Wednesday, November 19, 2014

ptosis - levator resection surgery

we knew from the time daxton was a few days old that his sweet little eye lid on the left side just wasn't going to fully open without some coaxing.  when he was first born the doctors told us to apply warm compresses and see if that would help.  after that wasn't doing much they then suggested a blocked tear duct was causing some issues and then finally derived with the diagnosis of ptosis.  they weren't sure how severe it would be when he was just a little fella, so his opthomologist suggested waiting until he was three years old to do the re-evaluation and consideration of corrective surgery.

the doctor had assessed that he had 30% of the range of the right eye's lid use and he was a good candidate for the surgery.  it was hard to believe the time had come so quickly.  however there was no question of if we'd elect to do the surgery for him.  his primary doctor's office questioned us about it each time he came in and we reassured them we were going through with the levator resection surgery.  we knew just from watching him that he was compensating for not being able to see things by holding his head certain ways - tipping it back to see tall people or trying to open his eyes wider just to take it all in.  there were multiple occasions where kids made fun of him and we knew that it would only get worse as children get older and they tend to compare differences. 

three years came and went and we faced november 11th 2014 like champs.  (well, dax was a champ and will and i were sleepless babies.)  we had to be at the hospital at 6:15am which meant we needed to leave our house by 5:15am which meant we had to get up at around 4:30.  for me this meant no sleep.  i am a night owl and rarely fall asleep before 1am on a good night.  we had to get sweet sleepy dax from his slumber.  we'd told him several days ahead that we were going to the hospital and the dr. was going to do a surgery on his eye to help him see better but it still came as a shock when we woke him up from a dead sleep to put on his coat and hat.  we loaded him up into the car and began the nervous drive across town.  he was quickly checked in to registration and then the wait began to have him called back to the prep area.

dax had a blast playing in the waiting area and even thought it was fun to go back and play on the "pad-pad" while the nurses scurried around doing all of their pre-op work.  will and i sat nervously as we waited for his turn in the operating room.  the doctor went over the procedure again with us and then we met with the anesthesiologist who must have had to prepare us for the worst but it was just making my stomach churn in knots.  he gave us scenarios of daxton  throwing up and regressing with his speech and functions.  it was all just too much.  but, at this point what are your options?  so, before we knew it our sweet fella was being whisked away on a stretcher by two nurses who told him it was like "lightening mcqueen" and they raced him off to surgery.  we gathered up his things, not really looking at each other once he was gone and we've both since admitted to be crying.

we made it out to the waiting room for what we were told was going to be a one and a half hour procedure.  we waited.  and waited.  and waited.  they'd given us a tiny little status card with a number on it that you were supposed to use to watch your patient's status on the monitors with.  but, we kept watching and our sweet little's status was just not changing from OR to recovery.  so, after over two hours of nothing will had to go and ask what was going on.  the receptionist called back and got him an update that while things were taking longer than expected, they were going well and they were closing him back up at that time.  shew!  i was still on pins and needles until the doctor finally came out to give us the low down - but at least we could breathe!  

once the doctor came out and gave us the good news we were then taken back to the recovery area after about twenty more minutes wait.  when we rounded the corner we heard dax crying and both of our hearts went into a bit of a panic.  last november (when dax had his ear tubes/adenoid removal surgery) he did not do so well coming out of anesthesia and this is what we were fearing most from this procedure.  then, when we saw him he was being held by one nurse, connected to monitors, with his entire left side of his face patched over.  gulp.  it was a rough twenty or so minutes while we attempted to calm him.  (i applied do terra essential oils while nobody was looking and he did calm down a great deal.)  however, i figured out that they'd given him NO pain medication and i immediately demanded that they give him something.  it took quite a long time and i threatened to go to a pharmacy in the hospital and buy something to give him and they finally produced some tylenol with codeine.  after the dose of meds he was free to leave after thirty minutes.  he was doing well, so at that time we packed up our things and scooted back home.

the first night was a little rough, but we were sent home with ointment to place on his eyeball every hour and another ointment to go across the eyelid where the sutures were once daily.  every time you put on the ointment you also have to remove the guard and therefore remove the tape that holds the guard in place.  after removing this guard several times we noticed sweet boy's skin was becoming irritated.  it seemed the tape given to us in the hospital was some sort of industrial strength and it was literally pulling off his top layer of skin!  oyesa!  once we noticed all of this we attempted to get better tape, some duo derm, apply the tape in different areas each time, and remove with a warm wash rag held against the skin.  however, it was a little too late and sweet boy was already a little traumatized.  sigh.

the doctor told us that his eye would need to be covered by a clear plastic guard for two weeks, it may not ever fully close again, and it may take up to a year for it to come to its final resting state - which could be wider or lower than the other lid.  with all of the extreme information we didn't really know what to expect.  however, we have been pleasantly surprised in all of the following ways:
  • how he had very few side effects from the anestesia
  • how willing sweet boy is to work with us on keeping on the eye "bubble" (as he calls it)
  • how he keeps tiny fingers away from his eye
  • how he is recovering so quickly
  • how amazing his eye looks
  • how he can already blink his eye and force his faced into a squinched up position to close it if he wants
  • how adaptable sweet boy is
this is one snapshot of daxton watching about the fifty third showing of "the fox and the hound" which he absolutely fell in love with during this time.
tomorrow we go in for daxton's follow up appointment with his eye doctor and we're fully expecting to hear that the eye "bubble" can be removed just in time for a happy thanksgiving!  we're so thankful we did the surgery and daxton already tells us that his eye is "all better".   

(so, no regrets here except for telling the nurses prior to surgery that we wanted him to have pain medication as soon as they were able to give it to him.  no reason for unnecessary suffering.)

1 comment:

General Manager said...

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