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!

No bad news doesn't mean GOOD news

This blog has been neglected- I apologize.  In reality, Tommy's eye is just such a small part of any given day that I don't have anything to share.  I have plans to post his story about the surgery- but I'm still processing that (yes, it has been 6 months!)

Patch pics even made the Christmas card this year!

We change his contact every day so that the timolol drops don't destroy the contact lens any faster than normal.  (the preservative in the drops can damage the contact- those babies are too expensive to risk it!)  When I first started- weekly changes felt like a huge burden, now daily insertion/removal seems like nothing.  (There's hope for you new parents out there- I promise it gets a little easier!)

We patch 4-6 hours every day- we now use only 1 patch per day.  This seems like such a far cry from when he was about 1 year when we went through 10-12 patches... sometimes in one hour!  (More hope for you newbies!)

Tommy wears bifocals- he doesn't love his glasses, but he generally keeps them on.

One thing hasn't changed- I still wish people had more tact.  Our latest interaction came at our local library.  A little girl (the youngest of 9 children- she's probably ~2 years old) came up to Tommy and pointed at his patch and said "Get that off your face RIGHT NOW!"  It was probably cute, but it irritated me.  Made me sad for what Tommy has yet to face with his peers.  Still want to scream when someone points it our rudely.  (yes, I know she is little, but to Tommy, it's still sad!)

So- basically no news.

He loves the play structure at the ophthalmologist!

Today we saw his ophthalmologist.  I could complain about the doctor-in-training who didn't know much about Tommy's history (hello, please read the chart just a little- basic medical school principle!)  But, what hit me the hardest is that Tommy will have to have a corrective lens in his GOOD eye.  I've been counting on that GOOD eye to carry us through his life.  His good eye was supposed to be the one that will allow him to read easily, to see the chalk-board at school, to drive normally.  All this work on his "BAD eye" was just supposed to be for "back up".  However, he is only seeing 20/25 in the good eye, and it should be better.  Much of me wants to protest- to say that he just didn't recognize those stupid pictures, he's shy, you didn't ask him enough, he's playing.... but deep down I know it's needed.  I also know that this isn't a death sentence for the eye- a small corrective lens in glasses he already wears will not change our life.  I know that lots of kids (with out cataracts) need corrective lenses and can still read, see the chalk-board, drive...  I just don't want it.

Dilated eyes- eye appointment craziness!

 What I know most deeply, however, is that for Tommy- he will take his cues from me.  I cannot show him disappointment.  I cannot show him that glasses or contacts or patching is anything but us working to make his eye as strong as we can.  None of this is about ME.  Tommy is the only one who deserves any kind of pity party- and so far, he is one of the strongest, happiest kids I know.  While he complains about wearing the patch or that he doesn't want a contact- his complaints never last more than a few seconds.  For this, I am eternally grateful.