Bone Graft Experience

This post is primarily for a couple folks I know who have younger children with clefts - who will have this surgery eventually. So, if that doesn't apply to you, feel free to read on if you want, but it may be a much of medical mumbo jumbo. :-)

We arrived at UAB hospital EARLY Wednesday morning (I think it was about 6). Surgery was supposed to be at 8:30, but I think it was more like 9:30. We had to go to the office for admitting first to pay the co-pay, fill out forms, etc. It was a very different experience than at Children's. Not better or worse - just different. Then we were directed to a surgery pre-op area. When it was time to prep someone for surgery, they called them to go to the back to get ready. They were only letting the one individual who was having surgery back (and later when they were ready, they'd get a family member to come sit with them). But being a minor, they allowed me to go back with Hannah and stay with her the whole time. She was the only child I saw..though I know from the nurses they actually had several children that morning. When we were in the pre-op room, it was pretty standard...vitals taken, meet with nurse, anesthesiology, dr., etc. They all asked the same questions. Interestingly, the all asked me how much she weighed and how tall she was, but not once was she actually weighed and measured. Just different because it seems like at Children's they are ALWAYS weighing and measuring! I knew how much Hannah weighed but didn't really know exactly how tall she was. They kind of laughed when I answered "tall enough for most rides at Disney World, but not tall enough to touch the bottom of a 4 ft pool" Everyone we met in this area was super nice. Any fears I had if it not being as "child-friendly" were erased. In fact, she may have gotten more attention being one of only a few children they saw. They actually couldn't find a child-size gown though, so Hannah was a given a gown that would fit me! Seriosly. I wasn't sure they'd be able to find her in there!! Hannah was pretty funny through the whole thing. She played video games and watched tv mostly. But she was not shy about answering questions honestly. "How are you doing today?" got the immediate answer of "bad. Want to know why? Because I have to have surgery". But when it was time to go, she seemed pretty comfortable. The nurse who took her was great and had her laughing as she wheeled her to the OR. They didn't put her IV in until she was asleep from the mask first. I actually heard of a slightly older child (9 I think) that day who was given the choice of an IV before or after and she chose before.

Anyway, surgery was about an hour and a half. I was directed to a waiting room area to "check in" and leave my cell phone number. Then I was able to go downstairs and get something to eat before heading back to the waiting room area. When it was over, her surgeon called the waiting room phone to tell me everything went well and she was headed to recover. It was probably a good 45 minutes later when I was taken back to recovery and she was just starting to wake up. Hannah was a little irritated, but within a few minutes was listening while I read Junie B. Jones to her. We went to the room after just a bit and settled in.

The night was pretty uneventful. Of course her medicines were spaced out far enough that someone was in her room every couple hours - so sleep was not really possible. But other than that, things were fine.
Hannah was able to get out of bed to go to the bathroom, but that was the only times she got out of bed that night. The next morning, a physical therapist came by to get her up and walking more. She protested and didn't want to do it, but once she got started, did pretty well. She walked around the whole floor and then settled back in her bed. Food wise - she was on clear liquids the whole time we were in the hospital. Apple juice, a little sprite, chicken broth, jello. That was pretty much all she ate.

Pain wise, she really wasn't in much pain the first night. She had a morphine pump that she could push when she was hurting. (and it "locked out" for so long after she pushed it so she couldn't accidentally give herself too much). She didn't use most of what she had available. And when she did push it, it was more often because she said her hand was hurting (where the IV was). I did get a mini-lecture when the nurse brought it about how Hannah was the only one who knew how much pain she was in so she was the ONLY one who was allowed to push the button. She kept reapeating it. I promised I wouldn't go push the button! But actually, Hannah would forget about it. She'd cry and say something was hurting and I'd have to remind her she could push the button. She also had a pain pump that attached directly to her incision site in her hip with a small catheter. It just automatically kept pain medicine slowly going to her hip.

The next morning the pain pump was taken away and the pump in her hip was removed as well. She was put on strictly oral pain medicine at that point to get her ready to go home (which she's still on about every 6 hours).

The first night Hannah didn't have much swelling, but by the time we left the next day, she had a good bit of swelling. Now (day 3), she's still pretty swollen, but it may have gone down some. She's also got the beginning of some bruising - also normal.

Food wise, since we've been home yesterday afternoon - she's had mostly liquid, but not just clear liquids. She's had a milkshake and some tomato soup and instant mashed potatoes that are so thin they were liquid, along with some yogurt. Tonight, she can start trying soft, but not liquid things. (eggs, thicker mashed potatoes, macaroni and cheese, soft pancakes, etc.). She'll stay on that diet for 2 weeks. A dietician did come by to give food ideas and talk to us while we were there.

Since we've been home, Hannah's hip is still really sore. Moving from lying to sitting to standing and back is the hardest. Once she's up - she walks around okay. I let her sleep downstairs (started on the couch, ended up on a blow-up mattress) so she wouldn't have to climb the stairs. But she's climbed the stairs twice now anyway on her own. She'll slowly start walking more and more on it and she's supposed to be back to normal in two weeks.

While in the hospital, we were on what seemed like a pediatric heart floor. I think because most of the pediatric patients at UAB are heart patients. But there were 3 girls including Hannah there for the same bone graft surgery. Interestingly, we knew one of them! We didn't know they were going to be there. I was walking down the hall that first night and saw a man I recognized. I couldn't remember his name in that moment but knew I knew him. Sure enough. He and his wife have children also adopted from China through the same agency I used. Their oldest daughter was there for the same surgery as Hannah. The girls didn't actually get to see each other until the next day, but Hannah was interested to know that someone else was there who was going through the same thing she was. The girls' mother stopped by our room for a chat and Hannah bombarded her with questions about her daughter "she's from China like me?, does she have a cleft lip and palate too? is she still bleeding too? (from her nose), is her face swollen too? does her hip hurt too? did they scoop out bone and put it in her mouth?,etc?" We ended up being discharged at the same time and walked out together. Both girls from China in wheelchairs with their faces swollen in similar manners. We were stopped and asked about them being twins and the people who asked found it hard to believe they weren't related at all and weren't from the same family.

Hannah's surgeon was very happy with how her surgery went. Both immediately afterwards and when he came by to see her later that day. The residents who saw her that night and again the next morning all said the same thing. They all said her surgery had gone very well, no suprises, and they expected success. We will go back to see them later next week for a post-op visit.

So for now, Hannah's on the "you have permission to be lazy" summer plan. Watching TV, playing video games, eating ice-cream, and asking for things to be brought to her on on her agenda. And I'm guessing she gets a pass on chores for up to two weeks!