Yesterday in the holding room before Diego’s surgery I was chatting with the nurse who would assist in the procedure, lamenting that this would be Diego’s third surgery in three months and the nurse replied, “Surgery breeds surgery.”
**Note to all medical staff: this is not information that you should tell a mother before her child goes into surgery, or at any point before or after a child’s surgery. In fact, this is something you should maybe only bring up at a cocktail party while making conversation or perhaps before an elective procedure. This is not something to say to a mother of a three year old cancer patient, who has enough to worry about.**So, that started off the evening. From my experience here at Kaiser, the pediatric surgeons have no bedside manner. This may be true of surgeons in general, but neither surgeon who has operated on Diego here has instilled me with a high level of confidence that he is the best person for the job. I have found some solace that the pediatric surgeons are all “on loan” from Oakland’s Children’s Hospital, but compared to our experience with the surgeons at UCSF they have come up short. Before surgery I had only spoken to the surgeon by phone. He was heavily accented so I felt the best place to talk would be in person. Prior to the procedure I asked him about risks, and he spoke about the risk of finding dead tissue requiring removal and resection the bowel as being most high risk. Not necessarily the resection but the 50% odds that the bowel would not repair after resection. So, post surgery when he told me that he did not have to resect the bowel, I was relieved. But, when he told me that he found “a lot” of abdominal adhesions which put him at a 30% risk of another bowel obstruction, I was not pleased. I had not been warned about this. The adhesions were apparently caused by radiation and surgery. And when I started to ask the surgeon questions about Diego’s long term prognosis, would he have gastrointestinal issue for life, etc and he told me not to worry. Okay, this made me laugh out loud, I told him “You’re telling a mother not to worry…this is impossible.”
Since then I have been researching therapy for abdominal adhesions. While Western medicine does not seem to address it, some information is available about massage/physical therapy, so I may look into that. I’m not sure if my level of concern is appropriate to the increased risk, but I am really unsettled by this. I need to keep remembering that the odds are that he will be okay.
One day post-op, he is doing well. When I came into see him last night in PICU he was sleeping peacefully. He looked great- good color, calm, and at rest. His surgery had been pushed up a few hours so it was only about 10pm. I opened up the cot and went right to sleep. Sometime later I awoke from a deep sleep with Diego’s crying, and I jumped out of the cot. “It’s the wrong bed!” he wailed. (They had put him in a crib, and he was incensed! He is, of course, a big boy after all!)He was transferred this afternoon to the floor and slept much of the day. His pain controlled with morphine once again, albeit in smaller amounts. Right now he is lying in bed watching a Curious George video, narrating it for me and asking me questions. It’s wonderful to have him so alert so soon. So far, the recovery is so much faster than the last couple of times. So, perhaps things will really be okay.