Saturday, January 14, 2006

A long day - a long post.

We came, we saw, and we got through a very tiring day. Today, the little monkey faced down another biopsy - this one was called as "annual." Regular biopsies measure any signs of rejection of the heart organ. This biopsy was more comprehensive in that it also evaluated any signs of deterioration of the major cardiac vessels. Regular biopsies take about an hour or so, plus recovery time. This one took two hours for the procedure and four hours of recovery time in the hospital. That doesn’t count the endless hours of waiting for the procedure itself to commence.

Any surgery carries risks. The old monkey and I are so well versed in the laundry list of potential risks associated with heart biopsies that we usually skip that part when the anesthesiologist or attending comes in to speak with us. (Boy, these kids are looking really young lately. That inspires confidence.) I do remember the first time an anesthesiologist explained the possible risks associated with a biopsy and sedation. I think I had a mild out-of-body experience when he said the word, “stroke.” It’s a little fuzzy. I know a year or so was shaved off my own life span after that. These days, we take it in stride.

There are some things I completely shy away from though – first among them is standing witness to the actual act of sedating the monkey. I learned that lesson the hard way. And although it makes me cringe to watch him wheeled away into the procedure room, alone, I know I am not doing him any favors by watching him struggle as the doctor slips a gas mask over his face. I’ll opt out of watching that because it does neither of us any good. Watching someone so little, in such a big, big hospital gurney-bed is a disturbing sight. It crushes me to see someone so small have to face something so big, all on his own. I wonder what is going on in his mind as he is wheeled away, bright light all around him, and strange faces peering into his eyes. If only he wasn’t so little.

The hardest thing from my perspective is depriving the monkey of food or water. You’d think such a picky eater would be indifferent to the absence of food. But apparently, when the monkey is hungry, he is REALLY, REALLY HUNGRY!!! Or thirsty, as the case may be. The drill is as follows: No food or formula after 2:00 am. From 2:00 – 6:00 am, he can have water or apple juice. After 6:00 am, nothing on. The little monkey was scheduled to be at the hospital at 8:00. Since another patient was scheduled ahead of us (a scheduling disaster from our perspective), I estimated that the little guy would not go in for sedation until 11:00 am. So, armed with this timetable, we planned.

The day before the biopsy, I force fed the monkey round-the-clock with all manner of food that I knew he liked and would eat … a lot of. Nutritional considerations were laid aside, in favor of the practical necessity of getting him full. Thus, the day’s menu consisted of yogurt, fortified thickened rice cereal, mashed potatoes, potato bread, veggies, crackers, cheese, cheerios, fruit bars, and formula at every opportunity. We even decided to wake the monkey up at 1:30 in the morning, the day of the procedure, to feed him another bottle before his window of eating opportunity was closed. He took a few ounces, under protest, and tried to settle in for some sleep. But we woke him up again at 5:30, to offer him some apple juice and some water, while he still had time. That was flatly rejected.

At that point, we were up for the day. (Oh what a beautiful morning! Oh what a beautiful day!) We left the house shortly after 7:00 am, accompanied by the whining sounds of little monkey who was beginning to notice the lack of a breakfast bottle. But there was so much ahead of us to do – check in, paperwork, poking with a stethoscope, weigh-in, blood pressure tests, height measurements, and of course our favorite – the timed blood draw. A detached observer might note that five vials of blood drawn from the small veins of such a little monkey might seem a bit excessive. But, we chalked this up to the comprehensive nature of the annual. So as to give you a full sense of what it was like to be there, imagine a soundtrack of blood-curdling baby screams playing in the background. Ahh, bliss.

The nursing staff at the cath lab was great. They deserve a lot of credit. They did what they could to comfort the little monkey and keep him relaxed during the hours while we waited for him to be taken into surgery. Babies awaiting biopsies on empty stomachs don’t make the best patients. Despite their diminutive status, they have very big wants – chief among them, food. Although they can’t communicate with words, they make their displeasure known. Loudly. And the little monkey did not let us down in this regard. We packed a suitcase full of toys to keep him distracted, but there’s only so much block stacking and rattle shaking you can tolerate when your stomach is rumbling.

Finally, it was time. The little monkey was wheeled away, and we settled in for some anxious hours. We ate, read the paper, dozed, and hoped for the best. Two hours later, the little monkey was brought back – groggy and glassy eyed, but still our monkey despite it all. As the effects of the anesthesia wore off, we were permitted to feed him a few ounces of water, then formula, then his medications. Gradually, he began to lift from his very drugged out demeanor, and make the monkey noises we know and love. More feeding followed, as well as some impressive diaper displays. Cartoons worked for a while to keep him calm, but the next four hours of recovery and observation time were long and tiring.

But the little monkey made it through them, and eventually, we were discharged. As usual, he made it through the ordeal with more smiles than I could muster, a few laughs, and a lot of resilience. His patience puts me to shame. Initial assessment by the doctor is positive, although official results will have to wait till next week. And so we settle in and wait some more. Stay tuned.
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