Surgery Recap

We made it through Ana Luisa's palate surgery, and are now one week into the recovery! It hasn't been easy, but she is doing great.

My mom came over at 6am the morning of the surgery so that Jeff, Ana Luisa and I could head off to the hospital. We were in pre-op for about an hour, getting Ana Luisa ready in her hospital gown, and answering the same questions over and over for every doctor or nurse who came by. Ana Luisa got to play with a toy that has buttons, lights and sounds...something we don't have in our house!
We were glad she was completely oblivious to what was about to happen.

She was given a relaxant, which I'm sure made the lights/sounds toy seem even more exciting. Much like many people experienced the 60's. Then the surgeon came to take her to the OR, and Jeff and I went to the waiting room to wait...and wait...and wait. The hospital is testing out a new system where they give parents a cell phone so that they can receive calls directly from the OR giving them updates on the surgery. Last time, we had a pager in case they needed to contact us while we were away from the waiting room, but didn't get any updates throughout the surgery. This time, we were supposed to get a call with an update within the first couple hours. By 9:30am, two hours in, we still hadn't heard anything. The receptionist at the front desk called the OR for us, and we were reassured that everything was going well. We walked laps around the hospital, talked, read magazines...then at noon, about four and a half hours into the surgery, we received a call letting us know that it would still be another hour before they were done, but everything was fine.

In the meantime, Juan Pablo was having a blast with Abuela. They played, read books, went to a toy store, watched Dora episodes on Netflix and had a great time in general.

At about one pm, as expected, Ana Luisa was taken to recovery. We kept waiting to be called up to be with her. Last time it took about an hour. This time, after an hour and a half, still no phone call. The receptionist called the recovery room for us, and they said we could come right up. When we got to the recovery room, Ana Luisa was being held by a patient care assistant. Her eyes were closed, there was blood coming out of her nose, and the lower half of her face was covered in blood. She was crying inconsolably. I held her, and started talking and singing to her, but nothing calmed her down. The surgeon came to tell us that everything had gone well. He had a lot to work with and was able to get a good closure towards the back of her mouth. As he got up to the front, he ended up having to take a fat pad from the inside of one of her cheeks to help close the gap, but he was happy with the way things turned out.

For the next hour, as we went up and got settled in to our hospital room, she just cried in my arms. Finally, she fell asleep for a while, but it didn't last long. We had thought we would have Juan Pablo come see her that afternoon, but since Ana Luisa wasn't showing any signs of improvement, we decided it would be better to wait so that he wouldn't be scared or worried. Tia Padu and Tia Chu both spent several hours with us that afternoon, evening and into the night, which was a great help. It was nice to have the company and distraction, as well as someone to ask to adjust a pillow here or there to help us feel more comfortable in the uncomfortable hospital rocking chairs. Ana Luisa slept on and off, but was obviously very uncomfortable. I left the hospital around 7:30pm to go home and put Juan Pablo to bed. Jeff stayed at the hospital with Ana Luisa overnight. She continued to get doses of morphine about every two hours throughout the night to control the pain. He kept her in his arms the whole time, and managed to get a little sleep on the couch in her room, but not more than an hour at a time.

Juan Pablo and I didn't have the easiest night at home either. He was exhausted from his fun day with no nap, so he went to sleep right away at 8pm when I got home. I couldn't fall asleep for a long time, and after I finally did, Juan Pablo woke up at 3:30am, apparently feeling well rested and ready to go, because he didn't fall back asleep for another two hours. Abuelo came over at 7am to be with Juan Pablo and I went back to the hospital and take over for Jeff, so he could come home and get some sleep. Ana Luisa had just received another dose of morphine when I arrived. To me, it seemed that she was more tired than anything else. She is a very, very light sleeper, so it was incredibly difficult for her to fall asleep and stay asleep with various doctors, nurses, cleaning staff, and others coming in an out of the room, the IV beeping from time to time, and noises out in the hall. She was breathing and drinking just fine, so if we got her pain under control with oral medications, she would be able to come home that afternoon, which I hoped would be the case. Thankfully, that morning dose of morphine was the last one, and after that she seemed ok on oral pain medication. We mostly stayed in the room, trying to get as much sleep as possible. Her IV came out around noon, so we went to the playroom for a bit, but she was really just exhausted. Jeff came back to the hospital around 2:30pm, and we got word that she was ok to be discharged around that same time. My parents and Juan Pablo arrived shortly after we signed the discharge paperwork. Ana Luisa was so happy to see her big brother, and her new favorite person, Abuelo.

After playing for a bit in the playroom, packing up our things, and saying goodbye to the giant Big Bird at the hospital entrance, we finally were able to go home. Ana Luisa went to sleep around 6pm, and slept until 8am the next morning. Poor tired baby! She woke up several times throughout the night to drink some milk or get another dose of Tylenol, but overall was fine. The rest of us also got plenty of much-needed sleep.

Eating those first few days was a challenge. Thankfully, we've been allowed to use our special cleft lip/palate bottles to feed her, which we had originally been told wouldn't be the case. But besides milk in her bottles, finding things to feed her was tough. Avocados are her favorite food, but avocado smoothies didn't cut it. Neither did Carnation Instant Breakfast, which came highly recommended by a friend who has had multiple oral surgeries. The only thing she at the first couple days was softened ice cream. Which meant that the only thing Juan Pablo wanted to eat was ice cream. Needless to say, healthy eating has sort of taken a hit around here. We've slowly been able to move on to other foods- applesauce, pureed beans, mashed avocado, yogurt, and mashed banana with peanut butter mixed in have been some favorites.

Ana Luisa slept fine her first few nights after surgery, and did ok napping during the day. She would only nap in my arms those first few days, but we're back on track and today she took a normal, almost 2-hour nap without waking up at all, which was nice. The last few nights have been very rough, though. She will wake up several times a night crying. She doesn't appear to be in pain (we're still giving her pain meds throughout the night), and she's not hungry or thirsty, so we're having a hard time figuring this one out. The current theory is that as the roof of her mouth/floor of her nose is healing, it itches and she can't really do anything about it which has to be frustrating. Although during the day she's fine, so who knows. Last night was a little bit better, so hopefully she'll be back to her normal sleep patterns before long.

During the day , Ana Luisa is back to her goofy, sweet little self. We are really enjoying her extreme cuteness, and getting to know her new, less nasal voice. Juan Pablo has done very well with the whole ordeal. We tried to make sure to build in lots of fun one-on-one things to do with him in the days following surgery, to make up for having been away from him for the better part of almost two whole days to give his little sister massive amounts of attention, but it turns out he probably missed her more than he missed us. When I suggested that he come with me to Whole Foods, just the two of us, to pick up some milk and have a lunch date, his response was, "No! Solo Mama, Juan Pablo Y Ana Luisa! Yo extraño a Ana Luisa!" ("No! Just Mama, Juan Pablo AND Ana Luisa! I miss Ana Luisa!"). He has definitely handled things better this time around than last time...maybe even matured a little bit?

Ana Luisa's follow-up appointment isn't for another week and a half, so things around here will stay the same for a while. Thanksgiving dinner for her will be mashed potatoes, and most likely, ice cream.

Thank you for all your prayers for our family. This surgery and recovery has been harder than the last one, but at the same time, it has been nice to see how much more attached Ana Luisa is to us now, just three months later, and how much better we know her. It's also very encouraging to see Juan Pablo handle everything so well. Transitions, both minor and major, are not really his thing, and this being a pretty major one, he has done much, much better than we expected. We are also so grateful for my family and the way they have selflessly helped out, taking care of Juan Pablo, coming over just to play with the kids, letting us come over to their house for a change of scenery and providing us with waffles and hot chocolate while we're there, and making and arranging meals from friends for us. We are truly blessed. And done with surgeries...at least for a couple years. YAY!