Breathe Easier

After a few months of doctor’s appointments and tests, Neala had her tonsils and adenoids removed as well as her turbinates reduced. She was diagnosed with severe sleep apnea, and after her sleep study, we went to the ear, nose and throat doctor for a follow up appointment. They informed us that she’d greatly benefit from surgery and as she sat contently reading her books in the doctor’s office, he said, “Oh, yeah…we can really help that!”  The “that” he was referring to was her Darth Vader breathing which I’d become so used to that I hadn’t realized that our definition of quite and everyone else’s definition of quiet was completely different.

We (Patrick & I) were both a little concerned about the side effects of the anesthesia on such a little person, but it was explained to us that we could wait a while to do the surgery, but that during that time, Neala wouldn’t be breathing well at night. Or, alternately, we could take the risk of one low dose of anesthesia and get it over with. We chose the latter.

Nea’s surgery was scheduled first thing on a Wednesday morning and Patrick (miracle of all miracles) got the day off so we could all be together. They took us back to the pre-op area almost immediately after our arrival and asked us a battery of questions including Neala’s health history and family history, they weighed her (still not up to 20lbs. yet…), took her blood pressure, and measured her. The anesthesia team came in and explained some of the risks, and then our ENT came in and, cool as a cucumber, said she’d be taking her back shortly and that she thought it would take about an hour. The anesthesia team came and gave a dose of versed, and our peppy little gal started to sway and slur a bit. It was nothing that would have gone viral on YouTube, so we didn’t bother with the video. Oh well. Shortly there after, she waved bye-bye and they took her back while Patrick and I did our best to hold back our tears.

As I’ve said before, we have an incredible support team and they were by our side while we waited for word from the surgical team that Nea was in recovery. The delivery of breakfast burritos, coffee, nuts, trashy magazines, chapstick, deodorant (yay!), and a little owl named Oscar (for Neala), provided some much needed distraction! About an hour and 15 (longest 15 minutes of my life…since our NICU time) minutes later, the surgeon came out and spoke to us in a very dark and quiet room that seemed quite ominous to me. She said the surgery went well and that she removed the adenoids, tonsils, and reduced the turbinates in her nose, a portion of the procedure we’d signed consent for but were not sure would be necessary until the surgeon was able to “get in there and take a look.” She said the adenoids were blocking about 80% of her nasal passageway and that her tonsils were basically touching in the back of her throat and looked like “giant meatballs!” I asked how old her youngest patient to receive this surgery had been and she said, “Nine months, but I’m pretty sure that kid was about the size of Neala.” She said she couldn’t use her usual tools because little Neala is sooo small! Before we were even finished talking to the doctor, a member of the recovery team came to get us because Neala had woken up!

Her little face was swollen and the hospital gown swallowed her. She was very upset and her heart was racing. I sat in the chair and put her on my lap with her head on my chest. Her heart rate lowered and her breathing slowed and she fell back to sleep almost immediately for another hour or so. She choked down some liquid Tylenol and we were then transported to our room on the General Pediatrics Unit where we spent the next two nights.

The big worry after surgery for a little one is that they can become dehydrated very quickly, so Nea had an IV to keep her hydrated. She was on Tylenol every 4 hours around the clock and her vitals were being checked every 4 hours as well. She never required oxygen after surgery, which we were told was a possibility, and for that, we were thankful. When we first arrived in our room, she seemed to be almost her usual spunky self, but as the anesthesia began to wear off, it became clear that her recovery was not going to be a walk in the park.

She gagged and snorted each time she had to take the Tylenol and wouldn’t eat or drink anything. I do mean anything. Not ice cream. Not smoothies. Not milk. Not chocolate milk. Not water. Not juice. Not popsicles. Not applesauce. Not jello…She finally ate some watermelon and grapes and we were able to bribe her to drink water with a combination of her pacifier and pictures on our phones! We had to track every bite of anything that went in at all and somehow, by the end of the Friday after surgery, we’d hit some sort of minimum requirement for discharge and were sent home.

For a full 7 days post surgery, our little Neala was not herself. She was clingy and whiny, constantly needing her pacifier, asking for “big hugs” (she is not typically our most affectionate child), not sleeping, not eating, throwing horrible tantrums complete with arching back, flailing, and clapping (who knew that was a thing during a toddler tantrum?), not wanting to play or read or dance (her favorite things). She wanted to be held constantly, except for when she didn’t…see not above regarding tantrums, and no combination of Tylenol and ibuprofen seemed to make a difference. Patrick and I were both so worried that the anesthesia had caused some permanent damage…of course, our collective sigh of relief on day 8 was the only conversation we had about it, for fear that actually saying anything out loud might make it true!

On day 8, the meds seemed to finally be making a difference and, to our huge relief,  her little personality and voice came back! We’ve hit a few rough patches since then, and she’s slowly re-learning how to drink and keep the liquid from coming out of her nose, but all in all, I think we are over the worst of it. She’s sleeping like a champ and clearly breathing much easier, though her new favorite thing is to sing and talk to herself for up to an hour and a half after we put her to bed at night!

And…the award for best brother goes to Mr. Rylan. He was a champ! Various grandparents kept him company while we were at the hospital, and when we returned, he was SO sweet to his sister! He also really came out of his shell and is talking much more than before, can put on his own socks and sometimes his shoes, can climb into and out of his high chair, and has come up with a few new dance moves!