The 1st 48 hours post-op.

(This is a narrative of the day of surgery, and the day after. The bullet points are my Facebook updates).

Surgery was set for Tuesday, June 21st at 7:30 am.
We were supposed to be at Loma Linda Children's Hospital at 6am.
After writing the post before this one, I went to bed at 12am. My 7 month old woke up at 2:30 am to be nursed, and at 4:45am the alarm went off. I nursed Jack again since I knew I'd be gone all day. I sent my niece (who lives next door) a text to come over to stay with Jack, and my 2 year old, Ava who were both back asleep.
We gathered all our stuff, woke up Josiah, and got on the road by 5:15am.

• Tuesday 6/21 5:46am: God clearly spoke this to my heart last night : "Be strong and courageous. Do not be afraid or terrified because of them, for the LORD your God goes with you; he will never leave you nor forsake you." Deut 31:6.When I shared it with Jo he said, " oh, I've heard that before! I think its a God Rocks song. Then he sang it :) We're in route to Loma Linda.

On the way to the hospital, we say a cloud in the sky that looked like out-stretched arms & a head with "wavy hair." Josiah said Jesus turned himself into a cloud to remind us that he's with us. I agreed, and told him about how God did the same thing for the Israelites, to lead them through the desert.

We arrived at the hospital right at 6am. It was as gorgeous sunny day already, so it didn't seem so early. Inside, it was very quiet and empty. 3 other families road up the elevator with us, all headed to the Children's pre-op area. Josiah got in some scrubs, and settled onto the bed. The friendly nurse took his vitals, and showed him how to work the TV. Surgery was set for 7:30am.

My mom & John's mom arrived at 7am. Josiah was calm, and in good spirits, playing his Leapster.

At 7:15, the nurse came and gave him some medication to make him very "calm" so that when they took him back, he wouldn't be scared. This medication made him loopy! It was actually pretty funny because he was out of it. He was asking me why there were two Mickeys on the screen. :) He could barely operate his mouth!

Unfortunately, at about 7:45, Dr. Nelson came to inform us that a little girl was bitten by a pitbull, and in surgery, so we got bumped for about an hour. I worried that the calming meds would wear off while we waited.
While Dr. Nelson was there, (and since we were delayed), after asking him several questions about the operation and the recovery, I decided to ask him what he wanted to do eventually with the right foot (since he said he didn't think it was severe enough to use the TSF). He looked at it and mentioned a surgery... and then said, "Y a know, I be we could get a good result from casting it. Since he'll already be immobile for a few weeks, we could cast in now in surgery if you want." I said, "Well, you're the doctor, if you think that'd be worthwhile, ok."
Well, then he left and we didn't get to talk to him again about it.

The anesthesia team came by to discuss a new option for Josiah. It was a nerve block in the groin area that would block pain for that leg. Using an ultrasound, they'd find the correct nerve, and block it. They'd do this right after surgery to control pain for the 12 hours post-op, which are the most painful. This would reduce (or eliminate) the need for narcotics. We said, "Sign us up."

• Tuesday at 10:19am Got delayed due to an emergency, but was taken back at 9am and surgery began at 940am. Praise God Jo was relaxed and in good spirits the whole time, even before the "calming meds" were given. He kept saying, "I'm a Christian boy, and I have a Christian doctor. God is going to ta ke care of me."
• Tuesday at 11:56am Got update that they're almost done and Josiah is doing well.
• Tuesday at 1:00pm: Got a text to come meet th e doctor. On our way up.

Dr. Nelson met with us and told us that Josiah did ve ry well and that the surgery went well too. He apologized that it took longer than expected, but that he is a perfectionist. (We expected 3 hours total, 2 hours of actual operation, but it was 3 hours of operation, 4 hours total). He mentioned he did cast him, and I asked if it was full leg (something I forgot to ask before!) He said, yes, and exp lained that a short cast (below the knee) is ineffective for turning and stretching a foot. I told him that I regretted it already because that it seemed "cruel & unusual" on top of the TSF. He was very nice about it and said that if we felt it would be too much to handle, they could cut if off at any time.

• Tuesday at 1:45pm Jo is resting comfortably in recovery. The doctor & I briefly discussed casting the right foot in addition to the surgery on the left. I was surprised that it is a full leg cast! Should have figured it would be. Sec ond guessing that now. May have him cut it off

When we got to go see Jo, he was in the main hospital recovery room, so there were several older people there who had just had surgery. Uncomfortable

environment to be in.
Josiah was not upset or crying, he was resting comfortably. When I said his name, he opened his eyes and tried to talk, but because of the tube they p

ut down his throat during surgery, he couldn't talk. This upset him. I explained why his throat was sore and told him not to try to talk. I told him that his surgery was all done and that he did really good. I checked that he was not in pain, then told him to just close his eyes and rest.

I was so thankful we did the nerve block. This eliminated the need to give him narcotics which often make people (especially children) agitate

d and disoriented.
I was actually relieved when i saw the fixator on him. It was smaller than what I had imagined. Plus, the pin sites were wrapped in gauze, so we didn't have to actually see the "wounds."

We got moved to a room at 2:30pm.

He was doing very well, and I was surprised that he could move that foot around.

He was not happy about the cast, and neither was I. Besides being a full leg cast, it was very bent in order to get correction on the foot. I realized that this was absolutely impractical and too much to deal with. Unfortunately we wouldn't see the ortho team until the next morning, so we'd be stuck with it for the night.

My mom, mother in law & sister all stayed with us during the surgery, said hello to Josiah, and then went home at about 3pm.

We settled into our room.

One thing that was a challenge was using the bathroom. He had to use a bedpan and hand-held urinal. We figured out the best way to get him "into position," but it was still difficult and #2 proved to be impossible... the meds constipate.

• Tuesday at 7:50pm Jo's starting to get uncomfortable position wise (understandable!) The nerve block they did should keep the bad pain away until about midnight... pray for us. I am going to ask the nurse when he can have other pain medication.

Josiah got Tylenol with codeine at 8pm & every 4 hours through the night. He slept surprisingly well, flopping all around even with the full leg cast and TSF on. I, on the other hand, did not sleep well. We were sharing a room, the nurses were in & out, and the chair-bed was uncomfortable to say the least. On top of that, every few hours, Josiah would have to pee, and I'd have to get him in a sitting position and hold the "jar" for him.

One of Dr. Nelson's residents came in around 11:30pm (I guess after surgery?) to check on Josiah. I told him to tell Dr. Nelson I wanted this cast cut off before we left the hospital.

• Wednesday at 7:13am: We made it through the night. Jo's pain is manageable w the meds he's given. No tears yet! (Well, except for when I tried to leave him to go to the bathroom!) p.s. mommy = zombie
• Wednesday at 12:48pm Dr Nelson came by after one of his surgeries. Love that guy! :-) He had his resident cut off Jo's cast. He explained pin turning to us. Same time PT showed up w walker and wheelchair. Jo hopped down the hall. Not easy for him, but impressive! Orders have been written, equipment ordered =should be going home by 5

The resident who cut off Jo's cast needs to work on his bed-side manner!

He came in without saying a word, and turned on the circular saw thing. Of course, Josiah started freaking out. I said, "Jo, it won't hurt you. It's just loud and it will shake your leg as it cuts the cast. That tool doesn't cut skin."

The doctor said, "Actually, it can cut skin... but..."

What the heck! Ugggg. Anyway, thankfully Dr. Nelson came in right after that so we could talk to him and not this guy.

As mentioned in my FB update above, Josiah got out of bed and hopped out of the room and down the hall with the walker. It was hard for him, and he's never been a good "hopper" anyway, but the Physical therapy guy was very impressed.

• Wednesday at 1:07pm I think the walker-hopping was a little too much. Jo crying because of pain for 1st time. :(
• Wednesday at 2:47pm Jo, starting to cry. Me: What's wrong buddy? Is it hurting again? Jo: No. I miss Jack & Ava! :(
• Wednesday at 4:08pm: Watching DVD while waiting to be discharged.

We had to wait a long time to be discharged, mainly because we were waiting for insurance to approve the wheelchair & walker. Hindsight is 20/20. I would have just told them to figure it our and deliver them to the house. We could carry Josiah into the house or use a stroller. Very frustrating waiting around for nothing when we could have left at 2pm!

• Wednesday at 6:38pm: FINALLY on our way home

We got home and it was nice to see my smiling 7 month old! I missed him! That was the 1st time I'd ever spent the night away from him, and it was the longest I'd ever been away (38 hours: Tues @5am to Wed @7:15pm)

My mom arrived shortly after with Ava, who I was also happy to see. She was such a sweetie! She was very concerned for Jo. She kept asking, "You ok Jo? Jo ok? Jo have owie?" She gave him lots of hugs.

My sister Kim also came at that time to deliver a box-spring and help us fix up his room.

Josiah had a loft bed, and so we had to take it apart, and put the box spring & mattress on the floor. That makes it just the right height for him to sit on the edge & eventually get up with a walker. We also rearranged some things in his room and brought in the lazy boy recliner to his room.

Everyone left, and we got Josiah settled into this room.

He wasn't due for medication until 9pm, but he started crying and yelling in pain at 8:15.

It was hard to see him like that, knowing there was nothing we could do.

Everything had gone so well up to that point, I had hoped we'd be the exception.

I finally gave in and gave him meds at 8:30, knowing it'd take another 30 minutes to kick in.

Eventually it did, and Josiah fell asleep.

• Wednesday at 9:48pm: Rough start for us back at home. 40 min of each pain-med cycle is torture. Jo cries/yells it hurts & there's nothing we can do.He'd done so well after surgery, I hoped maybe we'd skip the "horrible 1st week or 2" that the been-there-done-that-mom's had told me about. Please pray his body adjust quickly to the fixator & that his pain would be minimal. Pray the Lord would meet each of us where we're at.
  Thursday at 8:54am Praise the Lord- Josiah slept all night (and is still asleep, actually).Woke him up once around midnight to give him medication, and that's it!Now, if only Jackson would have done so well... ;) Even still, "some" sleep at home = 10,000 times better than hospital.