Yesterday, the day of surgery, we ended up getting lost on Hwy 98 west in Wake Forest, NC. I’ve driven that road a thousand times, but what used to be “drive straight all the way to Durham” turned into “hang a right just outside of Wake Forest” due to some construction. Instead of dodging work traffic, we ended up taking Falls of Neuse Rd. directly into rush hour traffic on a miserable, rainy morning. Hwy 540 was bumper-t0-bumper. I pulled over on the side of the road and called my brother to get him to pull up traffic on the internet. “Looks like there are two accidents ahead of you…” he said. Before he could finish, I hung up the phone and hit the gas to take Creedmoor Rd. back up to 98. It was truly the scenic route but at least we were rolling forward. We blazed into the UNC hospital just 15 minutes late, had prayer with our pastor, and watched the staff whisk our little 5 year old back into the outpatient area.

The surgery lasted about 2 hrs (they had scheduled it for 3) and we we discharged that afternoon with about 3 prescriptions: one for pain, one for nausea, and one for antibiotic. Once we made it home, I could tell that the stress was getting to us.

“Okay, I need to goto the pharmacy to get the prescriptions filled.” I said.

“After what happened last time we brought her home from surgery, I don’t want to be here alone with her. I’m scared.” my wife replied.

“Okay, fine. I’ll stay here and you go.” I proposed.

“No way, I’m not leaving my baby after she’s just had major surgery?!” she said.

Ultimately, I ended up hitting the pharmacy, the Chinese food place, and Sonic (great fountain drinks). I made it home just in time to see my daughter getting restless.  Within 30 minutes or so, my little girl was vomiting on her bed. I had to support her head to keep it above the vomit so her compression bandage would not get soaking wet.  Feeling the fluids run down my elbow, I knew at that moment what my next post would be for this blog. I need to write something about tips to help parents cope with this whole first 24 hrs post op thing.

“Honey,” I screamed, “she has thrown up on the bed and I need your help to keep it out of her hair.”

Finding myself holding the torch to the “Cochlear Implant Recovery Olympics” once again, I closed my eyes, put my game face on, and lip-synced to my little girl “Daddy’s here. Everything is going to be okay.”

I took a 1/2 day off work and we drove C to UNC Hospital for our post-op appointment. We waited a good 3hrs to see the Dr. for 6 minutes. His resident removed the surgical tape from behind the ear using some kind of anti-adhesive ampule. The scar was concealed behind the ear, but it the tissue was very raised and it was traced in dry blood. Apparently, we can remove the dried blood from the scar with hydrogen peroxide. Wow, what a long scar. Later, the surgeon joined us and said that everything looked fine and that we could wash C’s hair with a mild baby shampoo anytime. Looking inside her implanted ear, he commented that things looked better than expected in that our daughter did not have a blood clot behind her eardrum, which apparently is typical for CI surgery. His only word of caution was that C was not to participate in high energy activities, within reason, for another 3 weeks. Even though her CSF gusher during surgery had been packed very well, he wanted to make sure that C formed some good scar tissue to decrease the chances of spinal fluid leakage.

I reviewed the engraving on C’s MedAlert bracelet with him, and he said that everything sounded fine. On our way out the door, I had the chance to speak with our surgeon’s head nurse who told me, “Your daughter speaks very well with the hearing aids, but once they get the implant turned on an she gets used to it, her speaking will sound as pretty as can be….”

It looks like the surgical tape held the incision closed very nicely. Perhaps the oddest thing about this day was that C-Note’s ear was sticking out 90 degrees from her head. I had read online that this was very typical so we didn’t freak out over it. Again, this was one of those times when we had to ask ourselves, “Was anyone ever going to mention to us that our daughter’s ear would be sticking out like this?!”

She won’t let us turn on the light. What’s going on? First thing this morning, whether in the bedroom or the bathroom, C-Note wouldn’t let us turn any lights on. Instead, each room had to be dim, lit only by the tiny glow of a nightlight. “It’s too bright. My head really hurts.”

After all the progress made yesterday, we were starting to taper back on the liquid Tylenol so that her stomach would not get upset, but this morning made us reconsider our decision. Within 1 hr of taking the medicine, she was singing Strawberry Shortcake songs on her bed, but she wouldn’t lift her head for very long. She stumbled, towards the implanted side, everytime she took more than a few steps across the room. Breakfast consisted of some Pediasure and DVDs and much of the morning was spent in her room.

By lunchtime, we went downstairs to C’s Elmo table. I made her some soup and she readily sat at the table to begin eating. After only 2 spoonfuls of soup, she said her stomach and head hurt and that she didn’t want any food. I followed her to the recliner, where she layed her entire body flatly across the seat cushion. Her forehead smoothed out slowly with relief, and I thought I’d give it another shot and feed her while she was on the recliner. She finished the bowl of alphabet soup one spoonful at a time in rapid succession and chased it down with some potato chips and a deviled egg. There as no sign of a headache or stomach ache anymore and I found myself scratching my head again. I wonder if she is having a migraine or something as a result of the spinal fluid incident during surgery?

With C-Note’s restored mobility, we all sat at the dinner table and ate together as a family. Prior to that, C-Note really couldn’t eat very much at all unless she was in a reclined position. She would say that her head and tummy would hurt, then lay on the closest thing to her, like the rug, a bed, or a couch.

We had popcorn this afternoon and took pictures of one another on the Blackberry. Overall, it was a very good day.

This morning, she went ballistic over the bandage. “It’s itchy!” she screamed. She kicked her legs and started shaking her head side-to-side. We had very little hope of comforting or distracting her until something very special happened. Grandpa came to town. Grandpa, whom C calls “Paw Paw” came to visit us for a few hours. Grandma, a.k.a. Maw Maw, was not able to join us due to back problems.

Within seconds, this little child, who was determined to peal her ear and bandage off her head, melted into the sweetest little Granddaughter to walk the face of this earth. She was sitting up, laughing, and playing. It was a beautiful thing.

Some of the swelling in her eye actually went down a bit, with all the upright activity of the day. I was thoroughly refreshed to see how Paw Paw could bring my little girl more happiness than all the toys and DVDs in our home combined.

We tried to call our OD to see if he could suggest any drops or ointment to help with the irritation but got no answer. We didn’t want to bring C into the eye Dr’s. office but really needed his help. Having nothing to lose, we sent a picture message to our OD’s cell phone and quickly recieved the reply, “Cold compress. Call surgeon. If you need to, bring her in.” The hospital confirmed that the swelling was a normal part of the recovery process. We were to use cold compress and call again as needed. Sure wish that nugget of wisdom had been included on the post-op sheet.

• She threw up her medicine and was clearly in severe pain because we could not get any painkiller in her. We called the hospital 4 hours after discharge to ask for some advice. We were told to give her some flat soda to get her sugar levels up and to try again. The soda idea was a flop, but we were able to give her 1/2 dose of Tylenol that night.
• She ate 1/3 cup of kid’s yogurt about 3 hrs after surgery. Then, we gave her some Tylenol chewable Meltaways, which did not sit well with her. She threw that up too and did not want any more yogurt or medicine after that.  Luckily, we had bath towels nearby to catch the vomit and tossed them into the bathtub until we knew she was okay and one of us could break away to wash them with any soiled pajamas.
• The remaining doses of Tylenol stayed down like clockwork. We had switched to grape flavored liquid Children’s Dye Free Tylenol instead of the Meltaways and had good luck. We believe that the Tylenol with codeine administered at the hospital was making her nauseous and dizzy.
• Considering all the IV fluid they pumped in her, I would have thought she would have had to urinate more than she did. She didn’t urinate for the first time until 8 hrs after the procedure. Had she not urinated by 8 hrs, we were instructed to bring her back to the hospital.
• Her speech was slurred, and we couldn’t understand what she was saying.She remained nauseous and dizzy throughout the night. Her mother had to sit behind her, leaning against the headboard, to hold her up long enough to take her medicine. When she wasn’t fighting the medicine, she was trying to slump back onto the bed. Her head hurt very badly, and it was all we could do to persuade her to take her medicine.
• She could not walk at all. Between the codeine and the surgery, her balance was gone, leaving her feeling that her head was heavy and her legs were wobbly.
• She had the sniffles that night. The surgeon warned us to watch for spinal fluid dripping continuously from her nose, so we stayed up round the clock to watch for any increased drainage that would be a trigger to head to the hospital. During one moment in the middle of the night, we saw a puddle on the sheets that concerned us. I’ve never looked so closely at a puddle of druel in my entire life.
• She would point to the crown of her head (instead of her ear) whenever we asked her where it hurt. The only thing that made sense to us was that she had a headache that was somehow related to losing spinal fluid.It took two of us to give her the medicine: one to hold her up, the other to squirt in the Tylenol or antibiotic. To make a long night even longer, neither of the medications seemed to coincide the the timing of the other one.
• Her hearing aid wouldn’t fit because of the bandage. She couldn’t use it anyway because she couldn’t sit up by herself and it would have just whistled continuously against the pillow.

She didn’t want to watch TV, eat, sit up, or walk. It was a painful contrast to the bubbly little girl who was excited to be going to the hospital this morning. Here we were at the very day that our family had been anticipating for years and all I could think about was how much I never ever wanted to relive that day again.

In my head, I had envisioned the day of surgery to have a very Norman Rockwell flavor to it. We would entrust our daughter to the surgical staff. After about 2 hrs or so we would get our daughter back. She would have a head bandage and maybe cry from the anesthesia, then we would drive home as a family and my wife and I would take turns nursing her back to health. Unfortunately, the reality of the situation was somewhat different.