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Eleanor's surgery story

When Eleanor was born, I was totally shocked that we'd had a girl, since I'd been convinced we were having a boy. As I was processing the happy news of our little girl, I had a strange thought: "Hm. Since it's a girl, she can't have hypospadias like Sam did, so yay for not having to worry about surgery in the first year of this new baby's life!" I'm pretty sure I said this out loud to Matt. I'm pretty sure I jinxed everything.

Eleanor and I came home from the hospital on Saturday, December 31, just in time for New Year's. All was well. In her first few days home, she didn't so much love sleeping at night - hated being on her back, and was awake every 45 minutes or so, which meant a lot of bleary-eyed days for us parents, and at least a couple nights of sitting up with her and sleeping on the couch. But other than that, all was normal. We went in for a weight check on Monday, January 2, and she had gained a great amount of weight, and the nurse that checked her was pleased by how pink and healthy she looked, and by how normal her eating/peeing/pooping was going. Awesome.

So we were a little surprised that Wednesday evening when Eleanor, for the first time, started spitting up after her feeds. At first, it was just normal spit-up. We figured that she had now gotten old enough to spit up like a normal baby. But as the evening went on, she kept spitting up, even apart from feeds, and gradually her spit-up moved from a normal white, milky color to a more yellow color. We got ready for bed, and she was sleepy and cute, and kept pulling her legs up all the way to her belly, which we assumed was just a holdover from being all folded up in the womb. She fussed and fussed as we tried to put her down, and I finally gave up and went to the couch with her. She and I actually slept fairly well on the couch, though she was mostly disinterested in any feeding, and kept spitting up/vomiting. At this point, she was vomiting bright green/yellow, which we knew wasn't normal spitting up. She was willing to nurse while Sam ate breakfast, but then, as expected, vomited it all back up.

There'd been a stomach bug flying through my family at Christmas, so we assumed it was that. We called the OB nurses to get advice, and they said to make an appointment at the clinic. Our doctor wasn't in, but we got in to see a nurse practitioner at the clinic, who checked her out, affirmed that she seemed healthy other than the vomiting, but also concerned at the vomiting, because it was obviously bile, and that wasn't normal. He consulted with a few other doctors around the clinic, and the consensus was that we should head up to the Mayo Clinic emergency room because they are better-equipped to care for newborns.

We rushed home, threw clothes and necessities into a bag, and made our way the 70 miles up to Rochester. I sat in the back with Ellie, checking on her every five minutes in fear that she was going to pass out, or explode, or spontaneously combust.

When we got to the hospital, I realized that Ellie hadn't nursed well in 12 hours or so, and my shirt, sweater, and jacket were all already a little damp. No matter.

Into the ER we went. We checked in, and they immediately took us back to the pediatric wing of the ER. A slow but steady stream of nurses, residents, registration folk, doctors, and lab techs moved through the room. All were heartened that Ellie didn't seem dehydrated, but were as concerned as we were about the yellow vomit, her reluctance to eat, and her increasing listlessness.

Sick sleepy baby in the ER

They started a series of tests. First, bloodwork and a urine sample. Next up, x-rays. Then they moved on to doing an upper GI and ultrasound. Matt was able to accompany her to some of the tests, other ones they did in the room as we stepped out. At one point, I got myself a cup of coffee from a very 1980s-era vending machine, not because I was thirsty, but because my shirt was drenched from lack of nursing, and I was freezing cold.

The doctors had told us early in the evening a range of ailments that could be at play. Everything from a stomach bug to a severe case of reflux to a bowel obstruction to something called malrotation. I was sure that it was reflux or something of that medium severity.

While Matt and Eleanor were away for her upper GI, Matt's parents arrived in the ER. They had already been scheduled to fly in that day to Minneapolis and then to drive down to Decorah for a long weekend, to meet the baby and to celebrate late Christmas. Instead, they drove down to Rochester (which was on their way anyway), and met us at the hospital. I was sitting there in an empty ER room when they arrived. I was cold, and wet, and scared, and hungry, but couldn't get myself to eat. Matt's mom helpfully offered me granola bars, but I couldn't.

It was while the three of us were alone in the room that one of the ER doctors arrived with a nurse to tell us that Ellie's upper GI had confirmed a diagnosis: intestinal malrotation with volvulus. A two-part diagnosis. The first part, the malrotation, was a congenital defect, she explained, that affects about one in five hundred people. It means that when your intestines form and fold up and rotate to fit in your belly as your body is form in utereo, sometimes they rotate the wrong way, which means that your guts are all just in the wrong place. On its own, malrotation isn't necessarily a problem. People live long, normal lives with it. But malrotation makes it much more likely that something in your belly is going to get caught and twisted on something else, and when that happens, it's called a volvulus, and it needs to be untwisted ASAP, because it can cause tissue death, which might cause a range of reconstructive surgeries, or if serious enough, death. Cue my tears. And panic.

She explained that the only way to fix the volvolus was surgery, and that this is a serious enough condition that they were going to move very quickly. She wasn't kidding. Matt and Ellie returned, Matt's parents got to meet Ellie for the first time, and in the span of 15 minutes, we had signed consents, met her surgeon, the pediatric surgery resident, and a surgical nurse practioner who would be our guide and ambassador throughout the evening. They explained again that the condition was serious but (hopefully) fixable, and that it was a relatively quick surgery. About an hour of prep, an hour surgery, and an hour in recovery. And then, just like that, it was time to take her away. I didn't know how to say goodbye to her the "right" way. I kissed her forehead. I made the sign of the cross on her forehead. And that was that.

In the meantime, nice ER nurses had found me a breast pump, which I hadn't had time to use yet, and so we packed it up along with all of the rest of our stuff and followed our nice nurse through the hospital complex to the children's hospital wing, where we set up shop in a deserted waiting room. I numbly watched TV and pumped (finally), and confessed to Matt and to myself that I was worried that we might not ever see our baby alive again.

We kept tabs on the info screen in the waiting room that told us where in the process Ellie was. She moved quickly through prep, and then, before we knew it, the screen said that the surgery was done - only about 45 minutes from incision to completion! We hoped that was a good sign.

Our nurse came to take us up to Ellie's room so that we could get ourselves settled before seeing her in recovery. I was heartened that we were going to a regular pediatric room and not a NICU room. The nurses on the floor gave us a tour of the unit. There were two playrooms (perfect for Sam!), a nutrition room for me to get pumping supplies and store pumped milk, a shower room for parents to use, and a small room where we could get ice/water and coffee. As we were standing outside that room and the nurse was telling us about the coffee, Dr. Ishitani (Ellie's surgeon) walked up and commented, "Meh. That coffee's usually pretty bad. You might want to go to Starbucks instead." He then went on to say that since he was joking with us, that things had obviously gone well, and she was going to make a full recovery. Big sighs of relief all the way around!

At this point, it was around 9:00 p.m., and Ellie was headed to recovery. Matt and I went with the nurse to meet her there. We got there first, and stood around nervously in her recovery room. I remember how it felt to see Sam after his surgery, when he was all drugged and groggy and hooked up to stuff, and tried to brace myself for seeing Eleanor the same way.

The surgical resident came into the room first, and again affirmed that surgery had gone well, and that she was screaming her head off, which was a great sign. We heard her coming before we saw her!

So here's the thing. Screaming is a good sign, yes, but after a few minutes, you really want her to stop screaming, so that you know that she isn't in pain, and that she is actually fine. As they wheeled her in, they asked if one of us wanted to hold her,and I volunteered. I settled into a rocking chair that threatened to tip me out forwards, and into my arms they put my sweet, screaming baby. She had IV lines in one hand and one foot, and an NG tube in her nose, and a pulse-ox meter on her other foot, and bandages around her belly. They kept trying to get her to take a pacifier, which they kept dipping in a sucrose solution, which acts as baby pain meds, in addition to the fetynol and Tylenol that she was also on. I only lasted for about five minutes before holding her began to feel a little panicky for me. I didn't know how to hold her without worrying that I'd rip out one of her lines or hurt her incision. I didn't know how to soothe her when I couldn't hold her comfortably. The chair wasn't comfortable, and it was a small room, so I was feeling claustrophobic so close to the stretcher and surrounded by all the surgery and recovery nurses who were getting her settled.

No big deal. I asked Matt if he wanted to switch places, and the nurses helped us hand her off.

Our nurse practioner guide, however, immediately started tending to me as if I were about to have a panic attack or keel over. I was sitting down next to Matt, and felt just fine. But she asked if I wanted some water. Sure. So she went off, came back with water and also with juice and a bag of goldfish crackers. I don't know if I looked pale or shaky or what. I know that I felt tired as all get out. And that I was hungry from not really eating anything all day. But still. I felt fine. Maybe a little restless and oddly bored. But she was worried. So after about five minutes, she declared that she was taking me back up to Ellie's room, finding me a sandwich, and making me lay down. I didn't get to argue the point. She also wouldn't let me walk, which I suppose was fine, since I was barely a week past c-section. So into the wheelchair I went, and up to Ellie's room, where they both set up a special mattress for the couch and wheeled in a second cot for Matt to sleep on. It was weird and embarrassing to have Matt's parents there and to have a nurse make me lay down while she got food for me. But oh well. In the grand scheme of things, I am grateful that they were taking care of me as well as they were taking care of my baby.

Matt and Ellie got back from recovery at about 10:00 p.m. The nurses were amazing at getting her settled, and at holding her and moving her with confidence, despite all of the lines hooked up to her. Matt's parents left soon after seeing her, to drive down to their motel in Decorah.

(Meanwhile, Pastor Chad and family were amazing, and they had picked up Sam from daycare, fed him dinner, and then kept him for a sleepover that night. What great friends!!!!)

A fried of mine is a Mayo chaplain who happened to be on duty overnight, so we called her and she came up to keep us company for a little while as we worked to decompress. Between her visit and the steady presence of nurses in the room, we started to relax and realize that we had made it through the worst. We were exhausted, but starting to relax. Our nerves were a little fried, but all was stable.

The overnight nurses took charge of Ellie's care, getting a bouncy seat for her crib to help her be more comfortable, working on her pain management, and keeping an ear out if she fussed. They wanted both Matt and me to get a good night's sleep instead of feeling like we had to tend to her. It was very sweet.

Ellie, post-surgery, all hooked up but resting comfortably

Ellie's vitals were great that night, and by Friday morning, we had entered the waiting phase of things. Her little two-inch incision was going to heal quickly, they told us. And so the real work of recovery was going to be her bowel function. Basically, the deal is that they keep the NG tube in until she has a bowel movement, at which point they can remove it and start an initial feed of a small bit of pedialyte. If that stays down, then small attempts at nursing her. Once she tolerates a full feed, she can work on discharge!

Nothing happened on Friday in that regard, which is fine. Sometimes it takes a few days for things to get moving, they gold us. So Matt's parents came back up, this time with Sam, and we spent the day on the floor, taking turns playing with Sam in the playroom, keeping Ellie company, and even holding her in the rocking chair.

Holding my sweet girl

We felt good enough to go out for pizza that night, and then Matt and Sam and Matt's parents headed back to Decorah for the night. I stayed with Ellie. It was a less-restful night than the previous one, because the nurses didn't have to do as many checks, and I was trying to do some of the comforting when Ellie fussed. Also, she managed to pull out her NG tube at one point and they had to put it back in, which made her super-grumpy. Silly feisty baby!

NG tube, take two

On Saturday, everybody came back up from Decorah. Ellie had a dirty diaper early that morning, and so they were able to remove the NG tube for real, and Matt got to feed her a small bottle of pedialyte, which she tolerated like a champ. Yay!!

First feed

That afternoon, we had visits from some friends of ours from college and from my sister. It was lovely to see friends and family, especially knowing that Eleanor was well on her way toward discharge. Sam loved getting to play in the toy room with baby Henry and with his cousin Teddy. Meanwhile, we were able to give Ellie a bottle of milk, and then later, I was able to nurse her. Yay! They took off most of her lines, too.

First nursing!

Overnight, I was up a lot, but it was to nurse Ellie, so I had no complaints!

Sunday, the surgery team did their usual morning rounds, as they did every morning we were there, and affirmed that things looked good. They doubled checked with Dr. Ishitani, who gave us the green light for discharge! We spent the rest of the morning and early afternoon getting her fully unhooked, getting packed up, getting our discharge instructions, and finally getting on the road.

Fully unhooked!

Homeward bound

We made it home late in the afternoon, in time to eat a fancy Christmas-sequel dinner and open Christmas presents together. After a complete change of plans for Matt's parents' visit, at least Sunday night felt like what we had planned and expected.

We are now three weeks past surgery, and Eleanor is recovering well, though keeping us on our toes. In the first few days after coming home (again), she ate well, but her otherwise normal spit-ups were still a little yellow, so we were those obnoxious parentts who called the surgery team a couple different times to double-check that there was no cause for concern. Then when we went in for her follow-up appointment a week ago Friday, the nurse practioner noticed that one side of her incision looked a little red and swollen and separated, and then over last weekend, it started draining and stabbing, and so we had to call up two more times, which resulted in them putting her on some antibiotics to ward off infection. We followed up with Dr. Locke this past Friday, and discovered that she was spitting a stitch from her internal sutures, which was likely what caused the swelling and infection. Dr. Locke was able to pull the stitch, clean her up, and send us home with supplies to clean and cover the wound. He assured us that she was going to get better very quickly after that, and he wasn't kidding. Now that she's done with spitting that stupid stitch, her incision is closing up again, and the antibiotics have cleared up all of the stabbing and draining and redness. We have another follow-up with him tomorrow, and hopefully we are on the verge of finally being fully recovered from this whole ordeal!

We are so grateful for family and friends and for the four or so different prayer chains that were all praying for Eleanor during her surgery and recovery. I am grateful for a church generous in giving maternity leave, and for Luther college who is equally as generous in giving paternity leave. I am grateful for Sam, who adores his baby sister, and is protective of her, and always wants to hold her and hug her and kiss her; Sam, who is not appearing jealous of Eleanor, but who is quick to tell me, over and over again, that he is glad that I am home from the hospital and here at home with him - "I like you being here with me," he says frequently. I am grateful for doctors and nurses, here and at Mayo, who make our whole family feel cared for. I am grateful for lots of things, and especially for the health of little Eleanor, our sweet and resilient little girl, who is a month old and a joyous addition to our family. Here's hoping for a quieter second month of life for our little lady!

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