Mckenzie's PSARP Surgery

You ready for this week review?  I won't be offended if you only look at the pictures.  Most of these details are just for my benefit because I don't want to forget what we've been through in case I have another kid that needs the same surgery.  Let us begin!

The day before Mckenzie's surgery she was allowed to eat breakfast and then for the rest of the day she could only have clear liquids.  Below you can see her eating a popsicle.  She was surprisingly happy even though she wasn't allow any food.  Earlier in the week I went to Target and got a few new little toys and activities to help distract her from feeling hungry.  I made Channing eat lunch in his bedroom by himself, which he said he didn't like.  It was a good day of trying to have lots of fun with Mckenzie knowing that the next day was going to be really hard.  

Little did we know that we'd have to get through a bad night before Kenzie's surgery day.  I put Kenzie to bed, did her normal routine, she didn't seem grumpy at all.  But then she literally woke up about every hour that night.  We think having an empty tummy from no food all day kept her awake.  Whatever the reason, it was a long night.  Especially for Justin...who slept on Mckenzie's floor ALL night.  I would turn on the baby camera every hour and most of the time I would see her sitting up looking around.  Single girls out there: find yourself a guy like Justin and you will be happy.  Seriously, not all guys will get up at night to help you with crying kids, so make sure you find one that will!  While Justin tried to keep Kenzie asleep by snuggling with her I was scrubbing Channing's sheets.  Because he barfed, again....  Channing (and the rest of the family) got the stomach flu about a week before Kenzie's surgery and Channing, poor kid, continued to throw up about once a night for a week.  So at 3am I woke up to Channing crying and saying that he threw up.  I'm grateful for oxy-clean and a washing machine!

We arrived at St Luke's Children's Hospital at 7:30 am, tired but ready to go, on Friday March 17th.  While I spoke to the surgeon Justin watched Kenzie in the pre-op kids play area.  She was in heaven with this kitchen (see below).  Then all too soon it was time to get her in her gown and take her back to surgery.  I gowned up like last time and carried her back the operating room.  I pretty much lost it when it was time to lay her down and put the gas mask.  Ah my poor baby.  She cried "daddy!" right before she was out.  Makes me cry just thinking about it again.  Okay I gotta move on....

The surgery took about 3 hours.  This surgery is called PSARP.  Posterior sagittal anorectoplasty.  This procedure surgically repositions the anus.  You might have read in the last post about how Mckenzie's anus needed to be moved more posteriorly so it could be surrounded by muscle complexes which will (hopefully) lead to bowel control when we potty train her.  They called out from the OR twice to give us updates on how things were going.  3 long hours later the doctor came to speak with us.  He was really happy with how the surgery went.  He showed us a video he took on his phone of Mckenzie's anus before and after the surgery.  The video showed the muscles and how they reacted to an electric probe.  There was a huge difference between the before and after with the muscle reaction around her anus.  Success! Now on to recovery.  

One thing I wanted to remember was the caudal anesthesia they used on Mckenzie.  I told the anesthesiologist that I was nervous about her pain level after the surgery and they gave us the option of doing a caudal which is kind of like an epidural.  We didn't see any signs of incision pain until that evening when it had worn off.  So we felt like it worked really well.  

Mckenzie was really out of it after the surgery.  She had an IV, o2 sat monitor, and a foley catheter attached to her.  We were in the PACU for about an hour and then got moved up to the pediatric floor.  

Things I remember from that day is her acting really uncomfortable every so often, after her caudal wore off, and so they'd give her a bolus of morphine.  They were also giving her tylenol and toradol every 6 hours.  She continued to ask for food.  Like "raisin," "muffin," or "water."  And let me tell ya, it is so hard to have to tell your sad, uncomfortable baby that she can't have any food or drinks.  For the rest of the day we mainly held her and tried to keep her lying down as much as possible.

I went home Friday night and Justin stayed with Kenzie in the hospital.  Kenzie slept pretty good, from about 9:30pm to 5am.  Channing threw up AGAIN that night.  I was pretty much at my whits ends by that point.  Tired, stressed, and now cleaning up barf.  On Saturday I went back to the hospital to relieve Justin who went back home to take a nap and spend time with Channing.  Keeping her entertained and not in pain was a task.  Lots of patience.  And thoughts of "what have we done to this poor girl!"  She continued to ask for food and water every so often.  It was tough because you couldn't eat or drink in front of her so I was definitely dehydrated by the end of the day.  Luckily we'd get some sort of break when my mom or Justin would bring food and they would stay with Kenzie while we went to another place to eat.  

Some of the best moments was when Kenzie was asleep and comfortable.  Getting her to sleep was sometimes a struggle.  Then you add in having nurses and other staff coming in the room to check on her or take vitals.  So a sleeping baby made for a happy mom!!

Starting around Saturday afternoon we would see spurts of her being happy and her normal self.  It was usually followed by her crying and being uncomfortable, but at least we got to see her being happy occasionally.  Exhibit A:

Justin came back to the hospital to relieve me and spend the night at around 8:30pm.  We did Kenzie's bedtime routine and laid her down for the night.  I took off around 9:30pm which is when the fun continued (heavy sarcasm) and I got rear ended at the first light leaving the hospital.  I've never experienced being hit by another car before but I hope I never experience it again.  I had barely come to a stop at the red light and then BAM! It was the loudest sound and a very hard hit.  Luckily my pregnant tummy was far enough away from the steering wheel that I didn't bump it.  I was really shaken up and couldn't think straight.  My hands were shaking so bad trying to find the hazards button.  I immediately called Justin to come and luckily I was still really close to the hospital so he  ran over and took care of talking to the police. A husband and wife had witnessed the accident and came to see if I was okay.  They called 911 and got an ambulance.  The paramedics checked me out and said they would like to take me to get monitored at the hospital but I refused since I had been able to feel the baby kick a few times.  Justin called my OB doctor and told her the situation and she advised too that I go in to get monitored.  I headed to St Alphonsus (a different hospital than the one Mckenzie was in but the one that my doctor works with) got labs, an ultrasound, and monitored for over 4 hours.  I left the hospital at about 5am.  

At this point I was thinking, how in the world could this get any worse?  It seemed like if something bad could happen, it happened.  It felt like the trials were just piling on and I couldn't take anymore.  But at the same time I knew we were still very blessed because things could be much worse.  I could've gone into pre-term labor or Mckenzie could be in the hospital for even longer with complications.  I honestly just wanted Heavenly Father to take all this stress and suffering from us.  But I know that He won't always take your afflictions from you, but He will comfort and lead you with love through whatever storm you face.  Which is sometimes super hard to remember in the midst of a trial. (Guilty!)

I took this picture because I thought it was funny how many hospital bands I was accumulating.  They took really good care of me at Saint Al's maternity.  Baby Hamilton looked great and there wasn't any damage to my placenta.  

The next day was Sunday and I didn't get to the hospital to relieve Justin until mid-afternoon because I slept from about 5:30am to 11am.  Mckenzie was recovering well.  And that night she got to have ice chips!!

Yay for ice chips!  She called them "delicious" and even shared some with her stuffed animal.  Sunday night they also let her walk around.  She didn't tolerate it very well the first time.  But later that evening she asked to walk again and did really good.

This was her Sunday night (below).  They had cars like this one and wagons for the pediatric patients.  She loved going down the hallway to visit the fish and bang on the piano.

Monday morning she was allowed clear liquids!  People, this was a big deal!  She's so adorable as she clinged to her sippy cup of apple juice.  They also changed her from IV pain meds to oral medication.  And she started to have her first bowel movements.  Good things were happening!  At around 5pm the nurse said Mckenzie was allowed now to have real food.  Yeehaw!!  We ordered her a tray of food right away.  I think the first thing she ate was vanilla pudding.

Cici brought Channing to visit almost everyday.  Cici and Channing were best buddies while Justin and I focused on Kenzie.  They went to the park, chick-fil-a, toys r us, and lots of other fun places.  Channing also got a cup of caterpillars in the mail for his birthday and has loved watching them grow.  

This was Cici getting Kenzie ready for her first bite of food in 4 days.  Note the chocolate milk, Cici loves giving the kids chocolate milk!!

The hospital had a nice little playroom with tons of toys.  Following a 20 month old around with an IV pole is a workout!

The volunteer helped Channing make a bracelet. 

Day 5 in the hospital, it was Tuesday, and Kenzie ate french toast for breakfast.  The doctor said today we could go home!  Julia, my mom, and the kids came to visit before lunch.  We got discharge orders and then let Kenzie take a nap before we headed home.  She had started pooping more often which made her cry and she cried throughout her diaper changes.  Which means by naptime and bedtime she is exhausted.

Here she is all ready to go home.  We were so happy to be able to leave after 5 days in the hospital. 

Back home!

It feels great having everyone back under one roof.  Justin spent 4 nights sleeping on an uncomfortable fold out chair in the hospital but didn't complain once.  It was always so hard for me to leave Mckenzie at night but I'm grateful for Justin because I knew she was well taken care of.  Right now we are on day 5 of being home.  Things have not been easy.  Mckenzie has been pooping so much that we have to change her diaper sometimes hourly.  Which has made her bottom totally raw and sore.  She cries when she poops and screams when she gets a diaper change.  And right now since her bum is so sore she cries even when no one is touching her.  I've spoken to an NP and doctor on Friday and we're doing everything we can to help relieve her pain.  She's continuing to get tylenol and motrin around the clock.  We hope that her pain will be relieved soon.  She's such a tough little girl.   Even after screaming and crying during a diaper change she'll still give hugs and kisses to anyone around her.  I think she's been able to feel my distress because she's come up to hug me a few times and ask if I'm "Okay?"  Which is just crazy when she's the one in so much pain.  We're just trying to take things hour by hour.  Some moments are really good and some are really bad.  This has been the most stressful time of my life.  I've never felt so scared, worried, sleep deprived, frustrated, or sad ever before.  And I still continue to feel this way as we deal with her recovery.  I'll be completely honest, I have not managed the stress of this as best as I could have been.  I'm still in the phase of feeling bitter about how much pain Kenzie is in on an hourly basis.  Thank you everyone that has helped during this past week.  We're so grateful for family, friends, neighbors, and the gospel.