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Monday, July 12, 2010

Jagged Edge...

I've been nervously gnawing at my nails for almost an hour. It's a bad habit that I picked up when I was a kid. It helped soothe me whenever I would witness the domestic disturbances that would occasionally erupt in my household. Now as an adult, I still nervously chew on my nails when I'm worried, afraid, stressed, or upset.

And right now, I'm all four of those things.

I'm alone and I need to keep my fingers busy or I'll end up eating my whole hand. So, here I am turning to my therapy again. Trying to write my stress and anxiety away. John left to take Boo to school shortly after we got into the anesthesia room. And I'm really trying hard to NOT freak out.

 On our way down to surgery...
 Bye Bye, Broviac (hopefully!)
Cuddling with Daddy the Anesthesia Procedure Room

I put up a pretty good front. I can keep my cool in front of medical personnel, but truth be told -- I almost cried about a dozen times this morning. I met with the surgeon this morning. We didn't have time to set up a pre-op visit. However, Dr. O was is same surgeon that did Niki's 2nd Broviac installation so I had no doubt about his familiarity with Niki's condition. As it turns out, there is a 50/50 chance that this surgery will be unsuccessful. If her vessel is too small to accept the port, then the doctors sliced and diced her for nothing. This morning was the first time I heard about that possibility. He said she was a bit small for the surgery, but he would try. (Most port surgeries are done between 18-24 months. Niki is barely 17 months.)

If the port doesn't fit then we put her at risk for nothing. And I would feel like total crap.

There have been other issues this week. On Wednesday 7/7,  Niki's INR came back high -- 6.6 to be exact. (That is NOT good -- Niki's INR normally runs between 1-2.) And another issue was her hemoglobin was low at 8.3 so Nurse Richard was thinking she would probably need a blood transfusion prior to surgery if her numbers didn't improve. On Thursday, he had me redraw labs and her INR was 4.4 and her hemoglobin was 8.2. Still not good and not much of a change. A high INR is dangerous, I don't quite understand the mechanics of why it's bad, but I know that high INRs are no bueno. It was unusual for her to have such odd lab values two times in a row. Unfortunately, the Oscar Grant verdict came in on Thursday. So, the nurse covering for Nurse Richard told me not to worry about it --- that it would be addressed when Niki got hospitalized -- and that they would call me the next day to follow up. Well that would have been fine, but the next day was Friday and the downtown Oakland offices were closed because of the verdict. So, no follow up call.

Her high INR and hemoglobin didn't really get addressed until yesterday/this morning.

There was clearly some confusion about the right dose of NovoSeven that Niki needed prior to her surgery. I could see the Anesthesiologist Dr. B getting pissed off at the pharmacy. The anesthesia procedure room is right outside of the nurses station. He was on the phone and all I could hear was that she should have gotten bolus a dose of Novo ordered/administered before she went down to surgery. Her blood was not clot-ready enough for surgery.

So far, they only gave her two doses of 150mcg since she was admitted -- once at 9pm and another at 3am.

We got down to surgery at about 7:15 or so. There was a delay in getting her factor from the pharmacy and Niki was getting increasingly irritable. I tried my best to preoccupy her with my iPhone after John left so I played all sorts of Barney songs and Justin Beiber to keep her happy. After what felt like hours of waiting (but actually turned out to only be another hour), Dr. B finally came in to administer her factor and some Versed.

He administered 300mcg of NovoSeven over the course of 5 minutes. I was surprised that the nurse didn't do it. Then, before he gave her the Versed, he warned me that she would "get floppy pretty quick".

Boy, he wasn't kidding.

One minute she was playing with my fish Pocket Pond app and the next minute she looked up at me with an "I don't like this face" and started to whine. I felt my eyes start to sting with tears. She really looked fucked up. But...just as soon as expressed that she didn't like it, she suddenly switched to an "I like this face". For about a minute it was very scary to see her drugged up, but she almost instantly got used to the "high" and even half-heartedly giggled once. And then, it was slightly funny because Niki thought it was funny.  Even Dr. B laughed a bit at how she was acting. Niki is a determined little girl and she manged to focus her attention back to the Pocket Pond. She drunkenly tried her best to continue to tap away at the koi fish.

She is one tough little cub -- definitely her Daddy's daughter. (I personally hate being drugged!)

High off the Versed...

Less than 5 minutes after the Versed kicked in, the nurse took her out of my arms and whisked her off to have her surgery done. And I felt like crap again. I'm worried. It shouldn't have taken this long. It's been over an hour now and still no word. She went in at 8:20 and it's 10:42 now. Is port surgery supposed to take this long?!?!?!?!?!

I'm worried. I know I said that twice, but I don't care. How would you feel if you were me?

Or maybe I'm just a lunatic Mom for feeling so anxious about her still being in surgery.  Even writing about it isn't doing a thing to help keep me occupied enough.  What if she's bleeding? What if her INR was a problem and the dose wasn't strong enough? What if the port doesn't fit? What if there was a problem with the IV or the anesthesia? So many what ifs that I needed to know answers to 5 seconds ago. What the hell is taking so long??? John keeps calling me asking what's going on and it's making me even more nervous.

My jagged-edged nails are all tore up like I am. Now would be the perfect time to smoke. But I vowed to quit for good after Ethan died so that's not an option either. This sucks. Hoping, praying and worrying all at the same time...

 Give my baby back people!!!!

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