72 hours post op

Update from Mercy Hospital Rm 33-27

Gaby is doing well, tolerating her pain fine, charming all the nurses on the unit, and dominating the Old Maid card circuit, so it's safe to say she's recovering. It's been a crazy week and a half, and even though we are still in the hospital, we're so grateful she's been taken care of by great and dedicated doctors. She most likely will be released tomorrow, but her surgeon gave no guarantees.

A summary of the events that led up Gaby being 72 hours post op and still in the hospital follows:

On Thursday 10/2 (Taylor's 14th Birthday) Gaby went to school complaining about her mouth hurting. After a quick inspection, it was obvious that 3-4 of her 6 year molars were pushing their way through her gums. They looked swollen, but she went to school with a dose of Tylenol and a kiss. She lasted until 10am. When I picked her up in the nurses' office, she was crying/sobbing with ice packs on her cheeks. Poor baby. She got the full sick treatment with DVDs and Tylenol/Motrin cocktails. She was feeling better by evening and decided to join us for Taylor's birthday dinner with Monka and Nana, where she threw up on herself as the appetizers arrived. Joy.

Friday morning her mouth was still hurting and she still had a fever. One of the molars looked funny to me, so I called Taylor's ortho who is our neighbor and he came to look at it. He thought is did look like there was some infection present, but that it was localized, so keep treating the pain with Motrin and if she became more swollen call him.

She seemed a buit better as the day went on, but the fever kept coming back. Late Friday night she woke up screaming in pain about her arm. We thought she slept on it funny, but the pain persisted and it didn't seem to be pins and needles. We gave her ice and pillows and she slept fitfully for the rest of the night and continued running a high fever.

Saturday morning I took her to Urgent Care. The Dr. wasn't too concerned about her tooth or her arm after her initial exam. She did a throat swab and tested it f0r Strep; it was positive. Weird. My gut feeling the previous night was that what was going on with her tooth was causing a problem with her arm, BUT because she now had Strep, it seemed logical that her fever was caused by the Strep and her arm pain was caused by the fever. She was put on amoxacillin and went back to bed for most of Saturday and Sunday. Her arm really bothered her at night, but she was also running fevers, so we assumed it was all connected.

Monday Gaby was better, but still hestiant to use her right arm much. Lydia came home from school early on Monday complaining of a sore throat, so I took her to the doctor. Gaby was asleep otherwise I probably would have taken her, too. Lydia's Strep test was negative, BUT given a case of it at home, he put her on Amoxacillin, too. When I got home Gaby's fever was way up again, and I was beginning to be suspicious that the Amoxacillin wasn't working. Lydia and Gaby both stayed home on Tuesday and they were crazy, not acting sick in the slightest, other than Gaby still complaining about her arm. Her fever was down. They fought most of the day. Gaby was sleeping better at night, though, she still woke up with pain at night and refused to use it very much.

I sent them both to school on Wednesday and had a long talk with Gaby's teacher and the school nurse about how she was doing. I decided Tuesday that no matter what I was calling our doctor on Wednesday to see what he thought (when I was there on Monday with Lydia, I explained all of Gaby's symptoms and he seemed to think that maybe she had a virus, which would explain why the antibiotic wasn't working and that a condition called synovitis which is inflammation in the joints related to certain viruses causing pain- seemed logical to me). Gaby lasted at school until about lunchtime and then they called me to come get her because her arm hurt. She already had an appointment for 1:45, so I just picked her up early. At the appointment she sat and barely flinched as Dr. Booth poked and prodded her arm. I was like, you are kidding me! I kept telling her, Gaby, you need to tell us what hurts and where. Eventually, he moved her arm to the side and she turned white and started screaming. At least now we knew there was actually something going on and it appeared to be in her shoulder joint. He ordered an x-ray and we had that done late afternoon. In the meantime, Jerry flew to San Diego for a meeting.

Thursday morning Dr. Booth called and wanted Gaby to have her blood drawn for tests to tell them more. The x-rays showed significant swelling in her shoulder joint, enough that it was pushing on the bone, but the bones were not damaged. The blood draw went surprisingly well and the baby shower/brunch that I had planned for my friend Carrie was going to go on as planned. As the party ended, I realized I had my cell phone charging with the ringer off and the house phone had been left off the hook. Whoops. I had missed 2 calls from our doctor, not a good sign that he's calling you, twice.

Blood work showed infection was present and further probing was necessary which meant MRI. I knew that was going to be difficult for a wiggly 5 year old, but the MRI would show the doctors what was causing the swelling. Not too concerned at this point. All that Jerry knows at this point is that Gaby has to have her blood drawn. Dr. Booth's office calls back a bit later and says that pediatric MRIs are done only on an inpatient basis, so we have to check in as soon as we can. I left a message on Jerry's phone while in route to the hospital. And made a dozen calls to make sure the three other kids were going to be picked up, taken care of, dropped off, fed, etc.

Check in at 2, MRI at 3. The MRI was not fun, though it could have been a zillion times worse. I kept singing "Be Still My Soul" over and over and over and trying to entertain Gaby without making her move or wiggle or giggle. It took an hour for them to get decent images and I left exhausted and feeling like I had never prayed so hard in my life for anything. For it to be over, for Gaby to stay still, for her arm to be fine.

We saw Dr. Booth around 5, but no results were available, so he didn't know much. The orthopedic surgeon who I knew was helping Dr. Booth with this case came to see us around 7 at which point the MRI was ready, too. He looked at it then had me look at it and said we had two options. 1) Draw fluid from her shoulder and try to do cultures and see what it is and determine whether surgery is necessary or 2) do surgery. Thankfully I was sitting down. His gut feeling was that drawing fluid would be difficult and possibly painful and would most likely end up with surgery as the result. Given Gaby's symptoms and persistent fever and the MRI results he strongly felt that surgery was inevitable. OK. Considering I was all by myself I was handling and processing the information quite well. So I said, "does that mean she's having surgery tomorrow?" Dr. Pape replied, "No, she's having surgery tonight."

I called my dad to tell him not to bring the kids to see her. I called and left a message for Jerry not knowing when his flight was even scheduled to leave CA. The last time I talked to him had been in the morning and all he knew was that she had to have blood work done.

Gaby was a trooper all day. Her IV sticks when we first arrived were traumatic as it took 3 tries. The MRI was long and loud. She was NGO, so no food or drink. It was getting late, so she was tired. AND her arm still hurt. I explained that she'd go to sleep for a bit and Dr. Pape ("that boy nurse" as Gaby called him) would fix her arm. She was worried that she would still be able to breathe while having the surgery, but she was excited about riding on the table/bed to the surgery.

My dad made it here after leaving Owen with Taylor and Lydi with the neighbors. My friend Carrie made it, too and my mom arrived just before they wheeled Gaby into surgery. Gaby had the surgical suite to herself, so she quickly had the nurses falling in love with her and her Hawkeye bow in her hair quickly won over the anesthesiologist who travels with the Hawkeye medical team.

The only time all day that she looked scared was when I had to say goodbye to her, but she didn't cry. I did.

She went into surgery around 9:30. Jerry arrived from the airport at 10. I had my phone turned off, so I didn't know he was on his way. Probably better that the first time I talked to him was in person. They came to get us around 11, I think. Gaby was pretty out of it, but the surgery was successful. Dr. Pape said once he cut through the Rotator Cuff pus squirted out, so there was a lot in there that needed to be cleaned out and because of the location it would have been difficult and painful had he tried to draw fluid prior to surgery.

Thursday was a long night, but Gaby did great. She slept well in between doses of Morphine and by morning she was only taking Tylenol with Codine. Both doctors felt we'd be in the hospital for the weekend, given the length of time to have accurate results on the cultures. This type of case is rarely seen in pediatrics, so the orthopedic doc has been consulting with others who handle cases like these in adults.

Friday was mostly uneventful... for Gaby. She had lots of visitors and got lots of attention and treats. My friend and recipient of the baby shower/brunch had her baby boy in the same hospital we're in and on the same floor even, so we had lots of trips to see Baby Reece. Owen decided to wake up from his nap at the hospital and scream himself silly, so one more trip to Urgent Care was in order. Double ear infections. How ridiculous is it that I was in a hospital and had to leave the hospital in order to get care for him?

Saturday and today have been quiet. Lots of visitors yesterday and lots of stuffed animal friends much to Daddy's delight.


Here's to hoping that we go home tomorrow!