ABS surgery at Shriners Hospital

We have passed another major step in Katie's little life.  Six months to the day from Gotcha Day, Katie had her first ABS (amniotic band syndrome) surgery at Shriner's hospital in Shreveport.  We knew that she would leave the hospital in 3 casts which would really slow down this active two year old, so we decided to try to make a weekend mini-vacation in anticipation of a not-so-fun 2 weeks post-surgical.

We had some concerns before we even left on the trip because Jaden had a stomach bug and kept having vomiting.  We kept Jaden and Katie separated as much as possible during his illness, but the day before we were to leave on the trip he was still sick and we decided that he would stay home with Laura instead of going on the trip.  Fortunately, Saturday he felt much better and so he and Laura went on the trip ... she drove separately so we could separate them if needed and so she could take him on home if he got sick again.  (He did continue to have episodes of sickness but would feel fine in between ... not enough to slow him down!)

We went to the Great Wolf Lodge in TX for Saturday and Sunday and drove on to Shreveport Sunday evening.  The indoor water park at the Great Wolf Lodge was a ton of fun for both kids.  They have a wave pool and a pretty good sized kiddy area and a lazy river.  We spent several hours there Saturday evening and topped off the evening with pizza and cookies.  It was a nice break before the craziness.  It was a blessing that Laura was able to come to keep an eye on Jaden and to help entertain the kids with me when Tim took a little break and went to see the band Colony House in Dallas.  (This is the band that Steven Curtis Chapman's sons have formed.  It seemed very appropriate as SCC is part of the whole path that we took to get to adoption.)

Monday, we had to have pre-op at Shriners and we were under the assumption that Katie would have to have blood work done.  We pushed fluids like crazy to make the stick easier, but when we met with the anesthesiologist he said that the newest guidelines state that with an otherwise healthy child, no lab or ecg was needed!  Whoot!  We'll still have to do it at some point, but right now it was wonderful to avoid that scary event with her.

Katie did incredibly well with the doctors and nurses during her pre-op visit.  She let everyone check her pressure and examine her as needed without much fear.  She was much more comfortable this time than last.  I think that hanging out with my nurses and staff helped her be more relaxed with medical stuff.  Once we saw the Child Life Specialist, we were given a key to our guest room upstairs at Shriner's and were finished with medical stuff for the day.

We went back to Eldorado Hotel where my sister and brother-in-law were staying with Jaden and Laura, and we had a nice visit.  My sister brought home grown satsumas and a juicer and we all had fresh juice, yum!

The plan was for the big girls to have some girl time and the boys and Katie to go eat at the noodle bar, but just as they started to go in the restaurant Katie gave back all of the liquids we had been pushing all day.  Unfortunately for Tim, it was just as he was picking her up to see how she was doing.  He needed a shower and a new set of clothes.  Katie looked more confused than upset but still...Yuck.  Laura had a jacket on and so donated her shirt to Katie, who also needed a whole new set of clothes.  We decided to ditch the girls night and take Katie on back to the guest room at Shriner's.

We were very nervous that they would postpone her surgery since she had thrown up, and we were worried that perhaps she had gotten Jay's illness.  We were worried that they might cancel her surgery.  Many prayers and a sleepless night later, they felt like a single episode my have just represented a vacation diet or nerves and so we were still on the schedule!

She was on a clear liquid diet after midnight until 7 am.  We tried to wait until just before time to give her a full bottle so that she wouldn't have as long to be hungry.  When her surgery was scheduled, she was the youngest but between that visit and this one, 2 younger children had been added to the schedule.   Two little girls 5 months or less, that both had Amniotic band syndrome and needed surgeries very similar to Katie's were in the room with us.  They were first and second on the surgery list, with Katie being third.  The one that was just before Katie was adorable!  At five months old, she was about a pound heavier than Katie.  She was not happy about being without food!  :)  That pushed her back from the 7am, first surgery, to about noon.  I was worried about her being without food that long but needn't have worried.  She never once indicated she was hungry.  It really drove home the fact that she rarely tells us she is hungry; she just accepts that mealtimes will come if and when they come.  I know I sometimes irritate people (sorry, Laura) when I remind them to offer food to the two littles in our home but I think Jaden and Katie were so used to being hungry that they still don't think to ask for food when they need it.  :(  Anyway, she did fine.  Shriners is AWESOME with the kids.  They have a dedicated playroom for the littles that has tons of ride on toys and pull toys, wagons and tractors...you name it and if it is fun for the preschool age group, it is there.  They also had a welcome gift for her with a princess wand, a stuffed pig, a book and an Elmo etch a sketch.  She stayed busy and happy the entire time.

About 11:30 they brought her some pre-medication that had Versed and Atropine in it.  Let me say, my little girl enjoyed the Versed.  It made her giddy and very relaxed.  She fixated on her socks and if you said "socks" she collapsed with laughter.

When they wheeled her away from us, she looked a little confused but not terribly concerned.  The only time I got tearful was when we prayed for her after she left;  I wasn't sure how she would do away from us with everything that was coming.  They promised to "gas" her before the IV though and so I hoped all would go well.  About 20 minutes later, they called to tell us that the surgery had started and that she had done very well.  She never shed a tear.  The nurse said they all fell in love with her because she was so sweet and fun.  They said every time they would tell her what they were about to do she would say, "Sure!"  or "Okay!" and then when they did it she would say "Thank you."  She said when they laid her down and put the mask on her, she pulled it off, thanked them, put it back on and fell promptly to sleep.

They said the surgery should be about 2.5 hours or so and that they would call half-way through.  The only blip in her care was that they forgot to call and about 2.5 hours later the surgeon walked into the room.  We must have looked panicked because she held up her hands and quickly assured us all was well.  Dr Hollister said that the surgery went well and that she was able to do everything that she had hoped to this time.  Katie will still need additional work on the ankle band and also on her right hand at some point but for now, she had released the bands on her right long finger and right pointer, released the band and separated the two toes on the right foot and taken half the band on the left ankle.  She didn't do a traditional Z-plasty on the ankle but had been able to do it in a way that she feels will be a little less noticeable later.

Eventually, she woke enough to be brought down to her room.  The nurse didn't want us to pick her up right away as they wanted her feet to stay elevated.  They hoped that would reduce swelling and the risk of bleeding.  I have to admit here, had she woken enough to ask me to pick her up, I would have anyway.  Luckily, I didn't have to risk upsetting anyone; Katie slept for several hours hugging her doll.  She would wake on occasion, just enough to see that we were there, and fall back to sleep.  The initial plan had been for her to stay overnight but they decided that we would be discharged that same day.  So we fed her a bottle, which she kept down, had a wet diaper to prove she was ok and bundled her up and left for home.  The drive is about 5-6 hours and she slept the entire time.  I have to say that I am not surprised.  They gave her 5 mg of Versed!  I only had 3 mg the last time I had a colonoscopy and I slept all day too.  (Was that TMI?)

Since we've been home, she has done very well.  She is having some pain.  She gets a little frantic and cranky when it is about time for her pain meds and today she asked Daddy to kiss her ankle but generally, she is doing very well.  She tried to walk a few steps yesterday during Jay's soccer game, yeah!  I want very much to take off the casts and look at the areas myself.  I have so far resisted temptation.  I hate that they used the old gypsum casts.  They are incredibly heavy and she is so tiny.  She should gain some muscle strength in the next two weeks.  October 27th, she will get them off.  Prayers for Katie and for mommy please until then.  :)