Monday, September 22, 2008

Monday, September 22nd, 2008

Since I couldn't have anything after 5 am, the feeding pump woke us all up pretty early at 4:30 this morning. My parents got in the shower and I woke up on my own at 5:15. I was happy and ready to play but first I needed a bath. Then I got a 1/2 hour in of play time with my parents before it was time to leave for the hospital.

It didn't take long before they were checking me in. They had to get my vitals and my parents needed to talk to the anesthesiologist and the resident surgeon. They also had to write in purple marker the word "yes" on each side of my cheek where the distractors would be taken out. The plan was to remove the distractors that were put in place in June, loosen up the right TMJ and repair my cleft palate. The best laid plans....

I was given some medicine through my gtube to relax me and boy did I get relaxed! I was laughing and smiling at everyone in the preop room and waving at anyone who would look at me. A very far cry from the hour's worth of crying in the preop room at Shriner's when I didn't get any preop meds! I was really happy until the final pass off to the surgeons but even then it wasn't as dramatic as what my parents saw a few weeks ago. As I headed to surgery, my parents headed to the cafeteria for some breakfast and strong coffee.

The plan was that they shouldn't expect to hear anything for about four hours. The first 45 minutes would be spent getting me prepped and under anesthesia. The surgery itself would be about 2 hours. The remaining time would be spent in recovery. Just a 1/2 hour in, my Mommy got a call saying my parents needed to head back up to preop because the operating room had called out to them requesting to speak to my parents. Poor Mommy! I thought she was going to have a heart attack! My parents rushed back up to the second floor and then had to wait until someone from the operating room could come to the phone. It ended up they just had some questions about the blood that was being drawn and where it needed to go. There was a hugh sigh of relief from my parents and then they hunkered down in a quiet spot in the hospital to play the waiting game. A few hours later, Mommy was stopped by a volunteer who said the operating room had called out and said they were sending me to recovery. My parents were both very surprised - not enough time had passed. They waited a few minutes and then they were led back to the recovery area. There I was in all my after surgery glory! Mommy noticed right away that I didn't have a no-no on my left arm. She had a bad feeling that the cleft palate repair hadn't actually happened. Her suspicions were confirmed a few minutes later when Dr Schendel came into the recovery room to talk to my parents. The distractor removal had gone well and Dr Schendel was able to get my mouth to open quite a bit wider with the loosening of my left joint. When Mommy asked about the cleft palate repair Dr Schendel said that I don't have a cleft palate. That's right, I don't have a cleft palate. OK, so you are probably as confused as my parents were. Since I was born my parents have been told I have a cleft palate but no one could ever tell them what kind of cleft palate I had (complete, incomplete, hard palate, soft palate). Because my mouth opening was always so small, a good exam could never really be completed. When Dr Schendel went in to fix the cleft palate he discovered I don't actually have a cleft palate. My palate is closed all the way - no holes - but it is considered "short" and high arched. So that is good news and bad news. The surgery was less intensive then it was going to be - good news. I am probably going to need surgery several years in the future to make sure that when I talk I don't sound nasally - bad news. Even though my palate didn't have a cleft - because it was short and high arched it explains why I had a hard time sucking on a bottle. Dr Schendel said the muscles aren't really there so I didn't have the strength to suck like most babies do. At this point, my parents are just happy that I was saved from more pain and a few weeks with the no-no's. Instead of keeping things out of my mouth, Dr Schendel wants my parents to exercise my jaw to make sure I keep the extra opening that he was able to get by loosening the joint.

With that news, my parents were prepared for a pretty easy recovery but I didn't let them off so easy. For the first few hours in the recovery area I was not happy! I was crying and fighting almost the whole time - despite several doses of pain meds. When we got up to my private room I had settled a little but was still not quite myself. I napped a little and when I woke up I was just as grumpy as I had been earlier. Daddy asked for some pain meds and I got a dose of Lortab through my g tube. It was like magic. Within 1/2 hour of the pain meds I fell into a peaceful sleep for close to 3 hours and when I woke up I was a brand new girl. I smiled and laughed at my Daddy as he got ready to leave for the night. Then Mommy and I played for a few hours together before I turned over and went to sleep. If all goes well tonight, Dr Schendel said I could go home tomorrow afternoon. Yeah!

Peyton Nicole Smith

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