Ellie was born with a severe bilateral cleft lip and palate. This blog follows the ups and downs of her journey through the various stages of treatment, and offers some insight in to the life of a cleft-affected child. Being the parent of said child poses its own challenges, and updates are made when I can, not always as soon as something happens.
Saturday, 27 April 2013
27/04/13 - Our Post-op Routine
26/04/13 - Home, Sweet Home.
25/04/13 - Discharge Day Already!
24/04/13 - Post-op Feeding Issues
I woke to the sound of my phone vibrating on the bedside table. It was Ellie's nurse, saying she was awake and seemed to want her mummy. I said I'd be right over. I threw on some clean clothes and headed out the door. It's a good thing the hospital provides coffee in the parent's room, because even with spending the night at Ronald Mcdonald House I was still exhusted.
By the time I arrived on the ward she was asleep again, so I made myself a hot drink and went back in to sit with her. Even at 6am the ward was crazy. It seemed like every kid in there was awake already, certainly all the other babies in the nursery were. I was glad that I hadn't stayed the night, and I knew I probably wouldn't be getting much sleep that night.
At around 7.30am the plastics registrar came around to do rounds. He was the same man that had told us on Monday that our surgery was cancelled. I could see that he was nervous about how I would respond to him, but I was too focused on Ellie's recovery to be mad at anyone. He was happy with her progress, and said that as soon as she started feeding properly she could be discharged, maybe even that day. I was amazed. We'd been expecting to be in the hospital for three or four days.
My joy was pretty short lived though. At her next feed, Ellie barely managed to take 20mls before she started screaming and squirming. It was hard to tell if she was in pain or just frustrated, but I didn't want to push her too hard that soon after the surgery. I figured we were really in no rush. She still had her IV line in and was receiving 100% maintenance fluids, so it wasn't going to hurt her if her milk intake was low.
Getting Ellie to settle to sleep in the hospital was tricky. Not only was it noisy with three other babies and their respective parents in the room, but we also couldn't swaddle her like we do at home thanks to the IV line and apnoea monitor. On top of that, she was also harder to hold with the arm splints on. Sleep has never been her strong point, but now it was taking at least an hour each time to get her back to sleep.
At 9.30am Doctor Kimble came in to see us. He asked what I thought of the repair, and I replied honestly that it was taking me a while to get used to her knew look. He said again that a bilateral cleft is "twice as hard and half as good" and that sometimes parents are actually disappointed in the result. I assured him that we were far from disappointed! He was leaving that afternoon for a conference but he said his team were well versed in Ellie's case and could be contacted any time if we had any questions or problems.
Shortly after that Drew and Sophie arrived. We knew that the time Ellie was in hospital was going to be hard on Soph. She is an active little girl, and we didn't want her to be sitting around the hospital all day. Of course we could have left her at home with Bec or mum, but we also wanted her to be with us as a family. So the solution was that one of us would stay with Ellie while the other stayed with Sophie. We would switch out throughout the day, and swap each night so that one of us always got a good night's sleep.
Drew stayed long enough to have a cuddle and attempt to feed Ellie, and then took Sophie off to the museum to see a dinosaur. We're lucky that the hospital in Hobart is so centrally located. It means there's plenty of things to do with Sophie without ever being too far away from the hospital. Meanwhile, I settled back in to my chair to wait for Ellie to wake up again. There's a lot of waiting when your baby's in hospital.
After lunch Drew and Soph came back, and I swapped with Drew. I took Soph back to Ronald McDonald House and we both had a shower and got changed in to clean clothes. We went up to the rooftop garden for a while so that she could have a play in the fresh air, and I could get some sunshine after being inside the hospital for the better part of three days.
An hour later I decided I was hungry, so we headed over to the mall to get something to eat. The hospital doesn't supply meals for parents, only breakfast cereal, so I hadn't eaten since very early in the day. We found a cafe and had hot chocolates and sandwiches. I love taking Sophie out for things like that, she gets so excited about being a big girl.
Once we finished our afternoon tea we went back to the hospital. Ellie was still sleeping and hadn't missed me at all. Drew and Sophie left, and I said I'd come over to the house after her next feed so that we could have dinner together.
The next feed was even worse than the others that day. It was obvious that Ellie was struggling with the syringe, and probably in quite a bit of pain too. I was starting to wonder just how long it would take for her to get her feeds back to the normal amount. Would we be in hospital until she was allowed to have a bottle again?
It took more than two hours to settle her after that feed. She would fall asleep in my arms, but as soon as I put her down she would wake up again. After the 5th attempt our nurse for the night, Christina, suggested that we give her the oxycodone dose a little bit early and see if it helped her settle. By this time it was 7pm and I was starving. Christina offered to take over while I went to get something to eat but I was determined and eventually I managed to get her back in to the cot.
I made a mad dash out of there before she could wake up, and found Drew and Soph in the kitchen finishing their dinner. Soph had made friends with a little boy in the house, and she was more than happy to play with him while I updated Drew on the rest of Ellie's afternoon.
Before long it was time for me to go back to the hospital again. Ellie's routine was completely out of whack, so I had no idea when she would wake up again, or how long it would take to settle her, so I wanted to get back as soon as I'd finished eating. Not long after i got back to the hospital she started stirring again, and thats when we noticed that one of the arm splints had fallen off, and she was taking a sneaky chance to play with her lip. she didn't seem to be in much pain, but Christina gave her an extra dose of panadol just incase.I had a cup of tea in the parent's room and then settled in to my chair for what was bound to be an uncomfortable and restless night.
23/04/13 - Take Two
The 1.30am feed had one glorious moment - a soggy, wet nappy. I've never been so happy to change a wet bum in my life. Even if I was changing it with my eyes practially hanging out of their sockets because I was so tired.
Of course, because it wasn't the full three hours since her last feed, Ellie struggled to drink. She managed half of her bottle and that was all I could get her to take before she fell asleep again. I just hoped it was enough to get her through for however long they were going to keep her waiting that time.
We all woke up together at 6am. Ellie was surprisingly calm, only letting out the occasional protest cry, but not screaming like she had the day before. We got dressed and went down for breakfast. Bec and Ash arrived at 7am, and we headed back to the hospital to start again.
I had pretty much convinced myself that it wasn't really going to happen that day either. We'd been told that she was on the emergency list, but of course if there was an emergency come in then she would be bumped. I wasn't happy about putting her through the fasting again for nothing.
Surprisingly though, she was handling it much better. There was no screaming, she just grizzled a bit every now and then. It makes a huge difference waiting around when your baby isn't screaming her lungs out.
Shortly after we arrived we were taken through with the nurse to go back over the paper work. While we were in the the anethisiologist, Simon, came and introduced himself, and asked a few questions of his own. He was very friendly, and guarenteed us that we would be going in, there was just one surgery they had to clear out first.
After another little wait, Doctor Kimble arrived. He was very apologetic about the cancellation, and within seconds I was over my anger towards him, and he was back in my good books. He explained what he was going to do, and that he would call us as soon as he was finished.
Half an hour later we were still waiting, but Simon made a point of coming to find us and keep us updated. He said he'd tried to get another operating theatre opened, but there wasn't enough staff. It was really good to know that everyone was trying their best to make sure Ellie got in without too much delay.
Meanwhile, she was still being all bright and bubbly. She had a couple of little naps, but mostly was happy to be held and rocked. Sophie was more annoyed about waiting around for the second day than her sister was.
At about 10am we were taken through to the surgical waiting bay. Bec and Ash said goodbye to Ellie, and Sophie gave her a big kiss. Inside we spoke with Doctor Kimble again, and before long a nurse was taking her down to theatre. I did so well: no tears!
I mightn't have cried, but watching him walk away with my baby, and knowing that she would be so different when she came back, made me feel sick. I wanted to chase him down that corridor and resuce her from the pain we were about to put her through.
Doctor Kimble had told us the surgery would take two or three hours, and we didn't want to spend that time sitting around the hospital because it would have just seemed longer. So we left and headed across to the mall to do a bit of shopping and grab some lunch.
While we were in Target my phone rang, and I nearly had a heart attack. My hand was shaking as I answered the private number. She had only been in for half an hour, I didn't know what could have gone wrong in that time. It was only Big W ringing about my layby!
After some shopping Sophie and Drew were hungry so we stopped for an early lunch. I felt too sick to eat, but I managed a bite of Sophie's hot dog. I remember sitting there wondering how all these people around us could be going about their business so happily when everything was so scary for us.
To add to our worries, mum was back home having her gallbladder removed. We called dad and found out that she'd been taken to surgery around the same time as Ellie, so we had two seperate lots of worry going on at once.
At around 12pm my phone rang again. I panicked all over again, thinking it was too early for her to be out of surgery. But it was Doctor Kimble, ringing to let us know that he was finished. He said everything went well, better than expected actually. He didn't need to put shunts in her nose to keep her nostrils open and the procedure had been textbook perfect. They were taking her back to recovery, and we could see her in about half an hour when she woke up.
While we were heading back to the hospital dad called again, and said mum was out and also in recovery. We were a very happy group. We all had big smiles on our faces and anyone that saw us would have thought we were on a holiday or something.
The half an hour wait to go in to recovery felt longer than the two hours that she was in surgery. I kept looking at the clock and as time ticked away I was starting to wonder if there was a problem. But just before 1pm my phone rang again and we were told one person could go in. I let Drew go first. I wanted him to be able to warn me if there was a lot of blood or anything like that.
Drew came out after about 20 minutes and said she looked great. I headed in for my first glance. I was nervous. I didn't know what to expect, it was almost like meeting her for the first time all over again. I rushed down the corridor in the direction the nuse sent me, and paused in the recovery room doorway.
Laying there, on a little cot with tubes everywhere, was my little girl. My attention was instantly drawn to her mouth. She looked completely dufferent, she didn't look like our Ellie.
It's incredibly hard to describe what it's like to see your child after such an obvious corrective surgery. I'd tried to find post-op images of a bilateral repair but I hadn't found any to give me an idea of what to expect. It's not that I didn't like how she looked, it was just so very, very different to what we'd said goodbye to just a few hours before.
I stood there for a while, talking to the recovery nurse and holding Ellie's tiny hand. She was still unconscious, but was whimpering and starting to move around a little bit. The nurse explained that they would be monitoring her breathing with an apnoea monitor, and she had a drip in her foot for fluids until she could drink.
A little while later she was allowed to be transfered to the paediatric ward. She was going in to the nursery because she needed constant nursing presence for the first 24 hours while she was on the apnoea monitor.
A nurse and an orderly wheeled her out of recovery and we found Drew, Soph, Bec and Ash in the hallway. We all followed behind and headed to paediatrics. Soph looked scared and upset seeing her sister on the bed. She kept saying "I needa see my Nellenore" and "I want hold my Nellenore."
On the ward I waited in the parent's room while everyone else visited Ellie. We took it in turns to be in there with her because only two people were allowed at a time. The reality of it all hadn't really sunk in for me, I kept having to remind myself what was going on.
Ellie woke up at 5.30pm and we attempted our first syringe feed. I've had to feed her like that a few times in the past, but it was still terrifying. It was very awkward trying to hold her comfortably with all of her cords and her arms splinted, and I was scared of hurting her mouth. As it was I managed to drop the syringe on her lip and poke her a few times, and I felt horrible about it. She managed about 30mls, and then she went to sleep.
Because I'd had such a bad night the night before, and it had been such a long day, I aranged with the nurse that I would go back to Ronald McDonald House that night. I was planning to room in with her after that but I needed one full night's sleep before sleeping at the hospital. I know from experience with Sophie that there's never much sleep to be had on a paediatrics ward, and Hobart was a lot busier than ours back home.
We left after Ellie was asleep, and the night nurse assured us she would call if Ellie needed us. It had been such a long, emotional day. I felt like I'd run a marathon, I was exhusted, and I couldn't wait to get Sophie in bed so that we could colapse ourselves.
22/04/13 - One Angry Mama
Ellie woke up Monday morning just in time for her last feed, and I took her down to the sitting room so that Drew and Soph could get some more sleep. Soph hadn't been asleep before 10pm the whole time we were there, and she'd been waking up at 6am. The last thing we needed was a tired, cranky toddler.
She finished her bottle with just a few minutes to spare, and then power-chucked the whole thing back up. I'm not kidding - there was so much milk covering me, the couch and the floor that there was just no way there could have been any left in her tummy. I know from experience that you can't convince her to drink any more after a vomit like that, but I managed to get her to take another 50mls half an hour later, even thought it was technically the fasting period by then.
She went down nice an easily for her nap, and I started packing our bags for the hospital to distract myself. I had that sick feeling in the pit of my stomach again. I don't really know what I was so worried about. I knew that the fasting was going to be horrible, and that I would have to walk in to the hospital, but I don't think at that point the actual surgery was really on my mind.
I was fighting back tears all morning. I had to keep ducking in to the toilet to have a quick cry and breathe in to a paper bag to calm myself down. I didn't want to cry in front of anyone and upset them as well.
Ellie woke up at 9.30am and demanded her bottle. By 10am she was screaming, and it was breaking my heart already. I gave her a bath which always calms her, and she cried herself to sleep at 11am for half an hour. My nerves were shot and it had only been a couple of hours. Its so hard knowing exactly what your baby needs and not being able to give it to them.
When she woke up we headed over to the hospital. As well as Drew and Soph, there was also Bec and Ash, and mum and dad. They'd came down over the weekend to support us and to help with Sophie during the surgery and recovery so that we could focus solely on Ellie.
Although I'd been worried about going in to the hospital, I managed to walk straight through the door without another panic attack. Upstairs, the surgical admissions floor was packed wall to wall. There wasn't enough room for us all in the waiting area, and Ellie was screaming, so I took her out to the hallway to walk her up and down.
I had been doing so well up to that point to keep the tears contained, but as soon as one of the nurses came over and asked how we were doing the floodgates opened, and I broke down. I was sobbing, and she was so lovely and took Ellie for a while, just walking her around and shhh'ing her. I stood there in the hallway and cried on Drew's shoulder. I couldn't go back in to the waiting room because I didn't want Sophie to see me so upset.
After we'd been there for almost an hour we were taken in to a little consulting room to go through the admission details, and told that Doctor Kimble would be in shortly, an we would be the first surgery on his list. Ellie finally fell asleep in my arms and we went back to the waiting room again.
There was another little boy in the waiting room who was having his palate repaired. He had been fasting for the same amount of time as Ellie, but was doing a much better job of staying calm. He actually seemed quite happy and content, I guess because he was a few months older. Talking to his mum I found out that his surgery was only going to take an hour, and it seemed rather un fair that he was going to have to wait for our two to three hour surgery before he got his turn. But as it turns out, he was taken through not long after.
By 2.30pm we were all starting to get angry. Ellie had been screaming for hours, with small, 10 minute naps here and there, and we'd been cooped up in the hospital for too long. We kept being told "half an hour" "going in soon" etc etc, but no one ever came to get us.
I had gone from being nervous and scared about the surgery, to just plain pissed off that the whole process was taking so long. I just could not understand why Ellie was being forced to fast the entire day. She was so upset, and by 3pm she was showing signs of dehydration.
Finally, at 4.30pm we were taken through to the surgical waiting bay. We'd been at the hospital for almost five hours. It had been 10 hours since Ellie's last feed. My surgery nerves started flowing back in, and I was feeling really jittery again.
After about 10 minutes in there a man in surgical scrubs who we'd never seen before came over. He said that there had been a problem with the first surgery and because it had gone so far over time, they were going to cancel Ellie's surgery.
I exploded. I don't think I've ever been that angry in my entire life. I screamed and shouted, shook and raged but of course it didn't do us any good. I couldn't believe that they had put my baby through all of that for nothing. I was wild.
He said that they were trying to get her on the list for the following day, and he wanted to admit her overnight. There was no way I was having her stay there though. We somehow negotiated to come back the following morning, after putting Ellie through the whole fasting process all over again, and I stormed out with my screaming, dehydrated baby.
Back at Ronald McDonald House 15 minutes later, I was worried that Ellie would drink her bottle to fast and make herself sick. I had to keep taking it out of her mouth and burping her so that she would slow down. She managed to drink it all without any problems, and as soon as her tummy was full she fell asleep, finally happy again.
While I was feeding her Doctor Kimble called. Bec and Drew spoke to him because I was busy. He wanted to apologise and ensure us that he would do everything he could to get us in the next morning. I was still incredibly pissed off, but it was good of him to call, he didn't have to do that.
While Ellie was sleeping we went down to the kitchen to say goodbye to mum and dad. Mum was having surgery of her own the next day, so they had to get back home. I could see they were both upset that they wouldn't be there for Ellie, but mum's health was just as important.
After a cup of coffee and with the screaming finally stopped, I was starting to feel more in control again. I managed to put together a plan to get Ellie rehydrated again by waking her for feeds every three hours up to 2am when she had to start fasting again.
We had dinner, which was cooked that night by a group of volunteers, and headed back upstairs to feed Ellie again and get Soph ready for bed. She had had such a long day, and she was coping really well, especially after seeing everyone so upset.
At 10pm when I fed Ellie her nappy was still dry. She hadn't had a wet one since she woke up at 9.30am, and I was worried about what another day of fasting would do to her. I finally fell asleep around midnight, knowing that I would be awake again in an hour to give Ellie her last feed. It had been a horrible day.
21/04/13 - Preparing to Say Goodbye to Her Smile
After a weekend of window shopping, the zoo and eating out, it was time for me to face reality. I'd done a great job of distracting myself from what was coming, but Sunday night all I could think about was how different Ellie was going to look the next day.
It's funny, when we got the diagnosis at her 20 week morphology scan I was so nervous about how I would feel when she was born. I stupidly wondered if I would be able to bond with her, just because she was going to look a little bit different. I'm so ashamed of that now. Because as soon as I saw her I knew that sje was perfect. Now all of a sudden we were going to change her, and yet again I faced those same fears.
We spent three months falling in love with her big wide smile. I knew I was going to miss it, and I tried to take as many ladt minute photos as I could, so we could remember just how cute she looked with her ear to ear grin.
After her night feed I held her in my arms for just that little bit longer than normal. Tomorrow was going to be a long, hard day, and I just wanted to saviour our last peaceful moment.
