Jude’s Inguinal Hernia

Happy Tuesday! Today was Jude’s surgery day, and it started off with a bang. Let me explain how this came to be, first.

PRESENTATION AND DIAGNOSIS
I had noticed a month or so ago that Jude had a bulge in his right testicle that didn’t look normal while changing his diaper. He is 2 yrs old. The right side was larger than the left side, slightly darker and the upper part was more swollen.  I figured I would just watch it to see if it went down on it’s own, and it didn’t after a week. I searched online for ‘swollen testicle 2 yr old’ and found a few pictures looking very similar to what we were seeing. I snapped a picture myself and sent it to the Pediatrician at Doernbecher through our online chart application. There was definitely a mass in there that was separate from the testes. He wasn’t in pain but pointed it out as, “Ouch.” only once while changing his diaper, early on.
The doctor’s nurse responded with warning signs to watch for and confirmed it did look very much like it could be a hernia but that many times it will come in and out on it’s own and frequently they let it go unless an emergency arises, such as the bowel being obstructed or cut off by the hole.
I made an appointment with the pediatrician and after manipulating things a little by a few doctors, it was confirmed to be an inguinal hernia with a hole that was large enough for the bowel to fall through. Jude did really well during the exam with the exception of the anal exam to feel the bowel. Yeah, he didn’t like that so much. He was a little backed up apparently and the pediatrician prescribed a stool softener. From there they put in an order for us to see the specialty doctor in the clinic next door to rule out a hydrocele -which is basically a sac of fluid- and we waited for them to contact us.

I passed up the stool softener and gave him a few bottles of milk that night, instead, knowing that it tends to give him looser bowels and it did the trick.

A few days later we got a call from the pediatric surgeon and made an appointment for a consult. Comically, the day before his appointment his testicle went back down to size as the bowel seemingly has receded back up into the abdomen leaving a bit of a sack  of something inside. I’m pretty sure cleaning out his bowels helped to contribute to this but I held back the urge to cancel his appointment knowing that a hernial hole probably isn’t something we want sticking around. They would know what to do.

The appointment was quick, some interns came in and looked at his scrotum with a light to check for a hydrocele and then looked up the picture I had taken before in his online chart to see the extent of the swelling to confirm it was, indeed, swollen prior with a mass inside since he was asymptomatic at the appointment. I can’t stress enough how important it is sometimes to document things like this for situations like this. Had I not taken the picture they may have just decided it wasn’t warranted because they couldn’t confirm it with their own eyes.

From there the surgeon came in and looked at him and then said they close hernia holes after diagnosis and that they would schedule a surgery date for November 3rd but not a time- they would call later to give us the time. After his appointment I went over to the pediatrician’s desk to talk to the head nurse about our options to get caught up on some past due immunizations during his surgery or while he was unconscious. And yes, they do things like this.

They called a few days ago with pre-surgery instructions and a check-in time of 6:00am. Cereal and milk items after 10:30pm the night before, only clear fluids like Jello, broth, and sports drinks after 1:30am, and nothing by mouth after 5:30am. Last night the nurse called and confirmed she would meet us there to administer his immunizations before he woke up.

SURGERY DAY
Last night was really tough. I know this is a pretty minor surgery on the list of infant surgeries but any time you put a kiddo under anesthesia anything could happen. I mean, look at the case of the girl who underwent routine oral surgery and died. You really just never know.

imageMy brain was really more or less oatmeal all day. I was trying to figure out what I could do to prepare and I was Googling everything I could to find out information on the procedure. I found a really great blog entry on one woman’s son’s inguinal hernia surgery at Doernbecher that was so helpful! Go check out her blog sometime, called Only a Mama Knows. This is one reason I’m blogging this- I really hope to help another parent going through this, someday, too.
Insomniac JudeI originally had it in my mind to keep Jude up as long as possible the night before so he would be so tired he wouldn’t mind that he hadn’t eaten that morning- but you see, we just had daylight saving’s and everyone’s clock was really thrown off, including mine.

By 8:00pm I was done. I was so tired and so mind blown and nervous, I just took a bath and climbed into bed and grabbed my yarn and crochet hook. Jude, however, was not the least bit ready for bed. He proceeded to jump in his crib like a monkey and tear everything out for the next hour. Jumping up and down and throwing things everywhere, he refused to go to bed.

He finally fell asleep and I fell asleep… and I slept so hard that I didn’t wake up until my husband yelled, “Get up! We’re late!”  It was 5:30am and it takes an HOUR to drive to OHSU. Not only that, but we have one vehicle and my husband had to drive back to take the kids a mile down from the house to their bus stop for school. He had to drop us off and drive back in time to catch the bus.
We’re screwed, you have to reschedule.” he said to me.
I’m calling and letting them know we’re going to be late.” I responded. There was NO WAY on God’s beautiful wonderful earth I was going to go through another night like last night.
HE IS HAVING SURGERY TODAY!
Doernbecher was great, they said, “See you when you get here.” and we were off.

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Jude was in good spirits when we left. He was calm and content. It was a nice drive into the city.

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Doernbecher has free valet parking for those who need it as well as wagons to pull your kids and things in.

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With some time to spare, my husband got us out of the car, Jude buckled in and he was off to head back home to get the kids off.
As we entered the hospital, we checked in at the front desk with reception. She confirmed his name and birth date and thanked me for our pre-registration. She gave me a questionnaire and printed out our name bands double checking the names, again. She also asked what his condition needing surgery was and if it was part of an accident. I explained it wasn’t understanding that sometimes car accidents require separate insurance billing but she continue to dig in and inquire HOW he got the hernia.image
Um… it just happened? I don’t know, I guess these things just happen?” *Awkward silence.*
She stared at me and I stared back… beginning to wonder why she needed to know this detailed information thinking she was somehow an important part of the process and needed to judge how a child would get a hernia on his own. Mind  you- my pediatrician was not surprised at his hernia or inquiring of any injury he may have sustained so really, I think these things sometimes just happen.

She moved on, finally, telling me to go to floor 8. Bypassing Starbucks was really hard at this stage, as I was groggy and craving caffeine but seeing how we were late I continued onto the elevator.

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I took a right towards surgery and checked in at the desk there. The surgery receptionist rechecked my name and his name and birth date and made sure we had our bands. Then she gave me a pager and explained how to read the board with the number we were given to check the status of his surgery.  From there Jude promptly noted the toy car and signaled he no longer desired the beautiful red wagon he was in and now wanted the red shiny car across the waiting room.

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After a few minutes we were called back into the pre-op rooms where they weighed him and took his blood pressure and vitals. Everything went quickly because we were already running late.

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The anesthesiologists came in and explained what they were going to do. They explained how they were going to give him medicine to make him relax… a lot…. and that they would administer more anesthesia via a mask that would put him to sleep. Then they would put in his IV line and a tube down his throat to help him breathe. Sometimes the tube can make their  throats sore or lips swollen, and rarely even chip teeth or cut tongues. It’s just a risk.
Then a nurse came with a syringe of yummy orange looking medication and we fed it to him.

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Then they had me take 4 cloths that were medicated and warm and wash him down in certain areas according to a chart. One for his arms and chest, one for his legs, one for his back and one for his groin. After that we put a nice hospital jammy on him.

Within about 5-10 minutes Jude was already looking at people weird. The funniest thing to him was the nurse’s hair net cap. And he pointed at it and giggled. He started getting wiggly and moving around so I picked him up

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At this point he was throwing his whole upper body back going, “Wheeee!” and I knew he was high on happy. I gave him a last hug love and kiss and passed him off to the nurse. He waved bye happy to see the streaming blurred lines as he went. Wheee! this is FUN! No clue what I’m doing here, but I LIKE IT!

Pulling my wagon of things and one of his blankets out alone… was hard. I was shaking. I needed coffee, NOW. I went out through the waiting room and then back to the elevator and downstairs to the lobby where Starbucks was waiting.
Starbucks. I love you. Even if the barista DID spell my name ‘JAYN’ and ask how my day was going as I grasped at words that weren’t really how my day was going so that the next customer could order and I wouldn’t be the poor sop there. She must be new.
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I sat down and drank my venti house coffee (because it’s good, dark, and you get it right there at the counter instead of waiting in the high-maintenance people’s line) and egg and sausage sandwich on the chairs.
Well, I couldn’t really eat right away. I felt like a ghost in a room holding a pager and an empty wagon.

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I pulled out my computer and logged onto the hospital’s free wi-fi- successfully locked myself out of my own website. My security methods are a little too stringent, I think. I’m going to change that.
As time went on and I updated my husband and troubleshooted a few things, I got a page.

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I love the accountability, but the suspense is REALLY unnerving. In a way I just wanted to know he went in, everything was great, and he came out ans was ready for mama. On the other hand, this was sufficient at lighting up my imagination as to WHAT they were doing in the procedure RIGHT NOW.
Yeah, I don’t recommend doing that. My saving grace was the doctor’s conversation to my right that interrupted my own thought process. Seriously, any little thing probably could have ignited a gush of tears at any moment- distractions were good. I decided to eat my breakfast and drink my coffee and focus on what I was doing and not the wagon or anything related to a scalpel touching my son’s virgin abdomen, and 25 minutes later I got a page that he was finished and to come up to waiting.

I sat and waited crocheting more of my project and the waiting room got busier. I got up and inquired on if they had administered the immunizations and a nurse came out to tell me it had been done and taken care of. My husband was on his way back so he greeted me with my 4 yr old, Justus. Then the nurse came out and had me come back as he was waking up.

He was starting to try and pull out his lines and the band-aids on his arms. I bent down and whispered, “Hey bubuh! Shhhh, mama’s here go nigh nigh.” and he stuck his thumb into his mouth and relaxed as we put a warm blanket over him. He rubbed his eye a bit- apparently they put tape over their eyes so they don’t get a corneal abrasion from lines and equipment going over their face.
He started throwing off the blankets and tugging at the lines more so they grabbed me a rocking chair and allowed me to hold him as he drank some apple juice. She took out his IV line and he did great.

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After this we transferred to a room a few steps down so my husband and son could come out and hang with us. At this point we were waiting on a wet diaper to show his bowels were working again.

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My husband was able to hold him and he was relaxed most of the time with 0 pain. A nurse came in and brought Jude another cup of juice as well as juice for my 4 yr old. I handed my coffee to my husband and it was a great Kodak moment.

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They also have a handy little television that moves all over for the kids to watch. Interestingly, there are 3 ESPN channels but only 2 kid’s channels. image

Jude would go in and out of sleep as the anesthesia wore off. Still waiting on pee.

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Eventually it was all over. He wanted down, and he wanted in the wagon NOW. He was instantly temperamental. He didn’t want the gown on, didn’t want the blanket, but he wanted in the wagon and for Justus to NOT touch the wagon and he wanted to GO!

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He also, apparently, wanted my coffee and gladly took a nice big gulp. Oh well, I guess it wont hurt our need for him to pee.

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We finally got some gassy pops and some pee and got him dressed into his PJs. The nurse came over to check his vitals again and let us go.

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Time to go!

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On the way out were were told to pick out a hat. There was a pink and a purple available and he picked purple.

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As soon as we got downstairs it was apparent he was SUPER sensitive.

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Everything set him off.
Getting him into the car was very difficult. He didn’t want to be there.
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We decided to stop off and get some lunch since none of us had eaten very much. So pretty much the rest of this evening is consisting of him being totally fine but easy to anger with a LOT of stomping. We are administering Tylenol on a schedule to control pain, but otherwise he is normal! Doesn’t even seem to have noticed his bandage however his legs where he got shots DO hurt.

One of them was a tetanus so I can understand. Still it’s something we REALLY need, living on a farm. So for now our biggest feat will be keeping him calm! Haha!

 

 

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