Wednesday, February 1, 2006

A Big Day for Emma

Getting ready for surgery

February 2006. Emma underwent major surgery combining the nissen fundoplication with the removal of her tonsils and adenoids (T&A). It is very risky to perform surgery on a child so young (she was 15 mo) with diabetes, so they were able to arrange both surgeries and multiple doctors on the same day. The T&A was to take place first, followed by the nissen.

Surgery preparation consists of fasting for several hours prior to anesthesia (everybody has to do this), but this was not an easy task for a baby with diabetes. It was quite a stressful night before the surgery trying to maintain stable blood sugar because they couldn't operate without that. Has anybody heard of stable blood sugar in an infant with diabetes? NO. And without food it is even more impossible. Anyway, we did our best, but failed as her blood sugar dropped in the pre-surgery waiting room. So, they had to hook her up to an IV bag with sugar in it to help stabilize her which made the wait even longer (with a baby that hadn't eaten in hours!).

Surgery went very smooth. Recovery, however, is another story. Typical Emma style, she kept us hopping post-surgery. She went straight to the Pediatric Intensive Care Unit (PICU) as a precaution because surgery is stressful on the body, and stress makes diabetes difficult to manage. So, off she went to the PICU to be taken care of and monitored. Her diabetes went into a sky high tailspin which made her really sick on top of being miserable from the surgery. Her blood sugar was so high, it wouldn't even register on the meter (glucometer). This meant she was at risk for developing DKA again. Fortunately, she only had to spend (a long) 24 hours in the PICU, after which she improved enough to be transferred to a regular recovery room. She spent about a week in the hospital all together, which wasn't too bad, but we were ready to be out of there by the time we left.

In the regular recovery room, such a tough baby

This is how she was a lot of the week

Her recovery was very difficult because she had both surgeries at the same time, not to mention she didn't want to eat (sensitive from the T&A) which made her diabetes a nightmare to control. Her food choices were limited because she couldn't go directly back to eating solid foods after a nissen, she had to start with liquids and gradually work into solids again. The worst part, though, was that she ended up getting a stomache bug that made her want to throw up. A lot of times we take Emma to the hospital for one thing, and come out with another..... Anyway, this was the worst thing that could have happened after a nissen surgery because she couldn't throw up, but her body wanted to. It was so sad to watch her struggle through that. Nissen surgeries don't last forever, either, and they had warned us of the possibility of the surgery being ruined from prolonged stress on the site from the body trying to throw up. Mom came home with it, too, so the first few days after coming home were truly a nightmare.

Closer to going home

A few weeks later, Emma bounced back to her normal self, again showing us how tough she really is. In spite of how awful the nissen makes "the throw ups" for Emma, it has been amazing at controlling and helping her reflux.

Sunday, January 1, 2006

A Niss-a-what?

At the same time as the sleep study, Emma's reflux problems kind of came to a head. It started when she was a baby, and they wanted to wait for six months to see if she would outgrow it. She didn't (surprise...), so the next step was medication, which she was on for a while. In spite of the medication, she was still having problems, so they did an upper GI test and a biopsy of her esophagus. These tests helped determine that she needed to have surgery to help reduce the acid, because the medication wasn't doing enough. This surgery is called a Nissen Fundoplication (a big fancy name that means surgery to stop reflux, it also means you can't throw up your cookies anymore).