Post Surgical Lunatic

If there is a complication to be had, we have it. It's almost as if we seek them out. We don't however, so I guess it's the universe that seeks them out for us.

We went to the hospital early this morning for Nolan's surgery. Upon examination by the nurse he was declared healthy enough to proceed (still coughing and very congested), although the final decision rested with the anaesthetist. Hurdle one - success!

Nolan was a star and only complained of hunger once, happily playing and keeping himself busy during the two hour pre-op wait. We went down for surgery more or less on time, and the anaesthetist assured me his congestion was up high and therefore nothing too risky. Surgery was a go! Hurdle number two - success!

I stayed with Nolan while they put him to sleep. Nothing traumatic, and after a quick chat with the surgeon I was dismissed to wait for the very short surgery to be over. I went for coffee and when I returned to the waiting area, no one had been looking for me. I took that as a sign that clearly the surgery was underway with no complications! Hurdle number three - success!

Within a few minutes of sitting down, the surgeon called to tell me the surgery was over and completely uneventful. Hurdle number four - success!

We were almost there, right? Almost free and clear?

Wrong.

Because now Nolan had to recover. And recovery is where things have gone south with Asher in the past.

Sure enough, a few minutes later the recovery room called to say Nolan was "upset" and could mom please come down and try to calm him. On the one hand I knew this was serious because parents are not allowed in the recovery room, but on the other hand, when things were really bad with Asher that was the last place they wanted me, so maybe this wasn't so horrible?

Oh it was bad. Really, really bad. Nolan was absolutely hysterical, nonsensical, and delirious. He screamed at the top of his lungs, writhing, hitting, and biting whatever or whoever he could. I got on the stretcher with him to try to calm  him, but really all I did was restrain him from hurting himself or me and the nurses. I offered him everything under the sun and I may as well not have been speaking English. Nothing was registering with him, including the fact that I was his mom. When he did look at me, he was looking right through me.

After this continued for 20 minutes, they got the approval to give him a sedative, which they assured me would calm him in no time. Umm no. Didn't budge him an inch, in fact if anything it upset him more because they had to fiddle with his IV to administer it. So next thing I knew they were calling the anaesthetist to give him propofol. Immediately my heart sunk. Propofol is what not only caused Asher's apnea before MRI, but also killed Michael Jackson. Ya, that drug.

Within seconds of the anaesthetist returning and administering the drug Nolan calmed down. Thank goodness! Although not only did he calm, but I could see his eye lids turning grey. It was incredibly subtle, but even at one millionth of a shade off normal, mama picked up on this. Trust me, when you've seen your kid turn every shade of bluish-grey imaginable, you get pretty well versed at seeing subtle changes in their colour.

Just as I looked up at the monitors, I saw the numbers dropping rapidly. The nurses told me not to worry and to ignore the monitors, but they started moving quickly and put oxygen on him, so I could see they were becoming concerned. Nolan became greyer and greyer, and they confirmed he wasn't breathing. With that I was ushered out of the room, over hearing "Do we need an airway?".

Cue the drama for mama. Any parent who has had their child on a ventilator can attest that nothing can set you into a state of PTSD quite as quickly as even the slightest threat of intubation.

They pulled up a chair for me and sat me down and everything began to swirl. "So this is what a nervous breakdown feels like", I thought to myself, having wondered what was finally going to make me crack. This. This was my breaking moment.

But before I could plunge to the depths of insanity, back came our nurse! Literally, I was sitting there for not even two minutes, thinking the absolute worst, when she came to bring me back and tell me he was stable. Yes, that was scary, and I never should have seen it, she assured me, but he was just fine.

When I saw him, aside from the oxygen mask, it was as if nothing had happened. He was peaceful and bright pink. The anaesthetist rightly realized he was dealing with a woman on the brink, so he stuck around to give me a thorough explanation, which I appreciated immensely. It went something like this:

Drugs used for anaesthesia these days are so good that they are able to wake you immediately after surgery. That is great for some people, but for others, coming out of that deep sleep so quickly is too traumatic. In kids especially, they can experience delirium as Nolan did today. In a case where the delirium is so intense and the patient is so obviously not handling being awake, the propofol is given to let them spend a little more time "out", then ease themselves back into consciousness more slowly, in a much calmer state.

The doctor then explained that a drug like propofol can work differently in people - within a normal dosage range, some need a higher dose and others are very, very sensitive to it. Clearly Nolan and Asher are. He said it is a drug that should never be given and have the anaesthetist walk away (which is exactly what happened in MJ's case). He assured me that as terrible and scary as it was for me, this is what he is trained to deal with. That is why he was the one to administer the drug - in case of complications. In Nolan's case he was in the right place with the right people to stabilize him immediately.

So after that I felt better about things, and it actually helped put Asher's scary MRI experience into perspective. The doctor and nurses were all incredibly understanding that it was something terribly traumatic for a parent to see. Not just any parent, especially a parent who has seen their child turn blue and plummet their heart rate and sats wayyyyy too many times.

Once I was assured Nolan was stable, Jordan tagged in to see him for a minute. Poor Jordan, upstairs teaching in the hospital, got only a frantic text from me telling him things were bad, and then no other info! Luckily things were sorted out very quickly so before he was left thinking terrible thoughts for too long, he was able to see for himself that Nolan was safe and sound.

I then returned to the recovery room when Jordan left (no parents are technically allowed in recovery, so since they let us, they only let one at a time), just in time for Nolan to wake up from the propofol. Was it the calm wake up they promised? Oh God no, it was almost as insane as the first one. Scratching, screaming, biting, all over again. He was swatting at everything that came near him, and pulled his IV out. He was going absolutely crazy, yet the monitor showed he was completely stable. So you know what happens when a screaming lunatic of a child in recovery is completely stable? They get sent back to surgical daycare because they are well enough to be out of critical care!

Sure, he was medically stable, but this was not my baby - this was a child possessed by the devil! I absolutely understood why he needed to be moved, but I was terrified about how he would behave and if he would remain stable. Out they wheeled us - me in the stretcher restraining Nolan, who screamed and kicked the entire way, still not even realizing that this was me. Just before we reached surgical daycare, I readjusted and moved his gammies (his security blankets) and he caught sight of them. He ripped them out of my hands, shoved him thumb in his mouth and instantly he was quiet.

"Why didn't you give him those before?" the orderly pushing us asked in exasperation.

"YOU THINK I'M AN IDIOT? YOU DON'T THINK I TRIED?!" is what I screamed at him in my head. In my outside voice I answered him politely, of course.

I had tried his gammies. I had tried his stuffie. I had tried singing. And popsicles. And a drink from a straw. He didn't know who I was for God's sake, it was like a monster was burning a hole through me. NOTHING WAS CALMING HIM!

Until that moment. Apparently in that final moment when he saw his beloved gammies, that snapped him out of it. From that moment on, recovery was a breeze. We laid on the stretcher in surgical daycare and snuggled. We watched Toopy and Binoo. He ate popsicles. He had his vitals taken several times and was stable each time. Less than an hour after he was in recovery losing his mind, he was at home.

Now he's in bed resting, hopefully comfortably. He was frozen in the entire area of his surgery, so he's likely still feeling no pain. At least now he is back to himself, so if he starts to hurt he will be able to tell us instead of screaming nonsensically at me.

So we all survived. A little worse for the wear, but survived. Complications totally different from Asher's recoveries, but complications nonetheless. At this point I really can't expect anything else from the boys, can I?

Thank you to everyone for your concern and well wishes. After lots of sleep and fluids for Nolan, and lots of fluids (of a much stronger sort) for mom and dad tonight, hopefully we'll all wake up much happier (and more sane?) tomorrow.