Sunday, April 26, 2015

Strabismus Surgery in a 3 year old

It has been almost a year since Tommy had his eye surgery.  It was a much easier recovery than I expected and overall it went very well.  It just has taken me this long to re-visit it.  I tried to take a lot of pictures of each phase- just in case anyone wants to see the gruesome details.  It was much less scary than I anticipated.

The before:  Headed to the hospital at 6:30am.  Based on recommendations from the child-life specialist, we did not share a lot of details.  Tommy knew he was going to the doctor and knew they were going to fix his eye, but he didn't ask too many questions.  We thought it was best  to just not make a big deal out of it.  (We are very happy with this decision)

Check-in 7am- it was a busy morning, so my best laid plans of meeting with child-life was not happening.  But, we brought toys and just hung out.
They take us back around 7:45 am to do general vitals and get him ready.  This wasn't scary for Tommy, he's been to the ER a time or two.  He just liked having both mommy and daddy's attention!


My biggest fear was that this surgery would make patching and contact and drops and eye exams... much more difficult.  Tommy is extraordinarily tolerant and compliant with all of his eye stuff.  I was paranoid that this would change all that.  They assured us that they would give him medicine that would keep him comfortable- and make him forget.  This is Tommy right after midazolam.

He just got silly, a little slurred, and completely relaxed.
Note:  The black dot is standard procedure to mark the eye that is to undergo surgery

Medicine is in full effect- life is good for this boy
8:36 am:  And then things got real.  Totally zoned out.  Of note, we also asked for anti-nausea medication.  I had eye surgery as a kid, and can still remember the awful nausea.  I did not want that for him.  That added to the drowsiness.
This photo breaks my heart a little- totally out of it.  Necessary, but sad.
Next came the waiting.  It felt like 3 million hours, but it was closer to 1.5 hours.

9:45 am:  We get word that things went well and we can see him soon.  We can breathe again

10:00 am:  We get to hold our little boy.  Completely out of it, crying off and on, not seeming to be aware that we are there.  But feels oh so good to have him in our arms.
Eye is puffy and red, but he hasn't opened it yet
Bloody tears:  We were told to expect this, which I am glad.  It is a little strange to see (and a little scary)
Close up.  Single bloody tear.
Tommy had given up his pacifier by this time, but was very uncomfortable.  I  had one in my purse and we offered it to him for comfort.  He didn't really suck on it, but it did seem to calm him a bit.  The next 45 minutes or so were tough- he seemed very uncomfortable, but had not completely come out of anesthesia.  Cycles of moaning and discomfort and restless sleep.


The medicine worked- no vomiting.  The recovery room was full.  At one point they said he would be there for a little while, then what seemed like minutes later they were packing us up to go home.  Packed with washcloths (for the bloody tears) and crackers, we were on our way home!
Looks a little roughed up
11:59 am:  In the car- on our way home!  (I had thought we would be there until 3pm, so this was a nice change of events!)

12:37pm:  All smiles at home!

Ipad time!  Life is good.
The rest of the day was uneventful.  Tommy acted like any other day.  I was amazed.

Day 1 post-op:
6:31 am:  A little more puffy
The rest of the day was life as usual.  It was a little hard to keep him quiet, but all was well.
8am:  After getting up and moving, a little less puffy


10am:  Eye opens a little more- definitely bloody.
7pm:  More open, more visual proof of the surgery
Day 2 post-op:  What surgery?
crazy kid
8pm:  Each day it opens a little more.  The doctor had said "a day or two" to put the contact in.  There is no way I'm trying it today.

Day 4 post-op:  Eye open, very red, still not putting contact in- he's been through enough!

Day 6 post-op: Contact and patch!  Back to 100% normal!
Still red sclera, but he claims he can see and is not bothered by contact.

1 week later:  No one would be the wiser.
It took a few more days for the eye alignment to show- but here we are 10 months later, and he still has great alignment.  We've got new prescriptions in our glasses and contacts and a new drop to help control his pressure, but are very lucky!
10 months after surgery- what a grin!