Surgery #3 - April 7

I'm still not a fan of seeing numbers like 4:45 am on my clock, but being up that early did give me some extra snuggle time with Baby Girl before her surgery today so I guess it's not all bad...especially since that's the last time I'll get to hold her until next Monday :(

I got to the hospital a little after 6:00 and got to help get her ready for the morning and then she was wide awake and ready to go! There was not a chance she was going to go back to sleep and miss all of the action and excitement of shift change with everyone walking around and talking - and she was not disappointed; she had a number of nurses stop by and wish her luck before the surgery. They came and got her shortly before 8 and it was back to the waiting room for me.

At about 9:45 the ENT came out and I was expecting her to say they got her intubated and we're ready to go (that's about how long it took with the other surgeries...) but she came out to say everything went fine and they were taking her back upstairs! She said Baby Girl was looking around nervously at everything but never got fussy and even smiled at her a couple of times; they intubated before anesthesia and had no problems; and the procedure went great. They had anticipated a few specific problems, but the measures they took to mitigate them worked out perfectly so there were no huge surprises. They had to remove more of the fatty tissue under the skin folds of her neck (caused by the webbing / conjectures) but felt they were able to get a good opening to her airway.

She did evaluate the airway and vocal chords again after the surgery and said that other than a little irritation from the ventilator tube last week and a bit of extra cartilage on the top of her voice box, there's nothing physically wrong with her so they aren't sure why she's not making noises yet. That will be something to address later though. They will do follow-up evaluations of the trach placement every six months and keep an eye on the vocal issue as well.

We went back upstairs to wait for them to get her settled and about an hour later they still hadn't come to get us so I went in to see what was going on. Apparently she was starting to come out of the anesthesia as they were getting back up into the NICU and when she pulled her hands up to her comfort position right underneath her chin there was something in her way... So she started pulling. She managed to get the ventilator off of the trach tube before they could stop her and get the sedative and pain medicine in her. The NICU nurse said she felt so bad because as she was trying to swaddle her and get her hands down these big ol' tears just started rolling out of her eyes :(

Once they got her sedated and gave her morphine she calmed down, but her respiratory issues make her have a high metabolism so she was burning through the pain meds faster than they were allowed to give it to her and would wake up with tears. Broke my heart. The dr finally switched her over to a steady drip instead of a certain amount every two hours.

So for now they're keeping her sedated. They've got the trach attached to the ventilator to give her lungs some assistance / a break while she recovers but hope to have her off of it tomorrow afternoon-ish. They have to keep her as still as possible (HA!) until next Monday to allow a good tract to form before the first trach change and to reduce any issues with irritation and infection...but they don't want to keep her sedated that long so it'll be interesting to see how they manage that. I'll start working with the teach training nurse tomorrow on learning about the equipment, changing it out, keeping it clean, etc. so that when she's ready to come home, I'm ready too :)