JB's Surgery

[l_to_the_e]

This morning, JB had laparoscopic surgery to find and retrieve his undescended testicle. It has remained undescended since birth because of his gastroschisis. With his intestines protruding through the hole in his abdomen, there was insufficient pressure to keep the testes down and in the scrotum. The purpose of the surgery was to a) find the undescended testis, if there was in fact any evidence of one, b) save the testis and place it in the scrotum where it belongs or remove it if it is not viable, and c) confirm that his descended testis is healthy and viable, anchoring to the scrotal wall if necessary to prevent twisting and damage. 

We were scheduled to go in at 7:45 for surgery at 9:15. I got a call at 6am asking if we could come in early since the surgeon's first appointment had to be bumped back due to illness. Since I was waiting on my mom to watch the baby, we said we'd be in as soon as she got here. Checked in at 7:30 and were in pre-op by 7:50. JB loved the toys in pediatric pre-op, and clearly had no idea what he was there for. I think he assumed we were just there to play with the toys. We got his vitals, and when it was just about 8:15, they gave me an oral syringe of Versed to administer. For those who don't know, Versed is a pre-anesthetic that makes you loopy and causes amnesia. He only swallowed about half, but that is more than enough. We could tell it was working because he started blowing spit bubbles and going "be-be-be" with his finger to his lips. At 8:30, we slipped him out of his gown and into a warm blanket and he waved bye bye as his nurse carried him (that's right, no stretcher) to the OR. He was happy as a clam and showed no signs of anxiety.

Dr. Khoury informed us that surgery should take roughly an hour. They were going to go in through the groin at the hernia wall (sort of between leg and junk) and move up into the abdomen from there. What actually happened was that they were unable to find the testis in the lower abdomen, and had to enter through a second incision next to his fake-belly button to access his upper abdomen. Dr. Khoury informed us that he has a good deal of adhesions as a result of his gastroschisis repair (specifically, because he had to be siloed rather than being closed up right away) which made internal navigation a little more complicated. They found the missing testis by his left kidney, so it was UP THERE. What apparently happened is that the testis remained undescended at birth, and when the intestines were placed back into his abdomen, they were put in front of the testis and blocked it from moving any further down. The vas deferens was still attached, and while it is a good deal undersized, the tissue appears to be viable. Dr. Khoury made the decision to save the testis and moved it down through the abdomen into his scrotum where it belongs. It will likely never grow to be the same size as the healthy one, and will definitely never produce sperm or sufficient testosterone. However, his healthy testis is quite healthy and perfectly sized, showing no signs of damage. You really only need one, you know. 

When they called us into the recovery room of PACU (post-anesthesia care unit) he was just beginning to wake up, around 10:30. He had just opened his eyes and reached up for the nurse to hold him when we came in. They sat me down in a reclining chair and gave him to me to hold. He slumped right into my arms, face in my neck and arms around me asleep. His vitals were just fine. He has two bandages over the two incisions and had his IV in his left hand, strapped to a no-no. I kept having to shift his position whenever his O2 sats dropped below 90%, and that started to piss him off. He woke up enough to get mad about the IV and the no-no, so we took that off as soon as possible. He saw Daddy sitting in the chair next to us and decided he'd had enough of me and needed Casey. He refused to keep the bandage on his IV wound, so I was only able to hold it on long enough to keep it from bleeding. He got mad about the pulse/ox sensor on his toe and started tugging at his sock to get it off. We started getting his clothes on him to make him feel more normal and he settled down. He drank a cup of apple juice like it was the last thing he'd ever drink, and ate a red popsicle happily. He fell asleep on Dad's chest eating graham crackers, but woke up and cried because we still hadn't left. The surgeon and anesthesiologist released us right about 11:45, because he was showing no signs of major pain and his post-op flushed skin was already clearing up. 

We left CHOC at noon and came home. He slept on Momma and Daddy's bed for an hour, and is currently awake, sitting on his bed, watching Snow White, and eating a PB&J with milk. He should recover just fine, as there is no swelling and everything appears to have gone just fine. He needs to take it easy for the next two weeks (I don't know how we're going to keep him still though) and the bandages have to stay on for at least 3 days to heal before getting wet. We'll have a progress-check with Dr. Khoury in 3 months to check the retrieved testis. 

I was cucumber-cool the whole time... until we got to PACU. His recovery bed was a crib, just like 2 1/2 years ago in the NICU. It was in the corner with a window like the NICU too. The monitor beeps and alarms; the smell of sterile equipment; that plastic and latex smell of tubes, wires, and bandages; the neutered green and mauve wallpaper and curtains; the feeling of my (much bigger) baby boy asleep on my chest with all his tubes and tags trailing off the edge of the seat... Everything came flooding back. I felt exactly the same as all those weeks in the NICU, and I broke down crying. It's a difficult emotion to describe. I wasn't afraid then or now, because I know he is and will be fine. Not sad, because I don't think he will be permanently damaged from any of this. I was just... overwhelmed. Feeling small and helpless again, feeling like a little kid because my baby is hurting and I can't fix it. He is doing fine right now, but the mirror-image of the two recoveries sent me into a flashback I still can't quite shake. The nurses were great and totally understanding, and did everything they could to make it easy on us. 

Thanks to everyone for your prayers and concerns, and I'll post up pictures when I can.

[katieGrace]

Feb. 19, 2010 at 5:42 PM

I'm glad everything went well.  sending love and hugs your way.

[DevinAnnesmom]

Feb. 21, 2010 at 1:21 AM

Wow, what a story. I'm in the April 2007 babies group and wanted to visit your profile after seeing your pictures you posted. He sounds like a brave, strong boy and you've been very blessed. I pray that he will make a complete recovery very soon and be back to his old self in no time :)