The First Surgery
As I wrote before, MM surgery is usually carried out twice. On Thursday, November 11th at 4pm, the day before the first surgery, I called the nurse coordinator who was arranging the schedule. Because we had not heard the finalized schedule of Kota’s surgery, which was supposed to be informed by the day before (it’s today!). The coordinator said that probably it would be 6 am tomorrow (!), but I should wait another phone call from anesthetic department after 5pm. Actually, I received the call at 6:30, and the time to be there next day was 6am. I guess the reason why it is not decided until the last minute is that they have to consider every possible situation of emergency before finalizing the next day’s schedule.
Friday, November 12th was the day of the first surgery. No food since last night. Because no water was allowed after 4:30 am, Kota woke up at 4:30 and drank some water. We left home at 5:20 and arrived at the hospital at 5:50. After the process of admitting, Kota went through the check up and wore on hospital’s pajamas around 6:30. He waited for a while on a bed. Meanwhile, nurses and anesthesiologist showed up in turn and gave him some words. Kota had syrup for the anesthesia at 6:50. He looked very calm. At 7 am, an anesthesiologist and a nurse took Kota to a corridor leading to the operation room. I had to see him off at this point. It would be around 1 pm to meet him after everything would be done. I saw him off being moved to beyond a door until the door closed. As a parent, it was kind of a tough moment.
It was not before long that a surgical coordinator showed up, and I was taken to a waiting space. She was nice and gave me a pager, and what I was supposed to do was just waiting. The nice thing was this surgical coordinator is the link between parents and the operation room. Parents could ask her if the surgery is going well through this person and she calls the operation room to make sure. Kota’s surgery was anticipated to take about 6 hours in total, so I asked her to call the operation room after 4 hours had passed. It was so much relief to hear that everything was going on very well
Then a social worker came to me and said she was assigned to take care of Kota. She also kindly asked if I had any questions or problems. I thought there was so much of care compared to in Japan. The waiting space was made at a corner of hallway. Besides that, there was a Parent Lounge where kitchen and some sleeping rooms, and lockers are available. So I asked for a locker to put Kota’s cloths in.
Just before noon, my wife brought some foods and drinks so Kota could have them after waking up from anesthesia. A friend family of us kindly offered to take care of our daughter on that day.
Slight after 1 pm, Dr. Steinberg came to the waiting space with smiling and saying the surgery was carried out successfully. However, he had to give up direct bypass because the recipient blood vessel was too thin and fragile, so it was done as indirect bypass method. This time was right side, and he would not know about the left side until it is opened. He said Kota would be moved to PICU (Pediatric ICU) within one and a half hours.
But we were not called even after 1 hour and 40 min, so I asked the surgical coordinator what was the matter with Kota. Then it turned out that Kota had already been moved into the PICU! A nurse in PICU forgot to let the surgical coordinator know. We went to see him anyway. Fortunately he was still sleeping and woke up when we arrived there. The first thing he said was “thirsty”. But he had to wait until he became totally conscious. He slept again for another 2 hours. I heard that the nurses work for 12 hours a day as 7 to 7 for three days and take three days off. Because they don’t have so much free time during the work, I guess it could be very hard to work 12 consecutive hours.
In the surgery this time, the hair was shaved about 1 x 4 inch2 from a little front and above the right ear to upwards, and about 3.5 inches were cut straight. The wound was stapled and covered with a clear plastic sheet. Two or three in right hand, one in left hand, one in right leg, and one in left thigh, in total five or six iv lines were inserted. Saline with some sugar, nitroprusside, and esmolol were being infused. The latter two were the drugs to control the blood pressure. Probably these lines were used for anesthesia during the surgery, other lines are used to inject morphine and other agents. There is a line into an artery in the right hand to monitor the blood pressure continuously. Three electrodes were put on the chest to monitor pulse and respiration. Furthermore, a sensor on a finger is checking something like oxygen saturation.
At about 5:40pm, Dr. Steinberg showed up with a resident to see Kota. He said “You were so brave. You will be OK” or something like that, gave some directions to a nurse, and left.
After that, the baby next to Kota’s bed became somehow serious condition and doctors and nurses were a rush. Because we were asked to excuse, we went out from PICU for 20 min. When we returned, a nurse said Kota was almost vomiting, so water was still put off. Since his stomach must be empty, there should have been nothing to bring up. Probably it was because of morphine. He slept again.
At 7 pm, parents had to wait for 30 min outside PICU during the nurse shifts. My wife left to pick up our daughter. When I went back to PICU, Kota was still sleeping and woke up after 8 pm. He complained headache, but what he wanted most was water! He finally got ice chips. He slept again. Woke up at 10pm, Kota had some water and apple juice. Then he slept again. I woke him up at 11:50 to give aspirin. Aspirin makes blood thin, so he has to take it everyday. Since he slept again, I left for home at 12am. But when I look back, I should have stayed with him all night.