Wednesday, May 9, 2012

Ready, set...

This morning, we arrived bright and early at the hospital for Maddy's pre-op assessments. She had to meet with the cleft surgeon, the ENT surgeon and audiologist, the anesthetist, and she had to have a blood test to confirm she was infection-free.

The morning got off to a slow start and we didn't see our first doctor until around 12:30 - it was the cleft surgeon. I had written out a long list of questions and got the answers to all of them. In short:
  • Surgery is scheduled to begin at 8:30am
  • It will take between 4-6 hours
  • The schedule will look like this:
    • First, Maddy will be anesthetised but not intubated. 
    • Next, she will have a full airway assessment (endoscopy). 
    • If all is well, the breathing tube will be placed ready for surgery. 
    • After this, the grommits (hearing tubes) will be placed in both ears, and the gunk cleaned out.
    • Then, the brainstem response hearing assessment will be conducted
    • Lastly, the cleft will be repaired.
  • I will be able to take Maddy into the operating theatre and be with her as she falls asleep
  • When Maddy is waking up, if she is content, they don't allow parents in - but if she is distressed they ask the parents to come in to be with the child
  • Maddy will go to PICU immediately after recovery and will be there until they are positive that her airway is stable and not obstructed by swelling etc
  • After surgery, Maddy cannot eat or drink anything for the first 24 hrs, after that, she can take clear liquids only 
  • After surgery, Maddy cannot use her pacifier (dummy) any more, and she'll need to use elbow-splints until her stitches have healed
After seeing the cleft doctor, we went to see the ENT. We have a new ENT since our regular doctor is on leave until August (originally, our surgeon wanted us to wait for her to come back but we said no way!) - I have to say, I might like him even better than our regular ENT! He was very gentle and approachable, two qualities that are lacking in many doctors in Hong Kong. He confirmed that Maddy would need to have the hearing tubes placed. Much of what we talked about, I'd already heard from the cleft doctor. 

Next came the anesthetist - nothing new there either. From a physical check, Maddy seems good to go - that leaves one last thing: blood tests.

To begin, getting blood from Maddy is like drawing blood from a stone. It took thirty minutes for a team of doctors and nurses to get enough blood for the tests. Fortunately (or unfortunately? I'm not sure) they kicked Bernard and I out for the procedure but I think the whole ward could hear her screams. She had multiple pokes and each of them is a sizable bruise. When we got her back, she was so sweaty from crying so hard. She wasn't crying when I walked in but the moment she saw me she let out a pitiful sob and spent the next 30 minutes whimpering.

For some reason, the blood work was the last thing of the day - it was 6:30 by the time it was over - and the nurses wanted us to wait 2-3 hours for the results. Since we wanted to see Lana before she went to bed, we asked if we could go home first and they could call us if they needed to. There are three possible results for the blood work: pass, fail, or inconclusive. If it's a pass, we won't hear from the hospital at all and we will be at the hospital at 7:30am to proceed with surgery. If it's a fail, (if Maddy had an underlying infection), the hospital will cancel surgery completely. If it's inconclusive, we'll have to wake Maddy to take her in to get more blood taken. 

So if we don't hear from the hospital within the next hour, we can assume we're good to go for tomorrow morning. I will be so glad to have this over with...

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