What a way to start a post. I never would have imagined this header on any post of mine in my wildest dreams (or nightmares). Peyton is back from the operating room and we are excited, if you can use that word in this situation. The surgeons told us his surgery was a success, and though it is too early to tell if this will be the "end of the story," we are hopeful that it will be. The last two weeks have been an interesting ride with him. To explain why though, I have to summarize the whole process - bear with me.
Peyton started having tummy pain Tuesday, January 20. His appendix was hiding on all ultrasounds and x-rays so it burst unknowingly sometime before Sunday, January 25. The doctors now think it had been ruptured for quite a while, considering the damage that was done. Peyton seemed to recover alright from that incident but shortly before our intended discharge date he started having tummy pain again. In spite of preventative action to alleviate a bowel obstruction, he ended up with a full obstruction that had to be managed with surgery. On Friday, February 6th, he underwent bowel surgery to free up any adhesions and investigate why he had obstructed. We quickly learned that adhesions can be quite problematic and that they are places where inflammation has caused the bowels to become raw to the point that when they are healing, they adhere to something they shouldn't (best example - have you ever cut your hand and had a flap of skin that you pressed back down and it grew back together? Similar effect inside the stomach- an injured piece will stick to anything close). These can cause obstructions, as can scar tissue, so we didn't know what might be causing the problem for sure. When they went in, the surgeons found that he had adhesions, but there was a more likely culprit as well - he had 3 holes in his bowels from the afore-mentioned damage. These caused more abscesses, thus, more inflammation, and of course, more possibility for additional adhesions. Oh brother. Peyton recovered from this surgery quickly and we made discharge in under 3 weeks - for a grand total of a 5 week stay. Since that point, he has had tummy pain almost every day, for a minimum of 1/2 hour and up to a couple days in duration. He has had 4 admissions over the last 8 weeks, to try and manage the pain and ensure he doesn't go to a complete obstruction (he has been admitted for a partial obstruction each time). We were beginning to think it was going to be a way of life, or that the healing process for Peyton was fraught with more than the average difficulty and could last quite a bit longer than usual. Even the doctors were not sure what to make of his tummy.
All of the radiation variations done on his tummy (x-ray, ultrasound, CT-scans, etc.) suggested he had a partial obstruction, but the radiologist reports were inconclusive. Our surgeon said there was a questionable piece of bowel that might be causing the problems, but he said it might just need time to heal. It looked like there might be an area where scar tissue was not healing right, causing a tightening/thickening of the bowel.
A week and a half ago on Wednesday, Peyton started having more tummy pain again and by Friday (with constant cramping) we were back for the 5th admission. This time the CT-scan showed that same spot to be a possible culprit to all eyes - the bowels were distended on one side (the small intestines looked like large intestines) and collapsed on the other side. The surgeon came by and gave us our choices (I said I didn't want to make any more choices of this magnitude...). Choice 1) Take Peyton home and continue dealing with the tummy pain as best we could until he healed or until he fully obstructed. Choice 2) Let the surgeons inside Peyton's tummy to see what they could do. We talked with another surgeon who has been so helpful, to get a second opinion. She agreed. Groan. Sigh. Pause. Think. Pray. Cry. Nod. Act... don't think.
Last Wednesday we decided to let them operate. We set a date for this Tuesday.
The goal: free up any adhesions that may be causing a kink in the bowels, check for areas of scar tissue that might be contributing to the obstructions and investigate for any other possible causes. They told us going in that they may have to take a piece of bowel out if scar tissue had caused damage, and that, worse-case scenario, they might have to do a temporary ostomy (bring the damaged pieces of bowel to the surface until they healed). We were hoping the problem would just be some rogue adhesions and that Peyton would not lose any of his intestinal length, but they didn't think they would need to remove that much if they needed to.
Jordan and I were placing bets last night as to what Peyton would say when he woke up this morning - I think I won. First words out of his mouth, "Mommy, is this tomorrow?" We spent the next hour discussing whether or not today was tomorrow and where Tuesday fell in the grand scheme of things. We came to the conclusion that today was Tuesday, that he wanted to have his surgery tomorrow, and that today wasn't tomorrow. After that, he informed me that he didn't want an operation, but that surgery would be ok. We talked about that for the next hour in between conversations about why he couldn't have food. I exhausted my distraction techniques quickly in an attempt to divert conversation! All things considered, Peyton did amazingly well, and he was so brave as he went off to surgery. You would have thought he was going for a haircut. As he laid on the operating table, he put his arms behind his head like he was laying on the beach and took the "gas mask" without batting an eye.
Peyton went in at 11:20 a.m. and was out of surgery at 3:15 p.m. He travelled from the OR to the recovery room then where he charmed the nurses with his less than friendly smiles for the next 3 hours while they tried to manage his pain. That proved to be the most difficult part of the process and we are still working on that one.
The surgeons came by and told us they were very happy about how the surgery went. One of the surgeons was fairly bubbling with optimism and excitement over how it had gone. It rubbed off and Jordan and I have been in very good spirits this afternoon and evening, in spite of the deferred pain over Peyton's discomfort. They said there was no question as to what had been causing the problem when they went in. There were two places where scar tissue had tightened the bowel to the point that very little could get through. In one of these spots, there was only about a small pinkie's worth of space for things to pass through! She didn't know how he had lasted this long! It was such a relief to hear that we had made the right decision. We had been praying for peace over our decision and felt like we were making the right one, but how good can one really feel about turning your child over for surgery, when they seem to be healthy??!!! I can't begin to tell you what it felt like when we heard that Peyton would have either had significant long term problems or more likely emergency surgery within the next few weeks if we had waited. He should have a much better recovery considering his body was strong and fairly healthy going into surgery.
Peyton is not quite himself right now, as you can easily imagine. It's debatable whether he likes the catheter or the NG tube less. He hasn't noticed the central IV line in his chest yet and has already resigned himself to deal with the IV in his right hand, but he hasn't said a word about it - he just waves the cords around until he gets them where he wants them. The five inch incision on his tummy overtook an existing scar (for the third time) so he will be able to get used to that, but it's pretty sore right now. He did give us a smile tonight though and actually thanked me for something (we picked the right mix of pain meds this time I think!!!). I am hopeful that he will be feeling better tomorrow.
Thank you for all your prayers - we all had a surreal sense of peace and contentment with the situation today and that is the only explanation I can find. I will try to describe the feeling in a later post. We have been through many memories today too, that I am both thankful for and wistful about. Please continue in prayer for our family as we journey through this and pray specifically that no more problematic adhesions will form, and that the scar tissue around the two resections will heal very well. I have one more request - my sister-in-law (Nicola) had a beautiful baby girl last week (Lyla Claire) and Lyla needs prayers that she will have the energy to eat and to clear her system of any jaundice. Please pray that God will bless Nicola with peace as well. Thank you again from the bottom of my heart!!!