Kurt has been upgrading our computers. Like most things, it's a slower process than we anticipated. Consequently, I have no photos this week, and I might have to make the camera and the computer apologize to each other. They currently aren't speaking.
In other news, well, there really isn't other news. Quinn is getting bigger, and we're heading into fall, and looking at holing up for the winter against the sick season. We'll be seeing a developmental pediatrician later this week, to make sure Quinn looks and acts like a three month old baby, but other than that, we're on cruise control. I can't believe the worst day of my life was very nearly 6 months ago. How times have changed.
Monday, September 29, 2008
Monday, September 22, 2008
I suppose it's kind of flattering to be fought over.
I didn't have much to report this week. After last week, it seemed so boring. And truthfully, I'm more than okay with that. I want some boredom in my life for a little while. Just routine life. That's our aim for now.
Quinn is recovering well. I wonder if he'll even have very visible scars from the surgery. He's still growing, and still becoming more interactive with us. We don't have anything major going on this week, and we're going to enjoy that. Just life.
Sunday, September 14, 2008
Thursday morning at 6:50, I stopped nursing Quinn, beginning the four hour fast required for anesthesia. A little while later, we all got up and began the whirlwind preparations to get out the door. I packed my breast pump and Kurt and I packed books and a laptop. We were still counting on taking him home afterward and so packed nothing else. We dropped the older kids off at a friend's house and headed downtown. Within minutes, I remembered my breast pump was sitting in it's usual spot at home. Oh well. I'd figure something else out. We were going to be just on time as it was, so I didn't want to go back for it.
We got to the hospital and I tried to stop being melodramatic, and force the image of bringing sacrificial lambs into the temple from my mind. We checked in and were told they would take us in soon, because Quinn's time was near. We were keeping him occupied with a pacifier, which he normally doesn't have. He was unhappy with us. I didn't blame him. About half an hour later, we were called into the pre-anesthesia area and given a tiny hospital gown and socks for Quinn.
Over the course of the next hour, about 10 people came over and introduced themselves to us as various members of the surgical team. One nurse anesthetist went over some questions with us, mainly about Quinn's NICU stay, and how his needs there might affect his care that day. She mentioned he was slated to stay overnight. I told her no one had said that definitely, that we wouldn't know until afterward. She left to consult a calendar and returned to say that their policy was that babies be 50 weeks gestation, and Quinn was 49. (If we want to be picky, he was 49 and 3 days. Four more days, and he would have been at the magic 50 number.) Anyway, Kurt and I simultaneously made comments on the convenience of the number 50 and of our skepticism that that was the true number. The nurse was defensive, as well she may have been, and said she was sure the anesthesiologist had data to back up that number. Kurt took over the explanation and said he had no doubt that there was data, but it was unlikely the data pointed exactly to the number 50, that more likely the number was 49, 48.5, or something like that, and had been rounded. Easy numbers like 50 rarely exist in nature. She looked between the two of us, and said, "You two must be mathematicians." She must have said it jokingly, because she was sort of shocked when we told her in a sense we were. Kurt is an engineer, which is applied math, and my background in population genetics and statistics is another form of applied math. She sort of shook her head and said the decision would be up to the anesthesiologist.
We met the anesthesiologist, and expressed our concern about Quinn's previous experience with anesthesia. When he was a week old, he had surgery to insert a central IV line, and hadn't tolerated the anesthesia well. He needed blood pressure stabilization, and what exactly happened varied by who described it to us. The NICU staff used the term "overdose." But one doctor had said the anesthesiologists insisted it was an appropriate dose. We didn't really care. What it came down to was that it was too much for Quinn. If that isn't an overdose, I don't know what is. Anyway, this anesthesiologist said she was familiar with the case, that she had helped review it, and insisted it was an appropriate dose. We repeated, whatever their data said, it was too much for Quinn, and we were worried the same thing would happen. Overall, it was a pretty circular argument, as she insisted it was okay by their data, and we insisted we were still concerned. I honestly don't remember how it got resolved, if at all. It's beginning to blur.
Another nurse anesthetist came to introduce herself and say that she would be taking Quinn back to the OR. I asked if I could go with him, and she said no, they don't do that for babies. I asked why, and she thought for a minute and then shrugged and said "Policy." I fought back a laugh. That was the best she could do? She then said that parents distract the staff from the patient, and they allow it for older children because of stranger anxiety. But babies haven't gone through separation anxiety yet. "I have." was my response. Without any more argument, she left and returned with a set of scrubs, a hair cover, and a mask, as well as a waiver to sign in case I fainted. So much for policy.
By this point, Quinn had been sleeping on and off, and in between times was a little frantic to eat. But he seemed calm as I carried him into the OR. He lay on the table looking around, and it was good for me to see him okay with what was happening to him. Then they put the mask on his face and he fought it and cried. That was hard. I had been told he would take just a couple of breaths and be out, but it took nearly a minute. Then he was asleep and I was escorted from the room. Whoever it was tried to take me by the arm, but I walked out under my own steam. Did I look that fragile?
Kurt and I took up a post in the surgical waiting area. the surgery was an hour late, which wasn't surprising, just disappointing. About two hours later, the surgeon came to talk to us and told us he had been successsful, and Quinn seemed to handle it all very well. He said the hernia on the left side had been humongous and he'd had to do an adult-sized repair job. But everything else looked okay. We asked about taking him home, and he said he didn't have a problem with it, but his wasn't the final say. That was anesthesia's job. He said they probably would have allowed it if we still had an apnea monitor at home, but since we didn't, we had a weaker argument. I guaranteed him no matter where Quinn was that night, I wouldnt' be sleeping. He laughed, but reiterated it wasn't his call. I love buck passing.
About half an hour later, we were led into the post-op area, where a nurse was holding Quinn, and holding blow-by oxygen near his face. He looked bright eyed but a little dazed. She handed him to me, and said he'd come out of anesthesia quite well. He was hooked up to a monitor that showed his oxygen saturation, and it was a little low without the supplement. But other than that, he was okay. She said I could nurse him if I wanted. Of course I wanted. I hadn't pumped at all during the surgery and it had been about 7 hours since Quinn had last nursed. He was sluggish, but still, it was better than nothing. Then the anesthesiologist came over and told us she wanted him to stay overnight and be on an apnea monitor for 18 hours. She said the 50 week mark is really the beginning of a gray area that lasted until 55 weeks, and Quinn definitely didn't qualify because of his prematurity. We get tired of fighting, though I'm sure she could sense my disdain of her data. I said I would be staying with him, and she didn't have a problem with that. Of course she didn't. That wasn't for her to decide. That was up to the pediatric floor, 7 floors above us. More buck passing.
About an hour later, the nurse was going over Quinn's chart with the nurse upstairs who would be taking care of him. She noticed that the urologist had ordered Toradol for his pain medication, and was confused about that because it was related to ibuprofen. I said I had thought ibuprofen wasn't given to babies younger than six months, and she agreed. One of the surgical team standing nearby heard us and said "It's like ibuprofen, but it isn't, so it's okay. We prescribe it all the time." Trust us, we're doctors.
It took about an hour, all told, to get Quinn upstairs to his new room for the night. Kurt saw us settled and left to collect our other kids, who by all accounts had a wonderful time, didn't want to go home, and the kids they played with didn't want them to go home. It was very nice not to have to worry about them during the day.
I asked Quinn's nurse about his pain meds, whether he would have Toradol in his IV. She shook her head and said "You know, those surgeons down there aren't really used to dealing with kids this size. We don't give Toradol to babies under 6 months because it's related to ibuprofen." I would have felt vindicated, but I was too annoyed at my treatment downstairs. How dare I have a valid point. Quinn was given Tylenol instead. I felt sorry for him. My own experience with Tylenol is that it's worthless, but maybe it helped him. He seemed like he was in distress most of the afternoon. When he wasn't sleeping, he would wake up screaming. It was enough to make me swear off ever bringing him back to the hospital.
Within a very short period of time, it was obvious that the apnea monitor was too sensitive. It said he wasn't breathing frequently enough when that clearly wasn't the case. I watched him breathe and counted about 50 breaths per minute, while the machine counted 15. And that thing is loud. After about 2 hours of it's going off every few minutes, the nurse came back and said "I've had it!" and replaced it with an oximeter. If Quinn quit breathing, it would show up in his oxygen saturation. By this time, he didn't need the supplement anymore and was breathing fine on his own. But that monitor was also was too sensitive, as well as extremely loud. We ended up turning it off at about 11 pm and it never came back on. I was pretty thoroughly annoyed. The whole point in our staying over night was for a piece of malfunctioning machinery that everyone admitted was more trouble than it was worth. See if I ever make that mistake again.
We got a roommate at midnight, a baby about 2 months old. She needed an IV, and the nurses repeatedly failed, blowing each vein they tried. For an hour, we listened to this baby being tormented, before they decided to give her a rest and try again later. I slept for about an hour and a half before that happened. Then I slept for another hour before the urology resident came into our room, knocked on my head, and said "Hello! Good morning! We're here to look at Quinn!" It was 6:30 and I'd had less than 3 hours' sleep. I was too groggy to be very annoyed with this person though. As long as he got our discharge papers ready, I was beyond caring. He said they'd be ready whenever we wanted. I called Kurt at 7 and told him to come get us. It took another hour and a half, getting the other kids ready, and travel time, but we walked out of there. Quinn was in much less pain, it seemed. He had been lying on his back and kicking his legs happily that morning. You don't do that if your abs are in serious pain. So we went home, and he and I both took a nap. And I am further settled in my opinion that hospitals are no place to heal. If you must go, get out as soon as humanly possible. You'll do much better at home. And so we have. Three days later, Quinn looks pretty good today. We took his dressing off this morning. He's still bruised, but healing nicely. Let's just hope we don't have to do that again. For all our sakes.
We got to the hospital and I tried to stop being melodramatic, and force the image of bringing sacrificial lambs into the temple from my mind. We checked in and were told they would take us in soon, because Quinn's time was near. We were keeping him occupied with a pacifier, which he normally doesn't have. He was unhappy with us. I didn't blame him. About half an hour later, we were called into the pre-anesthesia area and given a tiny hospital gown and socks for Quinn.
Over the course of the next hour, about 10 people came over and introduced themselves to us as various members of the surgical team. One nurse anesthetist went over some questions with us, mainly about Quinn's NICU stay, and how his needs there might affect his care that day. She mentioned he was slated to stay overnight. I told her no one had said that definitely, that we wouldn't know until afterward. She left to consult a calendar and returned to say that their policy was that babies be 50 weeks gestation, and Quinn was 49. (If we want to be picky, he was 49 and 3 days. Four more days, and he would have been at the magic 50 number.) Anyway, Kurt and I simultaneously made comments on the convenience of the number 50 and of our skepticism that that was the true number. The nurse was defensive, as well she may have been, and said she was sure the anesthesiologist had data to back up that number. Kurt took over the explanation and said he had no doubt that there was data, but it was unlikely the data pointed exactly to the number 50, that more likely the number was 49, 48.5, or something like that, and had been rounded. Easy numbers like 50 rarely exist in nature. She looked between the two of us, and said, "You two must be mathematicians." She must have said it jokingly, because she was sort of shocked when we told her in a sense we were. Kurt is an engineer, which is applied math, and my background in population genetics and statistics is another form of applied math. She sort of shook her head and said the decision would be up to the anesthesiologist.
We met the anesthesiologist, and expressed our concern about Quinn's previous experience with anesthesia. When he was a week old, he had surgery to insert a central IV line, and hadn't tolerated the anesthesia well. He needed blood pressure stabilization, and what exactly happened varied by who described it to us. The NICU staff used the term "overdose." But one doctor had said the anesthesiologists insisted it was an appropriate dose. We didn't really care. What it came down to was that it was too much for Quinn. If that isn't an overdose, I don't know what is. Anyway, this anesthesiologist said she was familiar with the case, that she had helped review it, and insisted it was an appropriate dose. We repeated, whatever their data said, it was too much for Quinn, and we were worried the same thing would happen. Overall, it was a pretty circular argument, as she insisted it was okay by their data, and we insisted we were still concerned. I honestly don't remember how it got resolved, if at all. It's beginning to blur.
Another nurse anesthetist came to introduce herself and say that she would be taking Quinn back to the OR. I asked if I could go with him, and she said no, they don't do that for babies. I asked why, and she thought for a minute and then shrugged and said "Policy." I fought back a laugh. That was the best she could do? She then said that parents distract the staff from the patient, and they allow it for older children because of stranger anxiety. But babies haven't gone through separation anxiety yet. "I have." was my response. Without any more argument, she left and returned with a set of scrubs, a hair cover, and a mask, as well as a waiver to sign in case I fainted. So much for policy.
By this point, Quinn had been sleeping on and off, and in between times was a little frantic to eat. But he seemed calm as I carried him into the OR. He lay on the table looking around, and it was good for me to see him okay with what was happening to him. Then they put the mask on his face and he fought it and cried. That was hard. I had been told he would take just a couple of breaths and be out, but it took nearly a minute. Then he was asleep and I was escorted from the room. Whoever it was tried to take me by the arm, but I walked out under my own steam. Did I look that fragile?
Kurt and I took up a post in the surgical waiting area. the surgery was an hour late, which wasn't surprising, just disappointing. About two hours later, the surgeon came to talk to us and told us he had been successsful, and Quinn seemed to handle it all very well. He said the hernia on the left side had been humongous and he'd had to do an adult-sized repair job. But everything else looked okay. We asked about taking him home, and he said he didn't have a problem with it, but his wasn't the final say. That was anesthesia's job. He said they probably would have allowed it if we still had an apnea monitor at home, but since we didn't, we had a weaker argument. I guaranteed him no matter where Quinn was that night, I wouldnt' be sleeping. He laughed, but reiterated it wasn't his call. I love buck passing.
About half an hour later, we were led into the post-op area, where a nurse was holding Quinn, and holding blow-by oxygen near his face. He looked bright eyed but a little dazed. She handed him to me, and said he'd come out of anesthesia quite well. He was hooked up to a monitor that showed his oxygen saturation, and it was a little low without the supplement. But other than that, he was okay. She said I could nurse him if I wanted. Of course I wanted. I hadn't pumped at all during the surgery and it had been about 7 hours since Quinn had last nursed. He was sluggish, but still, it was better than nothing. Then the anesthesiologist came over and told us she wanted him to stay overnight and be on an apnea monitor for 18 hours. She said the 50 week mark is really the beginning of a gray area that lasted until 55 weeks, and Quinn definitely didn't qualify because of his prematurity. We get tired of fighting, though I'm sure she could sense my disdain of her data. I said I would be staying with him, and she didn't have a problem with that. Of course she didn't. That wasn't for her to decide. That was up to the pediatric floor, 7 floors above us. More buck passing.
About an hour later, the nurse was going over Quinn's chart with the nurse upstairs who would be taking care of him. She noticed that the urologist had ordered Toradol for his pain medication, and was confused about that because it was related to ibuprofen. I said I had thought ibuprofen wasn't given to babies younger than six months, and she agreed. One of the surgical team standing nearby heard us and said "It's like ibuprofen, but it isn't, so it's okay. We prescribe it all the time." Trust us, we're doctors.
It took about an hour, all told, to get Quinn upstairs to his new room for the night. Kurt saw us settled and left to collect our other kids, who by all accounts had a wonderful time, didn't want to go home, and the kids they played with didn't want them to go home. It was very nice not to have to worry about them during the day.
I asked Quinn's nurse about his pain meds, whether he would have Toradol in his IV. She shook her head and said "You know, those surgeons down there aren't really used to dealing with kids this size. We don't give Toradol to babies under 6 months because it's related to ibuprofen." I would have felt vindicated, but I was too annoyed at my treatment downstairs. How dare I have a valid point. Quinn was given Tylenol instead. I felt sorry for him. My own experience with Tylenol is that it's worthless, but maybe it helped him. He seemed like he was in distress most of the afternoon. When he wasn't sleeping, he would wake up screaming. It was enough to make me swear off ever bringing him back to the hospital.
Within a very short period of time, it was obvious that the apnea monitor was too sensitive. It said he wasn't breathing frequently enough when that clearly wasn't the case. I watched him breathe and counted about 50 breaths per minute, while the machine counted 15. And that thing is loud. After about 2 hours of it's going off every few minutes, the nurse came back and said "I've had it!" and replaced it with an oximeter. If Quinn quit breathing, it would show up in his oxygen saturation. By this time, he didn't need the supplement anymore and was breathing fine on his own. But that monitor was also was too sensitive, as well as extremely loud. We ended up turning it off at about 11 pm and it never came back on. I was pretty thoroughly annoyed. The whole point in our staying over night was for a piece of malfunctioning machinery that everyone admitted was more trouble than it was worth. See if I ever make that mistake again.
We got a roommate at midnight, a baby about 2 months old. She needed an IV, and the nurses repeatedly failed, blowing each vein they tried. For an hour, we listened to this baby being tormented, before they decided to give her a rest and try again later. I slept for about an hour and a half before that happened. Then I slept for another hour before the urology resident came into our room, knocked on my head, and said "Hello! Good morning! We're here to look at Quinn!" It was 6:30 and I'd had less than 3 hours' sleep. I was too groggy to be very annoyed with this person though. As long as he got our discharge papers ready, I was beyond caring. He said they'd be ready whenever we wanted. I called Kurt at 7 and told him to come get us. It took another hour and a half, getting the other kids ready, and travel time, but we walked out of there. Quinn was in much less pain, it seemed. He had been lying on his back and kicking his legs happily that morning. You don't do that if your abs are in serious pain. So we went home, and he and I both took a nap. And I am further settled in my opinion that hospitals are no place to heal. If you must go, get out as soon as humanly possible. You'll do much better at home. And so we have. Three days later, Quinn looks pretty good today. We took his dressing off this morning. He's still bruised, but healing nicely. Let's just hope we don't have to do that again. For all our sakes.
Sunday, September 07, 2008
"Hi folks! It's me again!"
This is quite a complacent look, I think.
Yes, we're getting ready for church here. This may be our last hurrah for warm weather clothes.
We had a busy week, a double header of specialist appointments. First, we met with the urologist, who thought we were there to talk about hypospadias. But I was there to talk about the hernia, which changed everything. Quinn is scheduled for surgery to repair it this coming Thursday, Sep 11. I thought that was a rather ominous date to schedule anything, but maybe I'm just paranoid. There's a good chance he won't have to stay overnight, and that it might only take spinal anesthesia, not general. Let's hope for both those things. I did ask the urologist when he thought a good time to do they hypospadias surgery would be. In Quinn's case, he said at least 5 or 6 more months. So I have that much time to seek a second opinion.
Our next specialist was the pulmonologist. We aged in his waiting room, but it was worth it for how well the appointment went. We got a glowing report. It probably helped that Quinn was perfectly bright-eyed and personable for the doctor, who said he looks fantastic, his lungs sound great, he's obviously thriving, and unless something drastic happens, he doesn't need to see him again at all. Woohoo! One more thing to cross off the list. Oh, and we got to weigh Quinn too. Ten pounds even on Thursday. We're watching him grow before our very eyes. We've been very blessed in his recovery. I hope and pray that continues this week, especially for his surgery.
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