Good News Post-Op

7/15/11  And the fun begins again.  Yesterday, Aaron’s lip became very swollen.  It really came on very suddenly.  I called and spoke with a resident at Primary’s and he suggested ice and Motrin.  I wasn’t confident in my ability to describe it well, so I also asked if I could e-mail him some pictures, too.  He thought that was a good idea and said he’d talk to his attending and get back to me with what we should do.  I sent the ones on the blog entry A New Bump in the Road.  The following is content of our e-mails:

10:06 pm  from the resident:

Hi Rebekah,
I definitely agree it's more swollen then we would expect but I still think it will be fine. Apply ice packs to it every hour when he's awake and give motrin every 6 hours. It should go down. If it gets hot and more red call or email and we will call in some Antibiotics.
Thanks

10:26 pm, from me:  Thanks! Will do.

1:30 am, from the resident:  Hi. I was told wrong. It's infected likely. Can you see dr Ley in his clinic in riverton Friday morning from 9-11?

In the waiting room before surgery.

So we had a 10 am appointment with Dr. Ley, a partner of Dr. Siddiqi.  He looked at it briefly (he’d seen the pictures the night before), and asked how he was fed.  I told him continuous g-tube.  He asked if he was feeding right then.  I said, yes, and he told me we needed to stop the feeds.  I knew what that meant.  We needed an empty stomach because he was going back into surgery.  He’s also concerned with the size it is, that there will need to be a drain put in and possibly a PICC line for antibiotics to help guard against sepsis.  He’ll be monitored closely for at least 24 hours after surgery, and then we’ll have several days on the floor while it continues to heal.  Once everything looks good again, they’ll go back and re-close it.  Right now, as we’re waiting, it continues to swell.  It’s 1:45 pm and they’re planning to take him back about 3 pm.  At least he’s asleep.  This looks so painful.

Trying to wake up after surgery.

8:30 pm.  Well, being an ad-on and not an emergency, we were the very last surgery of the day.  They finally took him back about 6:10.  When Dr. Ley came out to talk to me, he was very pleased.  There was blood, a LOT of blood and a large clot in there, but no sign of infection.  Also, the muscle that they stitched together last week was still intact.  He said he had actually been baffled by the lack of fever and red marks because Aaron’s face was so swollen.  But those would have been signs of infection and there just wasn’t any.  So he was able to evacuate the clot and even close it back up.  IF everything goes really well, we MIGHT go home as early as tomorrow.  Right now he’s still trying to wake up and we’re in the PICU.  He does look really good.  Dr. Ley’s big concern is the bleeding.  It doesn’t make sense that we would start bleeding and have this much bleeding at all, let along this far out from surgery.  Also, there was the matter of the circumcision bleeding earlier this week.  So they’re going to look a little more closely at his blood and clotting.  That one may take some time.