Day Surgery at Boston Children's Hospital

 It's been 5 days since Evie's day surgery at Boston Children's, and I am writing about our experiences in case it helps someone else. 

The surgery:  Baby teeth extractions and 3rd strabismus (eye turn) surgery.  Evie's teeth were coming in all crooked and she literally had 3 rows of front teeth in some places.  With strabismus surgery, it was always possible that Evie would need a touch up.   So here we were, getting ready for her to go in as a 10 year old for surgery, when her last one was 5 years ago.  

Things I was worried about: preparing Evie for the procedure, recovery from anesthesia, and nausea

Preparation

Social Story: I took the social stories on the Boston Children's Hospital page and found the day surgery story. I then converted it to an editable Word document so that I could customize it for Evie. I waited until 3 days before the surgery to introduce the story so she could have enough time to process it, but not too much time to be nervous.   

Waiting for the nurse's call:  It was standard procedure to talk to the nurse the day before to make sure that Evie was still healthy and ready for the procedures the next day.  She told us the time of arrival (7 am!) for an 8:30 am surgery, and I took the opportunity to tell her that Evie is very sensitive to sensory stimulation and would need some accommodations.  I am so glad that I said that, because...

[Pro-tip: Always make sure you have eaten something before you go, because the waiting time is never on schedule. I started getting really hungry last time around because I thought they would take her in to the OR on time, and had to sneak some candy in my mouth so that I wouldn't pass out.]

What I brought with me: 

-comfy clothes

-snacks

-water bottle

-headphones--very key; it's surprising how many people like to play videos on their phones loudly in a waiting room regardless of the people sitting around them! 

-social story (she did not want to read this!)

-g-tube

-favorite blanket

-iPad

Pre-Op: We checked in at the new Hale building at Boston Children's Hospital. It is beautiful!  They have a special waiting room where they have you wait until your procedure group is called.  Thankfully, Evie agreed to wear her hospital bracelet this time, which she doesn't usually do. (Thank you, social story!) A bunch of families followed the medical assistant to the main building (it's a bit of a walk, but Evie did it!) where the pre-op rooms were.   While everyone else was escorted to a multi-patient pre-op room, Evie got her own room!  We were so grateful for this accommodation to help Evie to stay calm. 

 

 

The surgeons came and spoke to us, and we firmly kissed Evie goodbye and told her she would go to sleep and we would see her when she woke up.  She didn't have a chance to wonder, because the Operating Suite was a few feet away.  

The Waiting:  2 hours for strabismus surgery to both eyes and 2 hours for ELEVEN baby teeth to be extracted.   One thing I wish I had done was to call a few days before to the Hale Family Center and ask if there were massage or Reiki appointments available.  I was so tense and that would have been nice. But my husband and I found a cozy corner in the Hale Family Center, rather than wait with the other caregivers in a holding room, where the energy was a bit tense, quite understandably.  You basically can sit there in the waiting room under a letter, which they write down and come and find you when there's an update, or they can call you.  We chose the phone call option and went down to Panera to have a nice lunch and just try to relax.  Every 90 minutes, they call you and give you an update from the waiting area after the attendant calls the OR.  I definitely appreciate that.  

Time to get Evie

We were taken to a very upset Evie, who was coming out of anesthesia.  She was crying and bent over, and was very upset that we had allowed this to happen to her.  Daddy got her to quiet down after they gave her some more pain meds.   Once she was calm, they gave us instructions and we were able to take her home.  

We were unable to be in a single post-op recovery room, so there was a bunch of intermittent crying from other kids around us who woke up at the same time, and poor Evie was in pain and over-stimulated. But the nurses were very efficient and helpful, and we got a wheelchair to bring Evie to the car. 

Recovery

So the good news was that because I had told the anesthesiologist how concerned I was about Evie's nausea post-op, they made sure she didn't this time.  The bad news was that we were in for 3-4 days of a very sleepy, crying, hurting Evie, which is the saddest thing you've ever seen. I wanted to cry when she cried.  The thing about a kid who has speech delay is that it can be hard for her to express where she hurts. She was able to tell us that she felt "sick," which she really means when she says this.  We stuck with Tylenol because Motrin can induce bleeding, and we needed her mouth to heal up and stop bleeding.  

Eyes: Her eyes were red and very light-sensitive this time.  We were able to get Maxitrol ointment to use as "eye lotion" so that she would allow it to get close to her 3-4 times a day.  We kept every room very dim for her comfort until she could stand to open her eyes, because she didn't want to wear sunglasses. 

Teeth: There was quite a bit of normal post-op bleeding the first day. Be ready to put towels on the pillow and bed to keep things clean.  We did a lot of laundry the first couple days! 

Thankful for a g-tube:  Evie uses her g-tube for hydration and supplemental calories.  This is when this comes in handy, because we could just give her some Orgain protein shake for kids, Pedialyte, and Tylenol to keep her hydrated and comfortable.  

Foods: We started with yogurt and apple sauce, but also offered pudding, ice cream, and then discovered that cold pumpkin bisque and 3-layer taco dip were eventually tolerable by Day 3-4.  By Day 5, she was eating her normal foods (blended a bit more smoothly than usual), and we are getting back on track with her eating schedule.  She has lost a few pounds, because my back doesn't want to break when I carry her, but hopefully we can gain that back quickly.  

It's Day 5 and Evie went for an outing with her bestie babysitter and has a nice new smile.  She is herself again and while I need a vacation now, I'm so happy for my girl that she has less teeth crowding her mouth and her eyes are straight! 

If you've gotten this far, thanks for reading, and I hope it helps you if you are preparing for a day surgery as well!