Ureter Pyelostomy and Psoas Hitch Surgery-Day 3

Brooke did really well last night, only waking for morphine. She started asking to get out of bed around 4:30, so she stood up for a while and played her DS. Around 6:30 we turned on the tv for her to watch cartoons, and she fell back asleep. Rob was at the hospital when she woke up, and we all walked down to the cafeteria to find something for breakfast. I picked out some toast with peanut butter, thinking she might eat some, but no luck. She was really tired after all that walking, so we put her in a wheelchair and headed back to the room. Her lower back was still really sore from where they attached her bladder to the psoas muscle, so it seems that she is tiring out more quickly this time.

Dr. Smith came by and checked Brooke's incisions-they still look really good, and have hardly any drainage. She said we could take the catheter out, and wanted us to get Brooke off the morphine-she can't go home on iv meds! We had one of our favorite nurses, and she was really good at working with Brooke to get her to eat a little graham cracker and applesauce so the medicine wouldn't make her sick. She has been switched to lortab, and it seems to keep the pain away longer than the morphine, which is great!

Dr. Smith had the nurses move us to a bigger room, and I was so glad to see sunshine coming in through the windows! Brooke went straight over to the couch and sat there for a good long time. She finally decided to get back into bed, and Rob sent me to the hotel to take a nap and then have a hot shower. I'm so glad he did that-it's amazing what sleep and a hot shower can do for you! While I was gone, the nurse took out Brooke's catheter, took off her incision dressings and let Rob give Brooke a shower. I was impressed-he even washed her hair!

I brought Cracker Barrel back with me, hoping she would finally give in and eat something. She wasn't interested at first, so we took a long walk through the hospital. When we came back to the room she wanted to color, so we set her up at the table with coloring supplies, french toast and applesauce. I told her she had to eat/drink every 5 minutes, and she thought that was a great game. She was really trying to convince us that she is well enough to go home, and even managed to laugh a little without hurting! When she started making silly faces I knew she was feeling better. Here's to a good night of rest!

Ureter Pyelostomy and Psoas Hitch Surgery-Day 2

Dr. Smith came by around 9:30 for her morning checkup. She wanted to check Brooke's incisions and change the dressings, and I think she has to be one of the best doctor's we've ever had. She let Brooke take off the dressings, peeling the tape really slowly while Dr. Smith put hand sanitizer on it to take away the stickiness...this was at least a 30 minute process. She kept telling Brooke to stop and take breaks, and she thought nothing of it when Brooke requested pictures of her incision so she could see what it looked like. She was happy with the incisions and the draining, and replaced the dressings. She was a little concerned that Brooke has developed a cough, and said her chest sounds really gunky. Anyone that has been through abdominal surgery knows how badly it hurts to cough or sneeze, so Dr. Smith really encouraged Brooke to squeeze a pillow as tight as she can on her tummy and make one productive cough to get this stuff out of her. She said that getting Brooke up and walking should help with that.

As soon as she left, Brooke asked to get up. She walked around her room for a minute, trying on her new robe and slippers, and then asked to take a trip to the playroom. She wasn't feeling very well, so we picked a book to take back to her room. After a little rest time, she asked to walk to the cafeteria. I was really proud of her for making it all the way through the hospital and through the cafeteria, where she picked out a smoothie to drink. By that point she was pretty shaky, so we snagged a wheelchair for the trip back to her room. She was exhausted, so she settled back into bed and took a good nap (and I curled up in the chair to sleep along with her!).

We had one of our favorite nurses in the afternoon, and she was so sweet with Brooke. She said she recognized her name on the chart, and was happy to see Brooke again. She convinced Brooke to get out of bed, and she spent a little time playing on the computer. We also took another walk to the cafeteria, but Brooke still hasn't found anything she can eat.

She is on morphine for pain management, as well as motrin for any swelling and her normal antibiotic to prevent infection. Getting the motrin in her is a huge ordeal, she really doesn't like the taste and it takes a lot of convincing to get her to open her mouth. When I told her it was time for meds earlier, she said 'no thanks' and clamped her mouth shut! At least she still has manners, even if she is hurting. She is finally in bed resting, and Rob is back at the hotel. I've pulled out the chair for the night, and am hoping for a good night for Brooke.

Ureter Pyelostomy and Psoas Hitch Surgery-Day 1

We had Brooke's follow-up appointment from her Bi-lateral Ureter Reimplantation surgery, and were disappointed to find continued reflux in the left ureter system, and scar tissue causing an obstruction in the right ureter system. Her renal u/s showed significant swelling in her right kidney, so we had no option other than to go back in and fix things.

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.