Thursday, April 15, 2010

Tonsillectomy/Adenoidectomy and PE Tube Surgery

Nolan was surprisingly cooperative and in a good mood on Tuesday morning as we headed up to Buffalo Children's. He allowed the nurse to take his vitals, we discussed the runny nose issue (his lungs were clear, so we were allowed to proceed), and we headed down to the surgical waiting room. Things were on-time, so the little guy only had to wait for 2 hours and 15 minutes once we arrived at the hospital, and Nolan was entertained by Mickey Mouse cartoons on the waiting room television.

Our ENT came in and took our little guy from us, and we waited for about an hour until the pager went off to let us know he was out of surgery. Everything went very well, and Nolan was taken directly to the PICU (Pediatric Intensive Care Unit) for monitoring. He was awake and screaming when we arrived, both in pain and confused from the anesthesia.

Because he has severe central apnea, the anesthesiologist only gave him half the dose of Morphine most children receive. He also received no pain medication after the surgery, to ensure that his breathing was stable. Our ENT prescribed Tylenol with Codeine for pain relief, but the Codeine has been cut in half to reduce any potential complications with respiration.

He was quite upset for the first two hours in the PICU, crying and becoming hysterical. He looked like a Very Sad Boy, with bloody ears (from the PE tube placement- this can be shocking the first time you go through the procedure, but sometimes the ears are a tad "messy") and a swollen neck. Luckily, the Tylenol with Codeine took over and he fell asleep.

He slept for about 2 hours, with no desaturations or apneas. When he woke up, he was a tad fussy, but not hysterical. A few popsicles and watching Cars on the PICU television settled him down nicely. He was fussy off and on throughout the day, and fell asleep for the night at 11:00pm.

He set off the alarms quite frequently during the night, but only once for a desaturation and only about 5-6 times for apneas. The alarm was constantly going off for "extreme brachycardia" (slow heart beat) which caused me some panic. The nurses explained this is a common (and normal) heart rhythm in children.

In the morning, he ate some jello and had a few more popsicles. The attending came in the morning to discharge us, and we headed home. Nolan was doing extremely well on the car ride home, even crying for french fries from McDonald's. We kept him to smooth foods that first day, just to be safe with his throat- so no fries for poor Nolan.

He ate macaroni and cheese for dinner last night and had oatmeal for breakfast this morning. He is refusing to drink anything, but will eat Popsicles. We're using Popsicles for his hydration needs, and hopefully it will be enough to stave off dehydration. Keeping up on the Tylenol with Codeine seems to be the most important thing at the moment, as he gets cranky as he gets toward the end of the 4 hour interval between doses. I have been warned, however, that the real pain of a tonsillectomy occurs later in the week- something that someone else who has been there confirmed. Sometime around day 7-10, the scabs in Nolan's throat will fall off and his throat will be extremely raw- this is also the time he is in danger of bleeding.

For now, we are managing quite well and he is becoming quite the Popsicle addict. Those Mighty Minis ("slow melt") are wonderful. I don't know what we would do without them!


JoeyRes said...

Wow. I remember how upset my daughter was when she woke up from her ABR anesthesia and there wasn't even any surgical trauma to deal with. I hope your son has a speedy recovery and you get back to normal soon.

tammy said...

Oh Leah, so glad he is coming along so well. It's so hard seeing our little guys go through so much! NOlan is such the trooper and I pray that he doesn't have it rough in that "week after" timeframe. I can't believe he was eating mac and cheese! I hear too though that this surgery is one you want when you're younger, because the older you get the harder the healing gets. Here's to a quick recovery! Hugs to you!!!


Glad to hear things are going well for him. Looking forward to the near future when you can make a special trip out just to get him his French fries!

Keeping you in our prayers...

Julia said...

I'm so glad it all went relatively well. Recovery rooms are a touchy subject for me. On the one hand, you're so relieved to see the person alive and well, but at the same time that's when he or she is looking and feeling the most pathetic. Neil had a couple of major surgeries the summer before Ben was born, and both times it was pretty hard to see him in so much pain; same with Ben after his CI surgery. Grrrrr, recovery rooms. Thanks for the e-mail update, too, and I'm glad that it's so far so good with recovery.