Thursday, September 29, 2011

Surgery - Lip, Palate and Ear Tubes

Preparing for a planned surgery with your child is like being pregnant and obsessing over labor and delivery.  I  wanted to hear every cleft palate surgery experience.  I wanted details.  I wanted to know what to expect including worst case scenarios.  Mainly, I wanted to know that my sweet girl would be okay and that somehow I would be able to help her through this.

Just a heads-up that this will be an unfiltered blog post, including descriptions of the surgery and post surgery photos.  It isn't gruesome, but it is descriptive.  And long.  I am hoping that my honesty will help prepare other parents facing the same surgery.

Presurgery

The night before - I don't sleep well at all.

Veronica's surgery is scheduled for 10:15, and we have to be at Children's Hospital in Minneapolis by 8:45.  She had to stop eating by shortly after midnight and she had to stop drinking before 7:00AM.  We stuffed her full of chili the night before (two adult size bowls) and woke her up at 6:30 to squeeze as much apple juice in her that we could.  We had been dreading keeping her awake for so long (1 1/2 hours before her normal wake-up time) without food and drink.  She takes some juice and then points to her crib.  She wants to sleep.  Thank you God for small miracles.  We wake her up just in time to put her in her car seat and go.

We check into the hospital.  I believe every employee is forced to ask if you have any cold or flu symptoms.  Suddenly I have an overwhelming urge to clear my throat and cough.  I manage to hold it in.

We wait in the waiting room for about 30 minutes.  She has a blast.  I feel compelled to take lots of last-minute pictures of my daughter's face the way God made her.



We move to Pre-op.  The Child Life expert talks to us about how we can best help Veronica through the surgery and shows Veronica the type of  mask that she will breathe the anesthesia through.  This becomes the ideal toy.  She turns it around and chews on the tube end, with drool oozing through it.  It falls on the hospital floor several times.  I shamelessly wipe it on my pants and give it back to her.  I am hoping there are no super-icky germs.  Veronica is completely tired of the pre-op area and the tube distracts her from her empty tummy.



By 9:30, I am feeling desperate to keep her happy without food or drink.  I am doing the mental countdown.  45 minutes till surgery.  43 minutes till surgery.  38 minutes till surgery...

The doctor comes in and says he needs to do another procedure before Veronica's   The procedure will take 15 minutes.  I smile and think how generous I am with the doctor's time.  "Sure, that's fine."   I add 15 more minutes to the countdown.  I believe I can handle the extra 15 minutes fairly well.  I was wrong.

The fifteen minutes stretched to about an hour, with the last 30 minutes being extremely difficult for Veronica.  She keeps asking for food and milk.  I smile and say, "Later!"  in my cheerful voice.  I feel like a fraud for not explaining how much later.
I also feel bad because I can't truly explain to my daughter what is going to happen to her.  I had told her all the facts, but if someone explained things to me in Chinese, I wouldn't exactly grasp what they were saying, either.

Finally, the anesthesiologist comes in to explain the process he will use.  We have taken other children to surgeries, so are comfortable with how things might go.

I hold her while she gets put under.  She handles things very well.  I, however, start to feel very, very sad.  With the mask on her, I couldn't see her cute little cleft mouth one more time before I left.  The doctor asks if I am okay.  I put on a happy face and reassure him that I know he will take good care of my girl, and I do know she will be well taken care of.  I was afraid I would burst into tears if I said out loud the reason for the sadness I was feeling.



Surgery

Veronica's surgery was scheduled to last about five hours, and ended up taking about 5 1/2.  First they put in ear tubes.  They drain out all the fluid, too.  I am pleased to know that her hearing should be in the "normal" range after surgery.  This part of the surgery takes about 15 minutes.

Then, the palate is repaired.  This is what it looks like before the repair.  The doctor says her cleft palate is fairly typical.  Not the widest and most difficult to repair, but not the easiest either.



In non-technical terms, to fix a cleft palate the surgeon takes muscle and tissue from around the cleft and attaches it over the cleft.  There are arteries running in this area, allowing the newly placed tissue to thrive and grow.  Once the materials are moved, there looks almost like channels in the area the tissue was taken from.  Amazingly, this tissue grows back.

Veronica had a split uvula, too.  (The uvula is the hangy-ball thing at the back of your throat.)  The doctor also sewed that together, but her mouth has been too sore for her open wide enough to see.  Later I'll post pictures of the repaired palate, but again, we couldn't get a clear picture because her mouth hurt too much to open.  Many times the uvula splits open again, but that isn't a huge deal.  Uvula - one of the least necessary body parts.

After the palate repair, the doctor begins the lip repair.  This involves attaching the lip muscles from both sides of the cleft as well as putting the cleft-side nostril into position.  Our doctor uses a zig-zag stitch to repair Veronica's lip.  The lip stitches, along with the palate stitches will dissolve.  A clear-type coating is put over her stitches to protect them while they heal.

Most kids with clefts have issues with the cartilage in their nose.  Apparently Veronica's cartilage issue is more severe than most.  She has one nostril nearly closed after the repair and the tip is very flat, almost non-existent.  This will be repaired in another surgery a few years later.

The lip repair takes about two hours.

All the while the surgery is going on, we get updates every hour or hour and a half telling us things are progressing well.  This is a very long time to wait and dwell on things that could go wrong.  So, my sweet husband and I spend the time reading magazines and entertaining each other with inappropriate humor.

Since lunch is smack-dab in the middle of surgery, we go one floor down to the hospital cafeteria.  I'm shocked that the food looks so good.  I feel guilty trying to relax and eat while my daughter is going through some pretty invasive procedures upstairs.  Since things seem to be going well, I am more apprehensive than worried.

Post Surgery

After Veronica's surgery is done, she is taken to a recovery room where she slowly cones out of anesthesia.  We wait in a consultation room for the anesthesiologist.  He tells us that she did great, but was belligerent when she came out of anesthesia.  Okay, he didn't say belligerent.  He said she was really feisty, which is a more polite way to phrase things. 

Then our doctor came to consult about the procedure and what to expect in the next few days.  I listen and ask seemingly intelligent questions, but really am just anxious to see my daughter.

Then, she is wheeled into the hallway on a hospital bed where we meet up with her. 

I didn't know what I had expected upon seeing her, but it in all honesty, I feel a bit of a disconnect.  My normally spunky girl is in a daze.  She doesn't look like my daughter.  I keep repeating in my head, "This is your daughter.  This is your daughter."  I feel like I have to convince myself.  I am surprised I feel this way.

We get to our room, and she is fighting off the remaining anesthesia.  She screams for two hours strait.   We hold her.  We talk calmly to her.  I am glad I wore an old, dark colored shirt because she is drooling blood on me.  I think nothing I do will ever help.   She sweats from the effort of it all.  Finally, she wears herself out and sleeps in Ben's arms.

Her own arms are in restraints called "no-nos" which are like Velcro splints.  These will prevent her from bending her elbows and potentially putting something in her mouth, thus popping stitches and requiring more surgery.  She will wear the splints for 2 weeks  She is not a fan of the no-nos.

She is on morphine till 10PM.  Then she switches over to Tylenol with codeine.  She also has ear drops for the tubes in her ears and Amoxiccilian to ward off any potential infections.



While Ben finally has her asleep, I take my shift to get some supper.  I am feeling so much more stressed out now than during the surgery.  I don't know if I can help her through this.  I finish eating quickly and then go to the chapel that is a little ways down from the cafeteria.

I start by thanking God for helping Veronica get through the surgery so well.  But then start crying.  Not the gentle eye-dabbing kind of tears but the blotchy faced, drippy kind.

Veronica has had three mothers in her life.  She has had a birth mother who loved her for the first nine months of her life.  She has a foster mother that loved her for the next 21 months of her life.  And now she has me who has only been loving on her for barely three months.  I wish I could convey to her just how much I truly love her and want to help.

I know when she gets upset, she doesn't always want me to comfort her.  I think about my biological kids and how they would not (and should not) immediately love a new mother if they were taken from me.  I doubt my ability to be the mother she wants to help her through this.

Since I want to look like I have things under control, I head to the bathroom and splash a bunch of cold water on my face.  I take a few deep breaths then head upstairs.  I don't tell Ben because he's concerned enough about helping Veronica through this. 

Earlier in the day we had decided that I would be the one to spend the night with Veronica.  I selfishly want to do this because I need to mother her.  I need to feel like she needs me.

It is a long night.  I rock her back to sleep after each round of medicine, vital checks, etc.  The nurses are wonderful and just doing their job, but I dread each time I hear their footsteps at night.  I sleep maybe 2 1/2 or 3 hours if you add up all the minutes.  I actually don't mind too much.  This is my chance to help my fiercely independent girl.  I'm beginning to believe she needs me as much as I need her.  I am thrilled to learn that my best effort is enough.







She has started drinking apple juice - a great sign that she is on the way to recovery.  Most kids don't start eating or drinking the same day as her surgery.

By 6AM the next morning, I recognize my girl.  She has gotten her spunk back.  She is eager to eat, drink, and get the IV out of her arm.  I try to keep her happy in a 2 square foot area until the nurse is able to disconnect her from her IV bag.  She still has the IV in her hand, but she is mobile.  And happy at last.

The doctor visits her on his rounds and is incredibly impressed by her progress.  My sweet baby girl is amazing!   She has eaten pudding and pears and applesauce.  (She will be on a soft food diet for 2 weeks.)  She has drunk milk and juice.  He says she can go home later today if we are comfortable, or she can stay one more day.  We will decide that afternoon.

She spends her morning happily playing in the playroom.  She learns to maneuver with her no-nos on.  She gets braver and tries climbing on things.  I worry how much to let her do because I don't want her to fall on her face and pop open her lip.  She can't really brace herself for a fall with the arm restraints on.

We decide she should come home that evening.

I am falling in love with her new little face.  She is acting more like her truly delightful self.  I am amazed at how quickly she is recovering.  While waiting for discharge paperwork from the hospital, she plays peek-a-boo with me.  She shows us her first real smile with her new lip.

She is still absolutely beautiful. 





Sunday, September 25, 2011

Wishing I Could Time Travel

I am trying to come to terms with Veronica's cleft lip and palate surgery on Tuesday.  I am sure the surgery will go well.  I have confidence in the surgeon and hospital.  Helping a child through surgery recovery is never fun, but we've done it before and can do it again.

But, this will radically change the way my sweet girl looks.  I have been committing her cute little face to memory (and taking lots of pictures) before her repair.  I am trying to look on the positive side - I will get to fall in love with her beautiful new face. 

As a mother, I alternate between wanting time to freeze at this exact moment and my impatience to see how my children will develop and grow in the future.  I want to time travel, to skip around in their life stories. 

On difficult days, I want to spring forward to see that yes, they will stay dry all night, eat with silverware, brush their teeth without reminders and generally be a productive member of society.  On the days when my children seem so mature, kindhearted and accomplish some great personal goal, I wish I could momentarily pop back in time to see just how far they have come.

Without this time travel possibility, I am resigned to relying on my imagination, subjective memory and lots of photos.



Bridget

Bridget - A Packer fan like her Mom


Riley - May the Force be with you

Riley

Connor

Connor - Watch out for birds

Sawyer - Homemade hat? Headband? Native American headpiece with feather?  Paper fire shooting out of his head?


Sawyer

Veronica - Baptismal Gown

Veronica - Howdy Partner!






Saturday, September 24, 2011

Can You Comment Now?

My good and faithful readers:

I have been experiencing technical difficulties.  Many people told me that they wanted to comment on my blog but could not.  I have been having challenges with this for a while.  This reassures me that the hundreds of you reading the blog are impatiently waiting for the chance to respond.  You are not trying to secretly laugh at my stumbling through life, but would rather laugh publicly.

Through the mystical powers of technology, I have tried to remedy the situation.  Could you pretty, pretty please with sugar on top try to comment so I can see if this is working better now?  If you can't get through, please continue to let me know via FB, e-mail or good old fashioned verbal conversation.

Thanks.

Friday, September 23, 2011

Homemade Fondant - You Don't Scare Me

Earlier this year my children's school had a silent auction to raise money for various projects.  One of our family's donations was a homemade birthday cake.  I just made a cake for a very nice family that goes to our school.

Their son really likes tools and is going to get "real" tools for his birthday this weekend.  Shhhh.  Don't tell.  The mom wanted a tool themed cake and this is what I came up with:





This is a white cake with homemade butter cream frosting topped with homemade marshmallow fondant.  I feel like I am starting to get the hang of working with fondant now that I have been doing so for about a year.

But, no matter what kind of cake I make, I always panic midway through, certain that I am not going to be able to do it - positive that it will end in shambles. I secretly resent the fact that children don't like easier things to make like rainbows or smiley faces.

Then I need to remind myself that it is cake, not brain surgery or bomb detonation.  Nobody will die from the cake.  And, after a few minutes of "Happy Birthday" the evidence is eaten anyway.

Thursday, September 22, 2011

Missoni Madness

Missoni madness has swept through Target.  Missoni was the latest upscale brand to partner with Target for an exclusive collection.  I had been seeing the advertisements leading up to the sales.  As a woman with a Mass Communication (with advertising emphasis) degree, I understood the sales tactics.  I could logically deconstruct the marketing plan and recognize the ways in which Target tried to manipulate my feelings toward the product.  I knew what was going on.  But I didn't care once I saw "the shoes".

These beautiful shoes had been shown in several print ads.  As a girl who buys majorly discounted everything, I surprised myself by my willingness to pay full price for something.  But they had been calling me relentlessly.

Then I read in the paper about how people had lined up outside Target doors before they opened.  I heard about people stocking up entire carts of Missoni products with the intent to sell them online at a large markup.  I found out that Target's site had been down due to the volume of people buying Missoni products and now they are sold out. 

All this happened the first day.

Two days later I had finally been able to get myself to Target.  The clothing racks were picked clean.  No bags or accessories could be found.  I dejectedly slumped and headed toward the shoe department.  There were a couple of pairs of children's Missoni shoes, but not women's shoes.

Then, stuck on an end cap all alone, I spotted a box with the iconic zig-zag pattern.  One forlorn and abandoned pair of size 11 shoes were left.  Thank you God for giving me enormous feet!!  I grabbed those puppies and put them on.  They fit fantastic!

I am typing this with a mixture of guilt and euphoria.  I am in shock that I paid full price for anything.  I have been waiting for a bolt of lightning to strike me down all day.  But my main guilt is that I don't care that I paid full price.  These shoes were worth it.

And my feet look so small in them that they might even be mistaken for size 9.

Wednesday, September 14, 2011

Baptism

Veronica's baptism was on Sunday.

She was dressed in our family's baptismal gown which is about 50 years old.  I wore it.  My brother wore it.  Some of my uncles wore it.  Assorted cousins wore it.  My children wore it.  One pooped all over it.

We keep a record inside the original box.  The records have gotten more detailed since the early "Stevie" and "Timmy" names.  Now we include the full name and the date of the baptism. 

When I showed my husband the gown when I was pregnant with our first child, he was slightly uncomfortable.  "Isn't that a dress?  What if we have boy?  Does he have to wear a white lacy dress?"  That is clearly the response of a man who hadn't grown up on a church with infant baptisms.

I was quite surprised that Veronica fit into the gown because most everyone else who was baptized in it was only a couple of months old.  The under slip fit fine, but the sheer lace overlay came just past the tips of her toes, whereas it normally would be long and draped over an immobile infant.  I was afraid she would trip on it and tear it, so she only wore the under slip for the actual baptism, but we have photos of her in the entire gown.

What I did not realize was that the lace overlay had a function beyond aesthetics.   It also functioned as a layer of traction, without which my sweet girl was as slippery as a greased pig.  She squirmed.  She twisted about.  She wanted up, then down, then up.  She vocalized her impatience - in front of the church.

I honestly was alright with her volume.  I just didn't want to drop her on her head and reveal my incompetent parental grip in front of the entire congregation.  Fortunately between Ben and I we managed to keep her locked in an upright position.

But, even with the girl fidgeting and fussing, I couldn't have been more joyful to have another of my children a baptized member of our church.  And I'll be praying that she grows in faith and wisdom, eventually fully understanding and embracing her relationship with the Lord.

My sweet girl is also very fortunate to have two wonderful Godparents - my cousin and my brother.  They are truly two of my absolute favorite people in the world.  Although I don't see either of them nearly as much as I would like, they are in my thoughts often.  And anytime we do get together, I will inevitably end up in a fit of laughing hysterics.  How can you top those relationships with people who have known you since you were born and still love you?  There is no pretending or putting on airs.  They know exactly who you are.

Our families had lunch at our house after the baptism.  There were a total of 21 of us and we had a feast!  Since it was Veronica's (and Jesus') special day, I made foods that I thought would be familiar to her.  We had congee, boiled pork dumplings, marinated chicken drumsticks in a Chinese sauce, fruit salad made with unidentified fruit from the Double Dragon Asian market, Chinese cucumber salad, marinated asparagus, green beans, day-glo colored Asian desserts, moon cakes, bread sticks (not Chinese, but still yummy) and cupcakes (also not Chinese, but still yummy).  I'm sure there was more food, but I just can't remember it all. 

My 26 pound girl ate two adult size bowls of congee, five dumplings, a whole chicken drumstick, over a cup of fruit, asparagus, a couple day-glo desserts, moon cake and a whole cupcake for lunch.  When she was done, she sat in her high chair in a blissed-out food induced stupor.

Unfortunately with all the squirmy child holding, we didn't have a free hand to take pictures.  When we get copies from other responsible and thoughtful relatives I will post them. 

Thursday, September 8, 2011

Getting Kids to Eat Well Isn't Tough

Recently at a well child check-up the doctor asked one of my children if they ate a variety of healthy foods and if they tried new foods.  My child replied, "Yes, but the last time we ate Ethiopian food, the goat was a little spicy."

The doctor was shocked.  So are many in my acquaintance whose children subsist on chicken nuggets and sugary cereal.

I don't think getting kids to eat a variety of healthy foods is that tough.  My job as a parent is to provide my kids healthy meals.  Their job is to eat it, or as much of it as they want.  I give them food at appropriate times and they can choose to eat it or not eat it.

As parents I think our greatest weapon in our arsenal is not caring.  Really.  Stay non-committal about food and don't make it into an issue.  I do not force my children to eat.  Nor do I praise them for trying "just one itty bitty bite of that cooked spinach".  If they eat the veggies, great.  I don't comment.  If they don't eat the veggies, great.  I don't comment.

They don't need to pick up on the idea that some foods are expected to taste lousy.  If you clap and cheer for a child eating asparagus, but not for macaroni and cheese, they are not stupid.  They will realize that they shouldn't like asparagus and Mommy will do crazy dances and sing silly songs and praise them extraordinarily if they do.  That is just reinforcing the idea that eating vegetables or any food that is new is a bad thing and they need a prize for doing what is expected. 

At each meal, I put small servings of the food we are going to eat on their plate.  They do NOT get special meals. (although I will add more chili powder, curry or other highly spiced seasonings to my food or my husbands when dishing up the plates sometimes).  I try to make sure that everyone likes at least one thing.  If I am not sure of some new recipes, I will often put biscuits or bread on their plate as part of the meal, NEVER as a last-minute alternative for someone who decides they don't want to eat supper.

Then the meal starts.  We talk about our day.  We tell stories.  There is usually some lame knock-knock joke and a made-up song involved somewhere in the conversation.  What we don't do is dwell on the food. 

The most important rule we have about food, though, is that you may NOT say anything unkind about the food.  "This is yucky!" may NOT come out of their cute little mouths.  If they choose not to eat it, they can leave it politely on their plate and not comment on it.  I have had many children eat at my house who do not follow this basic common courtesy, and frankly it shocks and offends me every time.  If somebody took the time and effort to make a meal there is no excuse for being unkind about it.  I want my children to be able to go to anyone's home and treat their hosts with respect.  Insulting the food is absolutely unacceptable.

Also, if parents are willing to try new things and be adventurous, kids will, too.   How can we expect children to try new things and keep an open mind without adults to set the example?

So what happens if they aren't a member of the clean plate club?  Nothing.  They sit at the table for the entire meal while others are eating.  They may not leave the table unless they need to use the bathroom.  Then they come back.  When they are old enough to sit on a big chair, they are old enough to sit for a half hour to hour to eat together as a family.  Our kids are capable of much more than we give them credit for.  (This is a generality.  Obviously there may be underlying medical or social-emotional issues that come into play.)

I truly believe that the nutritional component of mealtime is only a small part of the meal.  Family time and a chance to reconnect after a day apart is nearly as important.  I refuse to have this precious time sullied by fighting over food, and  I refuse to sit at the table all evening counting the number of bites a child takes. 

You may be thinking, "That's great for your kids, Kristin.  But mine are picky.  They just won't eat and they will whine and they will get hungry later and then they'll just eat a PBJ sandwich anyway."

If they don't eat all their food, they don't have any other food until the next meal. Yes, they might get hungry.  I understand that.  They also remember what it feels like to be hungry for a couple of hours until the next meal (no they will not die).  Then they are more likely to try things that might not be on their top 10 list at the next meal.  What motivation do they have for eating their food if they know they will have yogurt an hour later because they know Mommy doesn't want them to feel uncomfortable?  Sometimes the natural consequences of our actions make us uncomfortable.  I'd rather my kids learn that life lesson on small-scale issues like this rather than goodness knows what when they are teenagers.

I also think our society is going snack crazy.  Yes, young children often need a nutritious snack between meals.  But, if they don't want to eat a banana or carrot or whatever you offer them, they aren't that hungry.  I am not opposed to special treats, but it doesn't make sense to fill a kid up on a ton of candy, chips or crackers and then expect them to eat a good meal.  They should be a little hungry going to the table.  If a child is absolutely famished right before a meal, I will let them have some of the vegetable we are having for that meal ahead of time.  If they don't want the vegetable, they aren't really that hungry.  When a child is hungry enough, he or she will eat. 

Since I make every one of my kids meals, including packing their school lunch, eventually they will get some healthy foods into their bodies - without complaints, arguments, rudeness or starving away to nothingness.

Even Ethiopian goat.


*****  Please note that this way of handling meal times may not be appropriate for all children, especially those who may have food issues related to adoption or medical diagnosis, or very young children.  This is how I deal with my older (age 3 and up) bio children.

Wednesday, September 7, 2011

Routines and Self Improvement

I guess summer really is over.  I'm seeing some golden leaves on trees, spotted my first flock of geese heading south, have an overwhelming urge to simmer some homemade cinnamon potpourri on the stove,  and am sending my kids to school with a jacket in the morning.

And, I have been running my pens' ink dry writing the schedule on the calendar.  In addition to the normal work and church commitments, we have back-to-school night, classroom dinner nights (times 3!), cross country for my girl who "really, really" wanted to join but "doesn't really like to run.", swimming lessons, preschool and ECFE.  

The mornings have been earlier, the bedtimes earlier and we are all settling into a routine again.  And, my house nearly echoes with the quiet of only a preschooler and toddler at home with me during the day.

When the air turns crisp in September, I feel a strong urge for self improvement, more so than January first.  Just like a new school year is a do-over with no missing assignments and another potential chance to be teacher's pet (yes, I was "that" girl), I still feel like I can make enough to-do lists to actually better myself.

Yes! I will stop skipping workout sessions in the morning.
Yes!  I can keep the house company ready at all times.
Yes!  This is the year I will get my novel published.
Yes!  I will water my plants and  not kill them through pure neglect.
Yes!  I will speak in calm tones and come up with creative parenting solutions that would make Cliff Huxtable of the Cosby Show proud, even if it involves elaborate planning and the participation of family friends who have profound life lessons to share within 30 minutes.
Yes!  I will cultivate family friends who have profound (yet brief) life lessons to share with my children.
Yes!  I will spend below budget, and somehow not infringe on above mentioned elaborate Cosby-style parenting solutions.
Yes!  I will finally figure out how to apply eye liner without looking weird.

With pencils sharpened, I will (as every other year past) make elaborate lists and schedules.  I will truly convince myself that I can clean out the entire garage during one day's worth of nap time.  I will also convince myself that it is possible to fit into pre-baby clothes, get all my kids to love cooked spinach, and learn to find the beat to music and actually clap along without feeling foolish or incompetent. 

But, by the time October rolls around, the alphabetized lists that I have made regarding my self improvement will have scribbled on by a child, ripped up by another child, and scattered around my house by yet another child.

Fortunately, with the complete and abject failure to implement my plan I will have more time for board games with the kids and sneaking good chocolate without the kids.