Tonsillectomies, the recap

The dreaded tonsillectomies are thankfully over -- and for that, I am so grateful! Here's the story ...

We found out probably 4 months ago that the boys needed to have their tonsils out due to sleep issues, chronic throat issues, and potential aspiration issues that seems to cause too-frequent pneumonia and bronchitis in Ben. The ENT who performed Sam's ear tube surgery was our first consult, he said immediately, after a quick glance at the throats, that the tonsils had to come out as soon as possible, but he doesn't operate perform the surgery on children under 4. I was unwilling to wait through another winter with tonsils and the illnesses that seem to accompany the tonsils, so we went for a second opinion. The new ENT agreed that the boys' tonsils needed to come out immediately, and said that he doesn't have a minimum age for the surgery, so we scheduled the boys' surgery, which took place on Thursday.

My mom had originally thought she would be unable to come down for the surgeries, and I was obviously upset about that, but I asked my dad, and he willingly agreed to come down for a few days, at least for the day of the surgery. He had a long-planned trip to DC with my grandma several days after the surgery, and neither he nor I wanted him to cancel the plans with my grandma. Some scheduling resolutions and canceled appointments allowed my mom to change her schedule last minute, and she came down on Wednesday night to stay for the surgeries and the weekend, and I was beyond grateful to see her on Wednesday night! The boys were with their dad that night, so I had a ton of nervous energy and was happy for the company.

On Thursday morning, the boys' father brought them to my house around 7:30, and we expected to leave for the hospital around 8:45. At 8am, I got a call from the hospital, there had been several cancellations, and they could take the boys as soon as we could get them there. We immediately loaded up the boys, and off we went.

The hospital was a whirlwind -- check-in, insurance, hospital bracelets (Sam picked fluorescent orange, which nicely matched the pajamas he had picked out for the occasion -- orange with little monkeys on them, and Halloween socks with multi-colored pumpkins), and before we knew it, we were in a small room with the "patient life" woman (or whatever her title was), Alicia. She had a big bin of stickers, and Sam was more than happy to put on his yellow hospital pajamas to cover them with stickers (Disney princesses and Cars). Ben took a bit more coaxing, including some bribery with Alicia's IPad, and the games on Daddy's cell phone (seriously, a game where an animated Santa moons you? Really??), and then the surgeon was in the room, I was signing consent forms, the anesthesiologist came and talked to me, I tried to remember all the things I was supposed to tell her about the boys, and we found out the boys would actually be occupying the two ORs simultaneously -- so the surgeon would go directly from one room to the next. As he went off, he commented, "Just hope you don't see me -- because if everything goes fine, I won't bother coming out until everyone is in recovery." I put on my OR attire, grabbed Sam, and off we went.

This is the third time I've held Sam while he's been put under general anesthesia, and needless to say, each experience has been heart-wrenching, although knowing what to expect certainly makes it a bit easier because I know Sam is going to cry, fight, beg me to take off his mask, and that all I can do is hug him a little tighter and not cry in front of him. Thankfully, the process is quick, and he was sleeping within a matter of seconds (well, probably 45 seconds or so). I went off to give Ben a pre-surgery kiss, and saw him and his dad as they headed for the OR. Ben had no idea what was going on, and was content with his dad taking him, so I gave him a kiss, told him I loved him, and he was off.

Sitting in the surgical waiting room, I was so thankful to have my mom sitting with me, having both of my boys in an OR was not a good feeling. However, it was quick -- and probably within 15 minutes, the nurse was out to get me, telling me Sam was in recovery and I could go back with him. I grabbed their dad, and off we went. Sam was still sleeping, so I put his beloved blanket on him, and we sat in the chairs, hoping he would sleep for at least an hour to help the anesthesia wear off ... No such luck. Within 5 minutes, he was screaming, shrieking, wailing (and the first thing I thought was how sweet and baby-like his voice sounded, we had been told his voice would probably change post-tonsillectomy) -- and as I held him on my lap, he was incoherent. Waking up from anesthesia is often an unpleasant experience, or so the nurses have told us in the past, but there is really no way to prepare yourself to see your child in that state. I hugged him and contained him as best as I could, and we sat like that for probably 20 minutes (as his nurse gave him 2 doses of Fentanyl, I think?), and then Ben was wheeled out. He was still asleep, and again, we hoped he would stay that way.

No such luck. Within a few minutes, he, too, was screaming. By that point, at least Sammy was starting to calm down, but I couldn't put him down to go comfort Ben, which was gut-wrenching. I asked the nurse to go get my mom, and the nurse gladly agreed, and went off to get Mimi. My mom was there within a few seconds, and she sat in the chair next to me as I held Sam, and kept giving me updates as to what was happening at the next bed, where the boys' dad was holding the screaming Ben. Despite Fentanyl, Ben would not go back to sleep, and continued to scream, and after probably 35 minutes, his anesthesiologist, who had been sitting nearby doing computer work, came over and said his breathing sounded strained and he needed a breathing treatment to help ensure his airway was clear. I asked her a million questions, after the magnesium-sulfate induced pneumonia I had during pregnancy bedrest (due to being so pumped full of fluids and on my back for 3 straight days), I had a handful of breathing treatments, and they made my heart race and made me feel awful. She said they would use something that would not impact Ben in that way, and I told her I was concerned about them putting a mask over his face again, that he would panic after having just been put under using the "magic mask." The boys' dad quickly agreed, and asked if it was really necessary. The anesthesiologist adamantly said yes, and they tried to start a treatment. Ben obviously panicked and nearly jumped out of his father's arms. I couldn't see what was happening, the boys' dad's back was to me, but I could see the struggle -- and then I saw the blood. Big drops of crimson blood splattering onto the white floor, the white sheets, all over Ben's white socks. And I started to freak out.

As the blood continued to pool on the floor, Sam's nurse and my mom realized quickly that I was about to totally lose it -- and my mom immediately started relaying information to me. I kept telling her, "HIS MOUTH IS BLEEDING" -- which we knew meant an emergency trip back into the OR to fix whatever vessel was bleeding -- and I was scared. Once my mom realized why I was so upset, and once she realized that I couldn't see what was happening or get to Ben because I was still holding Sam (who was still hooked to his IVs, pulse-ox, etc -- let's not even start talking about the NICU PTSD with all those bleeping monitors), she told me what had happened. Ben had apparently pulled out his IV during the struggle, and it was thankfully his hand, and not his mouth, that was bleeding (although he has quite a bruise on his hand from that ordeal).

After the struggle, the nurse gave him a third dose of the sedative, and Ben drifted off to sleep. Both he and his father were covered in blood, and the nurses kindly brought a giant lap pad to put on the floor because they realized the sight of my child's pooled blood was making me upset.

Because Ben had had further medical intervention, he bought himself a few extra hours in the hospital. Sam was ready to be discharged by about 12:30, but they kept Ben for several additional hours. Ben refused to drink anything before we left, but Sam sucked down two juice boxes (and actually woke up for the anesthesia screaming for a popsicle).

The boys, Mimi, and I made the drive to the green house, stopped and got the boys' prescriptions, and settled in for a long couple of days.

The boys' pain regiment consisted of Motrin every 6 hours and Vicodin every 6 hours, so the boys were getting medication every 3 hours. This meant that someone was pretty much always due for medicine, but the pain seemed to be well managed by this routine. After getting home from the hospital, they each ate 3 ice creams (a combination of Strawberry Shortcake Good Humor Bars and neopolitan ice cream bars), and I was pleased with their appetites. Drinking was another story, but they were both well-hydrated from their IVs.

The first night was long -- Ben ended up sleeping with my mom, and Sam slept in with me, and I barely slept at all, each time one of the boys coughed, he would wake up screaming. And not just an scream, a chill-inducing shriek that was probably some combination of pain and narcotics. The screaming, as well as the medication schedule, didn't mean much sleep for Mama, a sacrifice I was happy to make to have the boys with me for their recovery.

The past few days have been a blur. Sam was not a happy child on the Vicodin, so 36 hours post surgery, we stopped the Vicodin for both boys, and their pain has been managed very well by the Motrin. They both get very droopy and whiny and clingy when it is getting close to being due for a dose of medicine, but thankfully, Mimi has been here (she left this afternoon, and I obviously cried), and the boys' dad has been in and out over the past couple of days.

Getting the boys to actually take their medicine has been a challenge, especially for Ben, and Ben spent a period of time refusing to drink anything, and when he spiked a fairly high fever, I started to get worried. However, being a smart little boy, I could reason with him -- and I told him he was going to have to go back to the hospital for another IV if he didn't drink, and my mom told him that his head was hurting him because his head wanted something to drink (true, the ENT told us the dehydration could make the boys as miserable as the pain from the surgery) -- and somehow, convinced Ben that Peepaw wanted him to be a good boy and take his medicine and drink all of his Gatorade. Ben bought into that, hook, line, and sinker, and we ended up on Skype with my dad so he could watch the boys take their medicine and drink their drinks. And it worked like a charm.

All in all, things have gone smoothly and the recovery has been much "easier" than I had anticipated -- and I am so glad that the boys are starting to feel better, and that this procedure is over!

** no real "hospital pictures" of the boys because we were just too busy for me to think too much about it. As you see in the picture of Ben, the corners of their mouths are cracked and blistered from whatever device is put in their mouths to keep them open during the procedure -- it looks so painful.