It was difficult to detect any apprehension on Naomi's face as we walked into the hospital from the cold, crisp morning air. She commented on the glittery presents hanging on the Christmas tree in the lobby and listened a moment to the player piano. We chatted about how the kids in her class were probably jealous of her because they had to go to school. She didn't seem to be bothered much at all by the fact that a doctor was about to cut her tummy open.
We were heading for a simple surgery really, just an inch-and-a-half incision in the middle of her abdomen to sew closed a hernia that Naomi had had since childhood. She'd been under anesthesia four times before (for an eye surgery, two MRIs, and the endoscopy in September), and remembered all of those procedures. This was old hat to her. My parents had come to visit for a few days and were able to stay with the other kids, freeing Matt up to come along as well. When she was changed and settled in bed the nurse turned on Mickey's Playhouse, and Naomi was soon giggling at Donald Duck's antics.
I'm thankful she was oblivious as I discussed her entire medical history with the nurse. It's such a long list that I'd rather Naomi not have to hear it repeated all that often. When I do talk about these things with her I downplay their significance and chat lightheartedly about how everybody has differences, because that's all she needs to know for now. But facing abdominal surgery I wanted to stress the significance of these issues with the doctors, not downplay them. The nurse listened intently and wrote and wrote and wrote. Then, flipping through some more pages, she looked up surprised. "Oh, she has congestive heart failure?"
I raised an eyebrow and shook my head slowly, "Nooooo...why would it say that?" Then I realized their mistake and laughed a little. "No, she has Congenital Hepatic Fibrosis, not Congestive Heart Failure--same acronym, very different meaning!" The nurse was relieved to hear that, as was the anesthesiologist. He was also concerned about Naomi's heart murmur, but I calmly pulled out the report from her echo cardiogram in 2008, and he was much impressed. "I learned to carry the medical file," I explained.
Our pastor showed up just in time to pray with us. Then we gave Naomi some quick hugs and they wheeled her away. We chatted with our pastor and a few others in the waiting area, and I tried not to think much about what was happening in the operating room. One hour later the doctor came to tell us that the surgery had gone well. Surprisingly, though the bulge on Naomi's abdomen was nearly an inch in diameter, the actual opening in the muscles was only 2mm big. Some fatty tissue had been squeezed through the hole and become trapped there, causing Naomi's discomfort. He said he just trimmed the tissue off and closed the hole in the muscles with a single stitch. The chances of the hernia re-opening are very slim and Naomi's recovery will consist mainly of the surface discomfort from the incision.
Given such a simple surgery, I was surprised to find my daughter looking like a raccoon with tiny purple dots all around her eyes. The marks were petechiae, tiny burst blood vessels, which Naomi will sometimes get with an extreme temper tantrum, but I've never seen so pronounced before. The doctor then explained that she had coughed and gagged quite a bit while they were intubating her and he thought that the pressure from coughing had caused the petechiae. Naomi had a sore throat, but was in good spirits. She was interested in the orange coating on her belly and the large bandage taped over the incision. A grape Popsicle and some cartoons kept her satisfied until we were discharged just one hour later.
We indulged all the girls in an afternoon of television watching while Toby slept and my Mom and I ran out to pick up the Tylenol with codeine that had been prescribed for Naomi. Unfortunately Naomi's mood had turned sour by the time we came home. Exhaustion and a low-grade fever (which is apparently common after surgery) brought on a mood swing, and I ended up with cherry flavored Tylenol syrup spit back out on me. Instinctive as it was to punish this behavior, I refrained, cleaned it up, and held Naomi and rocked her as she cried. After about half-an-hour she did let me take her temperature, only 99.5, and accepted some regular Tylenol with a more tolerable taste.
I asked her if she'd be ready to go back to school the next day as I tucked her in bed. "I think so," she answered, "and, Mommy, do you have my sugar cookies ready for the Christmas stations tomorrow?" My weary heart sank. "I'll bake them right now," I assured her. Once upstairs I dug out the gluten-free sugar cookie mix in my pantry, at least I was prepared. Unfortunately, the mix called for one cup of gfcf margarine, which I had run out of the day before. Matt and I made a late-night trek to the grocery store and ended up filling two shopping carts. I like to stock-up when I go. Two hours later I returned to the sugar cookies, which instructed me to refrigerate the dough "at least one hour." Nearly midnight, I decided to refrigerate the dough while I slept and finish the dumb cookies in the morning.
This morning Naomi was in a little more pain. She requested the Tylenol with codeine and actually drank it down. She was also anxious to remove the large bandage, and felt much better after a shower. I kept her home for the morning since I wasn't sure how she would react to the codeine and also to help with the cookies. Other than being utterly chaotic and exhausting, the cookie baking was fun and very tasty. As we packed up her special cookies and decorations I explained that Daddy would come with her to help her at the party since she needed extra help. "Yeah," she nodded, "I have a lot of special needs, but that's OK, because that just makes me more special." I had to agree.