Friday, March 23, 2007

Surgery Day

Our surgery time was scheduled for 10:30, so we had to arrive at 9 am. Lucas got up and had a shower, and I helped him wash all over with the antibacterial scrubby sponge they gave us at out pre-admissions clinic. He had a few cries during this process, asking why today had to be surgery day. I was able to help him calm down using the breathing and relaxation techniques his psychologist has been teaching him.

The whole family piled into the car, and Steve dropped Lucas and I by the hospital. He then went to take Coram to grandpas and came back to join us later. Our psychologist met us at the check in counter, and waited with us to get called in to daycare surgery. She helped Lucas practice some of his relaxation techniques., and she made him a really cute ‘certificate of merit’ congratulating him for learning to be a ‘master relaxer’.

When we got called in, Lucas had a few little cries with me as we changed into his gown. He again asked why surgery had to be today, couldn’t it be next week? And of course, he often asked why he was born like this. After the was changed, the psychologist came in and mentioned she might have heard some worried while he was getting changed, and again they did some relaxation.

The lady from Child Life came in with the Game Cube, and she played games with Lucas for the next hour. When Steve showed up, Lucas was calmly sitting on his bed, playing a racing game and having a blast. He wasn’t showing any anxiety at all.

When the anaesthesiologist came in, we talked over the options for going to sleep, which Lucas had already thought through. He wanted to use the needle, not the mask, and he refused the EMLA cream that numbs the skin. He said he was going to use his relaxation techniques when it was time for the needle. Our psychologist had arranged so Lucas could have the saline block put in his private room, before going to the ER. They lay him down, booted the rest of us out, and did ten minutes of relaxation with him. Then it was time for the needle.

And that is when the poop hit the fan, so to speak. All relaxation techniques went out the window. I think we all lost track of time, trying to convince Lucas to use his breathing and his ‘protective glove’ to cope with the needle. After what ended up being an hour, the anaesthesiologist suggested we abort the surgery since there was no way we were going to get the needle in his hand this way.

I immediately objected. First, I didn’t want Lucas getting the message that if he fights hard enough, surgery gets cancelled. Second, I did not think our family was capable of going through the anticipation of surgery for another few weeks. The psychologist did not want them gving Lucas a sedative, or holding him down, as she wa afraid it would just compound ohn his last bad experiece. The anestesiologist was unable to wait longer for a relaxation technique that was not working, so they wanted to abort.

I guess someone caught the look on my face and the desperation in my words, because the oral surgeon came up and stated that the surgery was actually overdue, and it wouldn’t be the best idea to abort for the day. He helped me to insist that they just quickly hold him still to put the needle in.

I opted not to be in the room. I stood outside listening to Lucas panic, which was really hard. But, it was over in less than a minute. Lucas had the stint in his hand, and was saying, ‘Is that all?’

One hurdle over, we now had to get Lucas into the operating room. No meds had been put in him yet. He was absolutely not going to walk to the OR, and stood by the doors screaming. We managed to get him to go into the hall, because he was really upsetting the other kids. They brought a stretcher, and the anaesthesiologist told Lucas she needed to check and see if the thing on his arm was working by putting more saline in. She put kedamine in, followed by saline, and Lucas was instantly relaxed.

So, in the end, he was tricked a bit, again. And, smart guy that he is, the first thing he said to me when he woke up was, ‘She lied, she said it was salt water.’ However, it was less traumatic for him overall than the last go into the OR, so I guess it’s a step in the right direction. I really didn’t see any way around it at the time.

The anaesthesiologist came out to talk to us later, and said that though she appreciates the relaxation work being done with Lucas, and finds it very valid. She said that with a case like Lucas, it probably wasn’t enough. She made some suggestions for sedatives next time, and I have to say, I agree with her. That hour spent trying to convince Lucas to co-operate didn’t help at all.

The surgery too just over two hours, and Lucas recovered for an hour before they called us. It was 3:15 when we got to see him. He was definitely groggy, but didn’t look to be in an pain.

Two different grandparents came for a visit, as did Jam and Coram. Lucas rested comfortable for the evening, and enjoyed watching the cartoons on TV.