yet and the nurse came in to check up on her.  She had a piece of paper in her hand and the other was behind her back.  We chatted for a little bit the she gave me the piece of paper.  It was so sweet!  It was a certificate of Bravery for Peanut.  It had a picture of a princess  and said, “Peanut is entitled to this award for bravery for her surgery at Children’s Hospital of Wisconsin.”  I loved it immediately.  She deserved that certificate months ago.  Then the nurse took her other hand out from behind her back.  It was a little handmade stuffed animal bear.  It had a ribbon tied around its neck and a big heart sewn on its chest.  She said it was a “bravery Bear” for her to take home to always remember this day.  I almost cried.  I don’t know why.  But it was just so sweet.  Someone took the time to make this little bear for kids who go through surgery.  My little Peanut got a Bravery Bear.  I profusely thanked the nurse while Peanut, who was getting back to her usual self, squealed and chomped away on her new toy.

Bravery Bear

An hour later we were getting ready to go.  Peanut, who was now screaming at the top of her lungs in delight every time she saw her bear, was “back to normal”.  When the nurses saw her thrashing and panting and squealing and laughing, they came in laughing and said we clearly didn’t need to stay here any longer if she was about to destroy the room in her excitement.  I agreed.  Right when  I got her in the stroller and pulled on my jacket Peanut’s OR nurse came in to check up on us.  Peanut greeted her with smiles, completely unaware of the death glare she gave her earlier in the day.  I chatted with her for a minute.  She asked about her siblings and I told her about Bear and Buddy and how they’re all already really close.  She told me to wait a minute and disappeared.  A few minutes later she showed up with two more bravery bears.  (Which resulted in more screams from Peanut when she saw them)  One for Buddy, and one for Bear.  I couldn’t believe how generous everyone was that day!

I gave Peanut all three bears in the meantime which she greedily chomped on, and we headed home.  It was around 1:30 PM.  By the time we got home we were gone around 8 hours, which was less than I would have ever expected!  When I got in the door, Buddy was right there waiting.  He saw his sister’s car seat and pointed over and over.  He wouldn’t get out of the way and kept telling me to put her down.  He insisted on seeing her right then and there.  I’m not sure if he sensed that something happened to her, or if he was just happy to se her, but he made it clear he wanted to see his sister right now.  I put her down and he squatted down next to her and closely examined her.  He looked over her face, checked her arms, poked at her casts and checked her buckles.  After the check he still stayed though and just chatted to her and pointed to her.  It was like he was so happy to see her.  It was really sweet.  When I got her out of her seat he ran ahead to her swing and waited for her there.  What a doting brother. 🙂

Doting brother

Now, three days later, you would never have known she had surgery if she didn’t have those casts.  She is more rambunctious than ever and smiling and laughing right along with her sister.  We have a follow-up appointment in a week and she’ll be getting her permanent casts then after removing the stitches and checking the healing.  (I’m still debating what color to get her.  I’m thinking bright pink will fit her just fine.)   In the meantime I at least have the scariest day of the year (so far!) out-of-the-way!  Plus, wouldn’t you know it, my sicknes is nearly gone now.  It was totally stress.

Everyone, thank you for your well wishes and prayers!  Peanut, and especially I, thank you for everything you’ve done and said.  I’m so happy that she has so many people who love her so much.  She really is a special girl!

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