Sunday, January 18, 2009

Gerritt's surgery



January 18
On January 15th I had another OB ultrasound. The doctor did not see any significant changes since my last visit. He is still concerned about me possibly having placenta accreta, or condition in which the placenta attaches itself too deeply into the uterine wall increasing my chances of premature delivery and/or hemorrhage (since such placenta has difficulty separating from the wall of the uterus after delivery). A previous C-section increases the incidence of placenta accreta, and the higher the number of C-sections the higher the chances of placenta accreta occurring. So, I need an MRI since it is difficult to tell by ultrasound alone how many layers of the uterus the placenta is penetrating (uterine wall alone, uterine muscle or an outside organ (e.g., bladder)). So my biggest hope at this point is that I don't have placenta accreta, of course, or if I do have it that the placenta has not attached itself anywhere but the uterine wall. I try not to worry about it too much since there is absolutely nothing I can do to change it. It just may be a rough few months for us - another C-section for me, possibly premature baby if she has to be delivered early, & a long list of possible complications that go with both of the above.
On January 16th Gerritt had his 15-month check up. He was 33 1/4 inches tall (95th percentile) and weighed 25 lbs 11-2 oz (50th percentile for his age group). He was in 75th percentile for weight during his last check up, but I was expecting this since he is so much more active now & is a picky eater (which is very common for toddlers). He will eat only a few bites of food during some meals. Sometimes he will stuff his mouth full of food & then spit it all out - it's like a game for him. Gerritt has received another couple of immunizations - pneumococcal & DTaP. The well-child visit was exhausting since he cried the whole time - from the time we walked into the exam room until the time we left. He hated being undressed & weighed, having the doctor look into his ears & listen to his lungs & heart, & the shots, of course. I felt like the visit was a big waste of our time & insurance company's money. I don't believe the doctor could adequately assess Gerritt's lungs & heart since he cried the whole time. The visit was about 15 minutes & the information I received I already knew. Dr. Sears' Baby Book has way more information for each age group & is a lot more helpful. I've decided to skip Gerritt's next well-child check up at 18 months unless something new comes up between now & then. I will just take him for his shots at the Public Health Department instead.
For the past week Gerritt has been insisting on going for walks outside. He just stands by the front door & tries to open it while telling me in his toddler language that he wants to go. A couple of times he wanted to do it first thing in the morning immediately after waking up. So I had to get out of my robe, throw something decent on & go out in the cold. Gerritt just loves walking around our house, looking at cars passing by & talking to a barking dog at our neighbor's house. He is very independent & does not want to hold my hand usually. Poor thing, 2 days ago, he tripped & fell flat on his face scratching his nose & forehead. The scratches were bleeding so I took him inside to clean them & apply some antibiotic ointment. This is probably another one of more injuries to come (not too many, I hope).
Chris & Gerry visited us this weekend to have a late Christmas celebration. They brought a big red car for Gerritt. He loved it right away & got in it as fast as he could. I even took him outside so we could ride the car on the street. The car has a horn, a radio, an ignition key & a door that opens on one side. Now Gerritt spends most of his time climbing in & out of this car & playing the radio.
He is trying to use utensils like spoon & fork more often. Sometimes he will refuse to be spoon-fed & insists on eating himself. So yesterday he had his hot cereal for breakfast - one spoon of cereal in his mouth, one spoon on his bib. While I was stressing out about the mess, Gerritt has really enjoyed himself. He loves to sit with everyone at the table. In fact, his 2 new words for this week are "See, see!" (I want to sit at the table) and "Baby!"

January 20
I had my MRI today & it was such an unpleasant experience. I was expecting the technologist to scan my lower uterine segment only, but she scanned the whole uterus. My little girl was head down & bent in half (her fingers touching her toes). The whole procedure took about 45 minutes. Very noisy machine. I had to hold my breath about half of the time. I didn't realize how claustrophobic I was. After laying on the MRI table & being moved inside a narrow tunnel-like tube, I looked up & started to feel panic. My heart was beating fast, I started to get short of breath & felt hot. I got an overwhelming urge to scream for help & get out of there as soon as possible. Then I thought about the reason for the procedure & that I really need it. I focused on slowing down & deepening my breaths, focusing on the music in my headphones & relaxing my body as much as possible (I was thinking, "Be a rag doll"). This process was very similar to hypnobirthing I practiced 1.5 years ago. I could feel the magnetic waves heating up my tissues & by the end of the exam I had red cheeks & felt hot & sweaty. From everything I've read the MRI is safe in pregnancy (it doesn't cause birth defects or mental retardation), however, the long-term effects on the fetus are unknown. I am glad this technology exists, however, I am sad to have one intervention after another. There is another follow-up ultrasound I need to do in 5 weeks. I wish I could have avoided my 1st C-section. None of this would probably be necessary now...
On a good note, Gerritt now loves his daycare. Sometimes when one of us is there to pick him up, he'll say hello & then go back to the living room to play. I was looking for a new daycare because he didn't seem that happy in "Rosinka," however, he started to like it ever since the new caregiver Dina started to work. I can tell she is very caring & spends quality time with the kids (such as doing projects, singing, drawing, taking them outside, etc. rather than just sitting on a couch most of the day). Also we were told by the owner if he gets someone to go to his daycare full-time, he'll have to say goodbye to us for financial reasons. However, 2 weeks ago we were told to stay at 3 days a week since Gerritt is such an easy-to-take-care-of baby & Dina has become too attached to him. Gerritt's lower & upper molars are peaking through. I can't wait for him to eat more regular food with us!
I am really enjoying my nursing job. I am working mostly evening shifts (3-11:30 pm). I am getting faster & more efficient. I am trying to pick up as many shifts as possible since I may be off work for a while (depending on whether I will need to be on bedrest in my 3rd trimester and/or long recovery from another C-section). I may also be too sleep-deprived caring for a newborn to work 3-4 days a week. Babies sure don't come cheap!
January 28
A couple of days after my MRI the nurse called me from the doctor's office & told me that my MRI was normal! I did not have placenta accreta or any other abnormal condition. I was so relieved & happy! I am so in love with our little girl already that I want her to be born as close to her due date as possible to give her the best chance for good health & development. Most important of all, there is still hope for a VBAC assuming she'll be head down by the time of delivery.
Yesterday Gerritt had his surgery at Swedish Medical Center. He had the release of prepuce (tight foreskin), right orchiopexy (his right testicle was not fully descended & was half-way down the inguinal canal) & release of buried penis. The surgery was much harder on us than on Gerritt. He did remarkably well!
We woke up around 7:30 am & left the house at 8:15 am. We checked in & registered at the hospital at 9:15 am. Gerritt could not eat or drink anything after 7:15 am so that was the hardest part. After checking in we met with the pre-surgery nurse who checked Gerritt's weight, temperature & health history including his allergies. I have changed Gerritt into his hospital outfit at that point. Gerritt was really anxious & protested loudly every time he saw the pre-surgery nurse & while being changed. I just lost it & started sobbing. It was quite a picture! After being changed we went into a surgical play room (place where kids & their parents await surgery). We met with Dr. Anderson to discuss any last minute details & sign the consent & with the anesthesiologist who talked to us about Gerritt's anesthesia (general & caudal). Gerritt played in the play room happily for about 30 minutes until the OR nurse came to get him around 11 am. My husband was the one to accompany Gerritt to OR. He put the gas mask on his face & saw him to drift off to sleep before being escorted back to the play room. I was originally set on going with Gerritt but after spending the whole morning crying on & off I thought this may just push me over the edge. It doesn't help that I am pregnant & can be overly sensitive at times. The procedure took about 1 hour. Gerritt had caudal anesthesia (similar to the epidural where he is numb from the waist down) so the general anesthesia used in conjunction did not have to be as deep. My hubby & I were both called into the recovery room. When we walked in the anesthesiologist was holding Gerritt over his shoulder & Gerritt was yelling on top of his lungs, which I thought was a good sign. I picked Gerritt up, gave him his favorite teddy bear Misha, covered him up with warm blankets & started to rock him back & forth in a rocking chair. It was so great to see my little boy back. He was groggy & continued to wake up slowly in my arms. He was clutching his Misha as his security object & I was stroking his head. He had quite a bit of coughing (after being intubated in OR) & was shivering slightly (anesthesia wearing off I was told). My hubby kept kissing his forehead. We took a peak at his surgical site & were amazed to see how much larger his penis looked. There wasn't much blood or scary incisions. The whole site was covered in a clear plastic dressing & looked a bit swollen. After being in phase 1 recovery room for about 40 minutes we went upstairs to the phase 2 recovery room where we stayed for another hour. We knew Gerritt was OK when he suddenly sat up & reached for the Graham crackers the nurse brought for us. He ate several crackers, drank some apply juice & finished off a cup of apple sauce. We were shocked! After getting him dressed & receiving discharge instructions we left the hospital around 2 pm. After returning home Gerritt proceeded to play with his toys, rough house with Spike, walk all over the house & laugh like nothing has happened. His legs were slightly wobbly until the caudal anesthesia wore off, but other than that we couldn't tell anything was different about him. The day finally caught up with him in the evening & he "passed out" (what I call falling asleep without any fighting or resistance) at 6:30 pm. I gave Gerritt infant Motrin to keep the inflammation & pain down upon returning home so the next dose was due around 8 pm. However, Gerritt slept soundly until I woke him up at 2 am. I changed his heavily soaked diaper & fed him a bottle of formula in which I mixed in some liquid Motrin again. He then promptly fell back to sleep & slept until 7:30 am today. Wow! I was expecting a sleepless night with Gerritt waking up multiple times in pain but it didn't happen. I even felt confident enough to send him to his daycare this morning for a few hours since I have my midwife appointment today. All in all, we are very pleased with Gerritt's surgical experience & his super speedy recovery. One less thing to do on our check list before the baby comes in May.

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