We arrived at the hospital around 8am yesterday, had Brooke change into her gown, and then let her play for a while in the surgical play area. While she was playing, Rob and I met with the anesthesiologist to discuss our concerns over pain management. I really think she would have had an easier recovery last time if she had woken up comfortable, and there was no way I was going to willingly let her be in that much pain again. The anesthesiologist was great, and agreed to leave the tubing in when they did the initial caudal block, and the redose it after the procedure was finished. She also loaded her iv with morphine and dilaudid, just to make sure she was comfortable.
We were moved to the O.R. holding area, where Dr. Smith met with us to discuss the procedures. The first procedure was a Ureter Pyelostomy to correct the obstructed ureter and allow her kidney to drain. Brooke has two ureters on each side, and the blocked ureter had a tiny opening at the bladder that had healed over with scar tissue. An incision was made just below her rib, above the kidney, and then the obstructed ureter was basically spliced into the good ureter. The second procedure was a Psoas Hitch to correct the reflux on the left side. With the psoas hitch the bladder is pulled up and over and then attached to the psoas muscle in the back, allowing for deeper tunneling of the ureters. The entire procedure was expected to last about 5 hours.
Brooke was given a dose of versed to help her relax, and she was acting so silly! She kept covering her face with her pillow and then looking at us and giggling. At one point she sat up and was laughing hysterically, telling me to look at her ears (that were covered with a surgical cap!). They rolled her into the O.R. and Rob and I began our long day of waiting. We took a trip to the cafeteria for a coffee, and then settled in at the family waiting room. We were prepared this time, and brought our laptops-cruising the internet can be good stress relief!
The surgery started around 10:30, and was finished at 5:00...a little longer than expected, but her doctor is very pleased with the results. She said the ureter portion of the procedure was 'textbook perfect'. When she got into the bladder, she discovered that the right ureters had retracted after the reimplantation surgery. She said that can be a side effect of the bladder spasms and is not uncommon. She said Brooke has a very healthy bladder, and she was able to stabilize it against the psoas muscle. She also routed the ureters along that muscle for extra stability.
Rob and I were both able to go into the recovery room (Brooke was the only patient left since it was so late in the afternoon) and Brooke looked so much better than after the first surgery. She was in and out of sleep, and able to move a little. She received 3 doses of morphine, and then was transferred to her room around 6:45 that evening. The nurses scrubbed Chimpy in for the surgery, and Brooke woke up with her monkey right by her side.
We had a really good night, she slept a lot and received morphine every 2 hours to stay on top of the pain. The only discomfort she has is when she coughs or moves too much. She remembers having bed sores last time, so she has been switching from her back to her side every time she gets meds or vitals. This is the view from our hospital room, and to our surprise, construction continues on the weekend...starting around 6:30am. We may change rooms this afternoon if possible-the noise really bothers Brooke.
The playroom is supposed to be open today, and Brooke is hoping to go check it out. Her doctor should be in sometime this morning to change her dressings, and then she will be clear to start sitting up and walking around. Looking forward to a good day with minimal pain for our Fancy Pants.
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