Tuesday, August 23, 2011

4 for 4

Every prayer request I posted yesterday was answered: God is good! But here's the thing about faith ... even if something had happened to Luke yesterday, God would still be God and He would still be good.

We checked in to the hospital at 6:30 am (thank you, Mom, for coming to our house so early to watch Laney!) and got Luke back in to the pre-op room. He was a trouper being woken up and the biggest hurdle of the morning was getting him into his hospital gown. After we jumped that hurdle, he was so cooperative with the nurse, jumping on the scale, giving her his arm for blood pressure, etc. Around 7:15 am, the cardiac anesthesiologist came in to chat with us and order up a good ol' dose of Versed. Soon after, Dr. Beck stopped in to go over the plan again and have us sign the consent forms. Luke was content watching Sesame Street on Dad's lap.

We had another little hurdle convincing Luke to open his mouth for the Versed ... he remembered the taste from last summer. Thankfully, only a little came back out and within 10 minutes Mr. Luke was silly boy (check out the video at the bottom of the post). Dr. Beck's nurse came in shortly after that to take Luke back on a "dinosaur hunt". Even though he was willing to go with the nurse, he was still cognizant enough to yell out down the hall at us, "Where are you guys gonna be? When will I see you?" I honestly cannot imagine that part of the day without Versed. I don't think I could do it.

The entire procedure took about an hour and by 9:15 we were back with Luke in the post-op room. Dr. Beck reported that Luke did fantastic and he was able to get everything done. He did end up having to pull that first molar on the bottom left and put a metal spacer in to save that space for his permanent tooth. He also put a crown on the lower right molar and put sealants on the rest of the molars. He mentioned another factor that I wanted to pass on to other heart families. He said he sees a lot of kids like Luke who need Pediasure come in with cavities. Luke was on Pediasure from ages 1 to 4. Just another possible factor and an encouragement for parents with younger heart kids to start seeing a dentist as young as possible! Dr. Beck is hopeful that we will just need bi-annual cleanings from here on out.

When we got to Luke, Dr. Lord (the anesthesiologist!) was holding him in a chair wearing a pink pull-up (Luke, not Dr. Lord). Luke was so ticked and had had an accident. So while Nurse George was changing the bed, Dr. Lord was holding Luke until we got there. There is not much more in life that I'm thankful for than good nurses and doctors. George told us first thing, "Your son was NOT happy with me for putting a pink pull-up on him, but it was all I had!" Later in the day, when his I.V. was taken out and we were getting close to discharge, Luke asked, "Can I take these pink underwear off now?" We had forgotten about them, but he hadn't!

God definitely answered our prayer to help Luke come out of anesthesia easier than in the past. Instead of 2 hours of misery, moaning and crying, it was only about 40 minutes yesterday. Once he was able to say his tummy was hurting, we got Zofran in him and he settled down almost immediately. Watching your child come out of anesthesia is just plain awful. I'm sure some kids come out easier than Luke, but watching him so agitated and uncomfortable and not-himself is hard. After the Zofran, Luke watched some Phineas and Ferb in my mom's lap while I nursed Laney before I burst. From that point on, it was just a matter of making sure Luke was eating and drinking, and that he wasn't in any more pain. By noon, the I.V. was out, the pink underwear were off and we were signing discharge papers. By 1 pm, we were at Target picking out a new dinosaur. Thank you Lord!

At Target, we also picked up pudding, ice cream, Jell-o and Motrin.

As of this morning, Luke is playing cars and not even needing the Motrin. We are so incredibly thankful yesterday went so well and so thankful for your thoughts and prayers. We are continually overwhelmed by people's thoughtfulness and care for our family.

We will follow-up with Dr. Beck in six weeks. In the meantime, we'll be brushin' and flossin' fools!

Sunday, August 21, 2011

Powerful prayer

Our family believes in the power of prayer. We believe that God hears us and responds. No, not always in the way we want, but He does respond out of His goodness. We trust Him with Luke tomorrow and ask you to pray with us that 1) He guides the dentist's, nurses', and anesthesiologist's hands; 2) Luke comes out of anesthesia easier than he has the past few times; 3) there are no complications; and 4) Luke wouldn't be traumatized in any way.

Luke is calling tomorrow "Crown Day!" and is actually excited because after "Crown Day", he can chew on both sides of his mouth!

You're going to do great, Mr. Luke!

Tuesday, August 9, 2011

We have a date

Luke's dentist called this morning and they were able to get Luke's surgery scheduled for August 22nd at 8am. So thankful it's first thing in the morning. We have to go in on the 15th for his pre-op to meet with the cardiac anesthesiologist. Our dentist doesn't think the procedure will last more than an hour, hopefully less. This will include a cleaning, x-rays, fluoride treatment and then the fillings and sealants. Our boy is going to come out sparkly and shiny!

My big question to Dr. Beck was how do we make sure we don't end up back in the O.R. in a year if he gets another cavity. His response was very reassuring. He said the reason we're in the O.R. at all is because Luke is four. Luke at six or seven is a whole different story. At that age, it is super manageable to treat cavities in the office and not have to use any sedation. Our goal, obviously, is to steer clear of cavities in the future, but it's nice to know we won't be looking at another surgery if one does crop up.

We asked all three pediatric dentists we saw their opinion on why Luke got these cavities. The first guy, Dr. O., actually had a theory we are following up on with an ENT doc in September. He noticed that Luke's tonsils and adenoids were enlarged, which could be causing him to mouth-breathe at night. If that's the case (and I have seen it a few times when I check on him in the wee hours while I stumble to little miss' room) then Luke doesn't have the saliva protecting his teeth overnight. I asked him if this could correlate with how gaggy Luke is when he gets a cold and he said most definitely. Not fun to add another doctor's appointment to our summer, but Dr. O. really pushed for us to get Luke checked. And definitely not fun to think about another possible surgery! I vote these heart kiddo's should be exempt from any type of procedure not related to the heart!

Thursday, August 4, 2011

Dental drama

One thing that is increasingly clear in this adventure of raising a heart kiddo is this: nothing is as simple as you think it's going to be. We took Luke in for a routine dental exam three weeks ago, after Luke had complained one night about his molar hurting. This was at our family's dentist and the verdict was two cavities and a crack in the sore molar.

Bleh.

Dr. E. referred us to a pediatric dentist, whom we saw a few days later. This dentist, Dr. O., after examining Luke, felt like that cracked molar actually needed to be pulled as well as the cavities filled. This dentist wanted to be extra cautious, so recommended general anesthesia, which he could do in his office.

Bleh. Through tears, I scheduled that appointment and then put in a call to Dr. Stefanelli, Luke's cardiologist. "No way" was basically his response. No way was he okay with putting Luke under outside of our hospital, without a cardiac anesthesiologist present.

That left us at square one, since Dr. O. does not work out of our local children's hospital, Mary Bridge. We got a referral to another pediatric dentist with privileges at Mary Bridge, Dr. B. Two weeks ago, we went to his office for another exam — yes, that's three already! After looking in Luke's mouth, this doc had a different plan of action in mind. He agreed that Luke should undergo general anesthesia, but didn't think his tooth needed to be pulled. What he wanted to do was put caps on all Luke's molars so that in the next eight years, we wouldn't have to worry about any more cavities in his baby teeth. His thought process was that we don't want Luke under general anesthesia any more than we have to, so let's do this one time and one time only.

Okay. Plan B sounded good to us. We left there with a tentative date in early September for Luke's surgery.

Then, then, we got a phone call from a friend who knew our situation and who also worked in the pediatric dentistry field several years ago. She wanted us to know that she thought we should get a second (actually, third at this point) opinion because she didn't fully trust this Dr. B. Although this complicated matters even more, we felt like we had to get another opinion.

So on to Dr. Beck's office. After examining Luke, he suggested we try to fill the two cavities in office with the help of nitric oxide to relax Luke. This wasn't even on the table at the other's two offices, so we were excited to explore this option. The positive to this plan was — and a big one — that Luke wouldn't have to be under general anesthesia in a hospital O.R. The negative was that if Luke freaked out, we would have to stop the procedure and schedule the O.R. for another date. At this point, we wanted Dr. Stefanelli back in the conversation to help us make the decision. Was nitric oxide safe for Luke? Was this a stable enough environment if Luke were to de-sat?

This is the point in the story where I blather on about how much I love and appreciate Dr. Stefanelli. He understands that with Luke, and many of his patients, it all comes back to the heart. Decisions can't be made apart from a cardiac standpoint. He was completely a part of this decision and I trust him implicitly.

Yesterday, he and Dr. Beck talked. The decision was made to go ahead and get Luke scheduled through the hospital and not even attempt the procedure in-office. A piece of me was disappointed, but of course I want Luke in the safest environment possible, even though it means a day at the hospital.

So I had a little disappointment to work through, but also a little anger. Anger at his heart defect that complicates his little life, that makes things bigger than need be.

But he will be in the best hands at the hospital and he will get his teeth fixed and we will move on, hopefully cavity free!

Thanks to my Auntie Jen

I am stylin' today!