Monday, December 11, 2017

Another A-word in Daphne's story

Another surgery.

Another hospitalization.

Another A-word added to Daphne's life story.

When I published the story about Daphne's emergency appendectomy, I thought the story was over. But it wasn't.

On Tuesday, November 28, Daphne woke up tired. She went potty, said she wasn't hungry, and asked me to cover her up with a blanket on the couch. Warning bells went off inside my head. I took her temperature – as I had every morning since we had returned home. Her temperature was 100°F – well below a true fever. But Daphne's discharge instructions said to notify her doctor if she had a fever greater than 101°F or a temperature of 100°F or greater for over 24 hours. I recorded her temperature and the time and got her some ibuprofen to help her feel better.

Eight hours later, Daphne's temperature was again 100°F. When she woke up from her second nap of the day at 7:00 p.m., I could tell right away her situation had worsened. She was yelling at the cat and felt considerably warmer when I wrapped her up in a hug to settle her down. The thermometer confirmed my observation: 101.5°F.

I called the hospital. The surgeon on call explained my options: if I felt her condition was serious, I should bring her in right away; if she was comfortable, I could wait until morning. He said there was a probable chance that an abscess had formed from bacteria left over from her ruptured appendix. In that case, they would likely need to drain the abscess using an ultrasound-guided procedure.

I gave Daphne another dose of ibuprofen and she went right back to sleep. An hour later, her temp was normal and she was still sleeping soundly. So I decided to wait until morning to go in. I tucked Dan and Monika into bed and tried to sleep myself.

The next morning, I wouldn't have guessed anything was wrong with Daphne.

Her initial lab work at the clinic, however, indicated that something was going on inside of her. Her white blood cell count was elevated and so was her temperature. Dr. Lundeen, the surgeon who examined Daphne, ordered another CT scan to check for an abscess.

Shortly after the three-hour wait for the CT scan began, Daphne began crying softly; she said her stomach hurt and that she wanted to lay down. We found a bench seat in a waiting room so Daphne could lay down. Thankfully, while I was on the phone with the imaging department trying to find some pain relief for Daphne, they said there had been a cancellation and her CT scan appointment was moved up.

Our friends in the pediatric unit – where we checked in first so that an IV could be started – welcomed us with smiles, hugs, and Daphne's blanket. Her blanket was in the laundry when we discharged after her appendectomy and I didn't remember it until a couple days later.

The nurses started an IV in Daphne's hand and then escorted us down to the imaging department. After the CT scan, we returned to a holding room in the pediatric unit to wait for the results. Daphne slept, which I've now decided is her default response to pain.

It wasn't long before Dr. Lundeen arrived with the results of the CT scan. There was, indeed, at least one large abscess – a little bigger than a golf ball – deep in Daphne's lower abdomen. There could be a couple smaller ones, as well, he said, or they might just be parts of the large abscess. Unfortunately, he said, because of the location of the abscesses, it would not be possible to use an ultrasound-guided procedure to drain the abscesses. Surgical removal was the only option.

Dr. Schmidt, the surgeon who did Daphne's appendectomy and who would also be doing this second surgery, came by a little later to explain the procedure. The plan included starting Daphne on IV antibiotics and pain medicine right away and doing surgery first thing the next morning. Most likely, the procedure could be done laparoscopically; Dr. Schmidt would collect a sample of the abscess fluid for culturing (if possible), drain the abscesses, remove any abscess walls, irrigate her abdominal cavity, and install another abdominal drain.

Daphne spent the rest of the day sleeping, eating popsicles, and watching Disney princess movies. (Before her hospital stay was over, we watched every Disney princess movie in the pediatric unit's extensive movie collection.) She told me that night, "Don't tell Dan and Monika that I got to watch two movies and eat two popsicles in one night!" Life is truly all about perspective.

Daphne's surgery the next morning (Thursday) went as planned. It was not nearly as frightening this time to send her into the operating room. Either because I wasn't sleep deprived or because I had a full night to let the reality of the situation sink in. My dad came down to sit with me during surgery and stayed with us at the hospital to help.

Daphne woke up in recovery a lot sooner after this procedure and was much more active the day of her surgery. Glen, Dan, Monika, and Glen's mom came down to visit that night; it was good for them to see her up and active.

I suspect that one of the pain medications she got actually caused excessive excitability, because she hardly slept after surgery and was still asking to go for a walk at 9 p.m. that night.

We switched pain medications and the next day (Friday) she took a 5-hour nap – which was much-needed for both of us.

Daphne also started eating right away, which kept us on the fast-track to going home.

On Saturday morning, lab tests confirmed that Daphne was recovering well. After the lab tech drew Daphne's blood for the tests, Daphne told her, "Thank you. That was very gentle." Then she asked the lab tech for a hug. From the surprised look on Sophie's face, I wonder how often lab techs get hugs from patients.

The abscess-fluid cultures and pathogen sensitivities finished that morning, as well. Prescriptions were ordered for continued treatment at home and Daphne was given the all-clear to go home.

My freak out moment for this hospitalization came when our nurse told me that Daphne would be going home with her abdominal drain in place. Daphne's first JP drain had been removed just before we left the hospital. The doctors wanted to leave this one in for another week, to make doubly sure all of the extra fluid in her abdomen had a chance to drain out. I balked at the idea – partly because there was next to nothing draining out at this point; partly because the idea of abdominal drains and Daphne playing in the barn didn't sit well in my head. And I knew better than to believe that I could keep Daphne out of the barn.

But, I agreed to let caution prevail.

When we got home, I strapped the drain tubing to Daphne's stomach with vet wrap. Daphne didn't let the drain slow her down. She did rest a lot for the first couple days, but it wasn't long before she showed up in the barn one morning and told me, "I laid on the couch for a while after I woke up and made a plan. I figured I could come out to the barn if I just tucked my drain inside my snowpants."

This past Thursday, I took Daphne back to the clinic for her follow up. Dr. Schmidt said she looked great and removed the abdominal drain.

Daphne got on the bus this morning to go to preschool – for the first time in over three weeks. I'm taking that as a sign that our lives are returning to normal (whatever normal is  ). I sincerely hope that this is the end of this chapter in our story.

And that leaves me with another group of doctors, nurses, and medical professionals from the St. Cloud Hospital to thank:

• Surgical Team: Dr. Schmidt, Dr. Lundeen, Dr. Singh, Dr. Martinson (after hours phone support), Dr. Fauske (anesthesia), Yen (post-surgery PA), Nicole, Denise, a few whose names I can't remember and more we never met
• Recovery: Jessica and Sam
• Pediatric Unit Doctors, Nurses, PCAs, and Staff: Dr. Peitso, Dr. Campbell, Dr. Newman, Kelsey, Deb, Toshie, Angie, Michelle, Katie, Trina, Kenzie, Kristina, Jon, Scott, Jess, Marcella, Laura, Claire (nursing student), Stephanie (the lady with the paints and all the toys), and a few more whose names escape me
• Lab Techs: Sophie and the techs from the clinic lab

Thank you, as well, to everyone who, again, visited Daphne, sent cards and gifts, brought food over, helped with chores, and provided long-distance emotional support.

Our perspective this Christmas season is much different than it has been in years prior.

More than anything else this year, what matters is celebrating the gifts of family, love, and health. We really don't need anything else.

The past three weeks were challenging for us, but we recognize that they could have been much worse. We know that other families will be spending Christmas in the hospital or without their loved ones. (In the midst of everything going on with Daphne, we buried Dan's beloved teacher after she lost her six-year battle with cancer.) We know that grief for our loved ones, regardless of when we lost them, is often strongest during the holidays.

We pray for those families especially. We pray for love and health for all families.

This Christmas, hold tight to those you love.

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