The Best Worst Scar Story Ever.

Tyler pulled the first chest tube out so easily that I blinked and missed it. Determined to see what was happening I watched closely as he began to pull the second tube out of an incision in the middle of Max's stomach. The tube emerged as a nurse stood by with bandages.  But instead of sliding cleanly out as the first one had, this tube tugged a long bloody tendril with it, plopping on to Max's stomach but with the other end still inside of him.

Hospital Rule #1: If the nurse is not worried, then you are not worried.

Tyler raised his eyebrows while Bard kept his eyes closed and I held Max's feet down. "Okay, this changes what we are going to do." Without stopping for a beat, the Physician's Assistant we had met last week on our hospital tour gave the nurse a new set of instructions, asked several questions about equipment available, and instructed her to create a sterile field. "This is very rare...Is Max allergic to betadine?" Not that we knew of, random thoughts of calling the orphanage director and translating "betadine" floated through my head as the inside of Max's stomach lay on the outside and Tyler switched gloves, preparing to strangulate it and "tuck it back in."

I guess every heart surgery has its unique nuances.

Surprisingly the first unique aspect of Max's heart surgery was how quickly it was over.  We arrived at the hospital at 5:30am, one of the first patients to check in that morning.  They showed us to our room-where Max would come back to after surgery-and where we would stay most of the week. Max was chattering away, pretty happy considering we had woken him up two hours early and hadn't given him anything to eat! He talked to the nurses as they gave him a check up and played with their stethoscopes while various doctors from our team came in to see how we were doing and if we had any questions.  Then it was time for his "loopy" medicine-that would relax him so he wouldn't mind separating from us- so they could take him into pre op. No one had any loopy medicine for me and I was a bit disconcerted to see that instead of making him giggly, like we had been told, the drug made him quiet and still.  Of course Max is never quiet or still and for some reason seeing him like that bothered me more than anything. We carried him down the hall to surgery while Nurse Kathy pushed his bed. Then we handed him over to her and she walked away, her blue gown trailing behind her as she cradled our baby. We stood in the hall. Alone.

Back down on the 6th floor we were the first people in the waiting room.  Checked in by two lovely ladies, volunteers who helped us feel at home, we set up camp at a table with a view of the mountain, TV, and a TIME magazine from October.  The clock ticked forward.

How odd, all of the waiting connected with our adoption had brought us here, to an actual waiting room.

Kathy called with the first update after just an hour.  Surgery had begun one minute early, at 7:59am. Dr Nuri's name on the monitor switched from being in pre op to "Surgery." Thirty minutes later she called to say Max was on bypass.  They had cooled his body temperature, redirected his blood to a machine, and were operating on his stopped heart.  We chatted with my dad, responded to text messages, and watched Oscar fashions on the news. My dad left for the Grandparent's Day performance at Cici's preschool, an angel with dreads came and prayed with us, and Nurse Kathy called to say Max was off bypass.  It was 10:30am, 5 hours after we had first checked in to the hospital.

While Dr Nuri monitored Max's heart to see how it responded to being back inside his chest, I finished my latte and started a book. Kathy called to say Max was in post op and the two ladies who had checked us in to the waiting room, made sure we knew where the coffee was, found us a table that had a phone, and watched our luggage while we went down to get breakfast, came and showed us to a private room. In walked Dr Nuri, smiling, and saying that everything had gone better than he had hoped for-no surprises, routine repair, and the valve looked great! Max was heading back to his room.  The nurses had to get him set up there and we could see him in 30 minutes.  It was 11:30am. A 4-6 hour surgery was done in 3 and a half hours, I hadn't even eaten any chocolate.

Reading his favorite book-1st day after surgery

Back in Max's room, we stayed with him the rest of the day as he fought waking up from surgery. He was fitful and pretty out of it and the first in a line of wonderful nurses, Carol, walked us through how difficult it was for babies to transition off the anesthesia. He was never really awake that day and stayed on pain medication.  He did sleep, although he was very restless and fought the nurses every time they had to check his vital signs-which of course was very often those first few days. I stayed with him that night and it is pretty much a blur. We had our second awesome nurse, Bonnie, and she was in and out of his room as we tried everything we could to make him more comfortable.  Unfortunately, I think it was a combination of sensorial issues and past experiences that really compounded his misery and it wasn't until about 2:30am that he drifted off into a deeper sleep.  Waking briefly for his morning chest x ray, he conked back out and truly woke up at a little after 8am.

From there on out he liked to pretend that he had never had open heart surgery at all!  Of course he wasn't bouncing off the walls, but even that first day he talked, played with toys, kicked his arms and legs around and did everything possible to rip off whatever the nurses were trying to attach to him-which was a lot. Other than a slight fever Tuesday evening-due to inflammation not infection-and his chest tubes coming out a day later than planned- due to a small air leak-his healing progressed rapidly and every day we saw big improvements. Time is everything and nothing in a hospital. Tests and check ups ran like clockwork.  Shift changes, x rays, and 3rd floor latte runs all came and went but I can't tell you what separated one day from another-sometimes the rocking chair was next to Max's crib, sometimes it was next to the table.  I'm not sure why. His doctors came in and out, all pleased with his progress and we were hopeful about coming home Friday-one day earlier than our initial timeline of 5-7 days.

Now we've been home two days and although he does have a big scar, it's those chest tube incisions that actually look more serious-they still have to be covered and his surgery scar does not! Nurse Linda prepared a "sterile field" for Tyler to complete his medical procedure, "Push Max's Guts Back Inside His Stomach So They Don't Dangle Outside Him Forever." New supplies, carts, and equipment were brought into Max's room.  As quickly as it arose, the problem was resolved because it turned the nasty little tendril was not attached to anything and just a piece of fatty tissue.  Of course that is not really fair because Max needs all the fatty tissue he can get! Tyler and Linda both said that Bard and I handled the Tendril Surprise amazingly well, that not all parents would have been able to deal with something so disturbing.

Home Again!

So, if someone could send us a gold star, that would be great.

Meanwhile, we go on Tuesday for Max's post op with his surgeon, cardiologist, and PA.  He is doing really well at home-still on pain meds, but no narcotics. We set up a pac n play in the front room to keep him contained-he is not supposed to climb on anything- and other than fighting us a bit on a regular bottle, he is eating really well. He actually seems to be sleeping less, maybe in part due to needing medicine in the middle of the night and also perhaps just plain old over stimulation. But that's okay because after a week of sleeping at a hospital, going back and forth between there and our house, the craziness of surgery, and trying to return to normal, adrenaline is all the energy I need right now.

Said No Mother Ever.

I'll just pop another chocolate covered espresso bean and fold another load of laundry. (By the way, do calories roll over? I mean, is it better if I just eat a ton of my sweets all in one day and get it over with or is spreading the calories out over a longer period less unhealthy? I really should have paid closer attention in science class.) Tomorrow the girls go to school and Bard goes to work. Yesterday marked six months home with Max and tomorrow marks one week from open heart surgery. The most interesting part of the week is just how uninteresting it was.  Maybe I over-prepared, but for some reason I thought open heart surgery, being away from the girls, endless medical possibilities, and total family disruption would be very difficult.

Silly me.

Nothing happens in a vacuum.  The surrounding forces are either positive or negative and in our case almost every single one can be chalked up to positive. Our incredible support network-see previous blog post-from grandmas flying in for the week to banana bearing friends carried the burden for us. And, although of course we were paying for their services (well, someone will pay, Hello Premera, my name is Max!) there is just no possible way we could ever repay the amount of over-the-top love and concern all the staff showed us throughout the week. Checking in on us-not just Max- bringing hand made gifts, moving services ala radio flyer wagons, and an overall attitude of compassion and and high standards permeated our entire experience.  If you're going to have open heart surgery, that's the way to go!

This week we rebuild.  I'm going to the European Store to pick up Ukrainian chocolate for our medical team. Max has his doctor's appointment and I'm planning several walks outside so he can enjoy moving while being strapped down! We'll check our spreadsheet for when his meds are due and make sure to lift him carefully-scooping him- not by underneath his arms, as that causes too much pressure on his sternum.  After I print out a bunch of pictures detailing his recovery, I'm going to mail them to Babushka, who has already enjoyed more than one Skype call seeing her grandson recover from his surgery.  Sometimes life seems so challenging, but then you blink and miss it, looking up only to find that there are many ways for a heart to be wounded and many ways for it to be healed.