Monday, June 16, 2008

Outpatient day

Natalie had her outpatient procedure today at 12:45 pm to re-insert the ear tubes and check her eyes for pressure and optic nerve cupping.

When this was scheduled at 12:45 pm a couple weeks ago, I almost screeched at the office assistant, "How is my daughter going to make it until 12:45 with no food!" I knew that she wouldn't be allowed to eat anything in the morning, and she eats dinner at 5:30 or 6 pm and goes to bed at 7 pm, so that would be about 18 hours without food. The office assistant said, "Well, when you come in for your pre-op appointment, we'll discuss it." She is one of the kindest medical assistants I've worked with, so I trusted her. AND Tom and I are thoroughly tired of giving Natalie eye drops twice a day (not to mention how Natalie feels about the eye drops...probably not good, judging by her continued resistance and crying)...if we didn't get today's surgery date, it might be another two weeks. Another two weeks of eye drops...

So at the pre-op visit last week, the office assistant asked how old she was: 2 1/2. We looked at the guidelines for eating and drinking before anesthesia, which are:
  • for 6 months to 2 years: no food 6 hours before
  • for 2 years to adult: no food 8 hours before
So with a surgery time of 12:45 p.m., she could eat breakfast at 6 a.m. and still be within the 2 year old cut off, but at 2 1/2, she should have to finish breakfast by 4:45 a.m. (8 hours in advance) to eat that day.

The office assistant told me to go with the 6 months to 2 year guidelines. Whew!

Of course the day we want Natalie to eat well for breakfast, she didn't. I had to wake her up a little before 6 am, and she wasn't interested in eating like she normally is. She only ate a few bites, whereas normally she has a good serving of Cheerios in the morning.

Tom took her to this appointment since I'm still the feeding source for Konrad. Then Tom called me at 12:30 and told me, "Bad news." The outpatient nurses said that since Natalie had eaten at 6, they would have to delay the event, and only one of the two doctors could do it at the delayed time.

I told him that we were instructed by the ENT's assistant to use the 6 hour window, so he would have to go back and talk to them and "be pushy." Those were my have to be pushy sometimes to get the medical care your kid needs.

Lukas and I prayed that everything would work out, and 15 minutes later Tom called and told me they were good to go. The doctor whose assistant gave us the 6-hour window agreed that this would be fine. (It's an issue of the anesthesia used, and not having a risk of her throwing up, but because it's a "twilight" kind of med they're using, I think they can be more lenient.)

Next time you can bet I'm going to fight for an earlier surgery time!

So now the results: left ear tube reinserted; right tube was still there behind a huge glob of wax. When the ENT removed the wax, the ear tube came out too. Unfortunately, it's not good to put another tube in the hole right away, so we have to leave it as is. Hopefully Natalie won't be digging her fingers in her ears anymore (and will be hearing better).

The eye situation is a little more uncertain still. The good news is that her eye pressures this time were 13-14 (last time was 18). But the "bad" news is that the ophthalmologist thinks the eye drops are helping to keep the pressures lower, so he wants her to continue using the drops. That's not what I wanted to hear! I have a call in to him, because I thought at our last office visit, he said if the cupping of her optic nerve didn't improve with the drops, then she doesn't have glaucoma and we would stop the drops. But what he told Tom is: the pressures are better, the cupping did not change, let's keep doing the drops. Tom asked him, "Does she have glaucoma?" The answer was, "I don't think so, but let's keep doing the drops."

I'm telling myself to have a good attitude about this, because it is not coming naturally.

Many thanks to everyone who prayed for her and us today...we are thankful for a good outcome from the anesthesia. She was a little cranky when Tom brought her home (she refused to eat or drink after she came out) but after a large snack and some milk, she's doing much better. We can't go outside today (no swing) because her eyes were dilated, so Signing Time is the afternoon entertainment.

1 comment:

Kelly said...

So glad things went well. AnnaKate was cranky this afternoon---maybe it was sympathy pains!! :)