On the other side! (Again!)

We got a call from the OR after about two hours letting us know that the neurosurgeon was starting his part of the surgery.  My heart fell.  After two hours they were just starting the main part of the surgery?  Turns out, they had some trouble getting him to sleep, (turns out he probably metabolizes anesthesia like I do because he ended us needed double the amount that a kid his size would usually need,) some trouble starting his lines, (again taking after mom, poor kid,) and they had to get the ear tubes placed.

And as a side note, can I just say "Hallelujah!" for ear tubes?  When the surgeon placed them, he told us that Max had fluid building up in his ears again, so it was looking like we were heading for another ear infection. 

It took the neurosurgeon another hour to finish removing his skull plates.  When he came back to the waiting room to talk with us, he told us that Max had significant scar tissue and it was "a little more difficult than usual."  Yeah.  What else is new?

I was incredibly antsy and restless at this point- I spent the next few hours pacing the halls of the hospital, running little errands, calling Serene, (who knew just how to distract me!) and probably making everyone around me crazy.  After lunch, I was so grateful to meet up with our surgeon in the hallway and hear that things were finished after more than six very long hours. 

The doctor said that everything went as well as he could have hoped.  Max stayed stable throughout the surgery, he received about a unit and a half of blood, and had quite a bit of scar tissue that he had to work around.  He removed the plates and screws from the first surgery and replaced them with different plates and screws that should dissolve within nine months.  The doctor said he was very pleased with Max's new head shape and felt that he was able to achieve the correction that he wanted.

The interesting part was that the doctor said that he saw some evidences of increased intercranial pressure as he was operating.  Hearing that confirmed to both of us that we had made the right decision to pursue a second surgery.

They brought him back to the PICU intubated because of the heavy amount of anesthesia they had to use.   This added a whole new intimidating mess of tubes, wires and machines to my poor boy.  They told us they would extubate him as soon as he woke up so that they could make sure he could breathe on his own.  We kept expecting it would happen right away, but we were in for a lot more waiting. 

And waiting.

And waiting.

They finally extubated him a few minutes ago when he started stirring and getting visibly upset.  They knew it was time when he started trying to pull it out on his own.  It was really hard to watch, but he looks so much better and more peaceful now. 

His sodium levels, which are a huge concern because of our previous bout with SIADH, are in the low/normal range.  We have to be at 135 to get discharged to the regular floor, and he's at 134.  I'm really hoping they come back up, because I would love to get out of the PICU.  Fortunately, we have a much better set up this time.  There's a small pull-out sofa, a bathroom to ourselves, a closet where I can put my suitcase so I don't end up getting robbed again, a slushie machine down the hall, and much more space.  That, at least, makes me feel a bit less crazy.

They told me I can try to nurse him as soon as he's awake and looks like he's ready for it.  He's in a big bed this time around, so I'll probably just climb up next to him.  I'm going to hang here for another hour or two to see if he'll wake up, because I don't want to miss the opportunity to feed him.  If he doesn't stir, I'll head to the pumping room (where I ineveitably feel like moo-ing!) and then off to my tiny, glorified closet they call a sleep room.

Check that.  Max is now officially fluid restricted due to his dropping sodium levels.  Sigh.  They're not officially calling it SAIDH, but they are working to get on top of it before it gets too crazy.

So now for the pictures.  If you're squeamish, you may want to skip them.   They're not gory or bloody, but they're a little sad, especially if you haven't ever seen this before. 

Playing in the bath the night before surgery.  I was loving playing with his curls for the last time.

"Before" shots- this triangular shape is called triganocephaly- the exact thing we set out to fix.

Hanging in the waiting room, sporting the shiner from last night's fall from the bed.

Rocking the baby scrubs.

Happy as can be after a serious dose of Versed.

Just out of the O.R.

Extubated and very sleepy.  The swelling is starting to kick in.