Tenotomy operation

We finally got a phone call last week from the surgical appliance officer. It seems getting hold of the brace was not as straightforward as the surgeons thought. There was too much red tape involved; being a preferred supplier, navigating through customs, it was all going to take too long. They had found a British importer who had a very similar brace and needed to measure Emma before deciding on the size. Once they had that they could get the brace couriered over and the operation could go ahead the next day.

Later the next day, and having Emma measured, we got a call that we could bring Emma in by 10 the next morning, nothing to eat after 7am. It was no longer to be a day clinic and they wanted Emma to stay in one night. I packed a little suitcase - prepared this time (just a suspicion it might be longer then one night). I added leggings, vests, strong shoes to walk in and not just her favourite Crocs. As you will see later, this showed I was not prepared for what lay ahead!

Emma was quite excited - looking forward to the adventure. I told her she would be a little sore after, but would feel better quickly. We were shown a bed, the same bed as the summer when she was in traction. Saw various people to answer all the pre-op questions. The SHO was lovely with Emma, instead of drawing and arrow on her left leg he drew a cat from her t-shirt. I told him I had brought with me leggings for her to wear as I'd been told the brace was not comfy against the skin. He wasn't sure but to take them to the theatre with me to hand over. The anaesthetist made it fun too. So when it was time, we left to walk over to the theatres, had to wait around a while, Emma got changed, we were asked name and dob about 2 million times! The consultant arrived with the brace, wasn't what I was expecting - it looked very futuristic, all white like Eve from Wall-e. He said it was a very simple operation, would only take about 10 minutes and the clothing I brought wasn't necessary yet.

When it was our turn, Emma was not scared. Unfortunately they had difficulty getting the needle in her hand, then Emma did cry, so they had to use gas. She held her eyes wide open when the anaesthetist said she was asleep and wouldn't remember anything, then her eyes closed and I had to leave and return to the ward.

Of course that was the hard part, she wouldn't be long and 45 mins later I was called back to recovery. Emma looked all bleary eyed, spoke with me a little, then said she couldn't see, then said everything was blurry. The anaesthetist reassured me, it was normal and she'd be OK soon. I was shown the brace, she did look like a robot. The consultant came to say hello, said it all went OK. Then told me something he hadn't mentioned before, Emma was to wear the brace for two weeks solid, only sponge bed-baths and to be non-weight bearing for the first week. So no changing of clothes and the padding wouldn't of made that easy either. The brace was against her naked skin and a bed pad had been folded up and placed as a nappy.

Now I realised my folly in the clothing I brought with me. I thought I'd been well prepared, but what about knickers - should I have been advised to get large nappies? I would have to amend trousers to fit - velcro up the sides?

Emma was comfortable till early evening till the medication started wearing off. We had to wait some painful time before she could have more pain relief. As you can see from the pic, there is lots of padding. Emma did suffer with a lot of pain that first night. She had repeated muscle spasms that came in waves. The combination of paracetamol, ibuprofen and codamol were not enough. They tried codein instead, but she was still in pain. So we both had a difficult night. In the morning we saw the registrar who said he could give something for the spams. And 20 mins later after having Diazapam they subsided.

Now I'm thinking here, surely they know this can happen - why wasn't it written up so she could have it if need be. The physio came to visit - another Emma, she was super with the kids, but had to battle with their fear of moving and the pain that might cause. Emma did not want to use the bed pad to wee in, it was not a nappy in any case. It was just going to be too painful to get her on a bed pan. So the physio was able to eventually find a commode through a lot of phone calls. I did have to leave the room for Andy and the physio to get Emma onto the commode, she hadn't been for over 24 hours! It's been a difficult day as another boy had screamed intolerably as they had the cut his cast after just having a big op on his leg.

I listened to Emma scream from the parent room, not for too long, and a great relief to go to the toilet. If we could have a commode at home we could leave, a wheelchair wouldn't be available till after the weekend. In the end, they said they couldn't deliver till the next day but Andy volunteered to go get it from the warehouse. So a mad dash was made - too much traffic, but they waited. In the meantime Emma became very uncomfortable and decided she preferred to stay another night. Good job she did, as the evening progressed her surgery site became very painful and she started screaming with the pain.

This went on all through the night, with small breaks when she'd conk out, then resume again when she woke a few minutes later. It was terrible for Emma, me and the other poor kids in our ward. The nursing staff came when they could to give her more meds, but nothing quite broke through. By daylight it had eased a bit, but she was so pail and unhappy. The registrar arrived, surprised to see us. I told him what our night had been like. He decided to issue oral morphine, if more unbearable pain happened.

This we hadn't really been prepared for. Having been told it was a simple little op, would take 4 days to get use to moving in the brace I had just assumed, she'd be up a walking in days - actually walking out the hospital, and she'd be a bit sore. It may be a very simple operation, but for some children, it is very painful.

We did return home later that day, after a dose of morphine for the journey. Although our med bag did not contain any strong pain relief as I was told she'd have, in the end she did have a good night. By the end of Saturday, she started moving herself around and by Sunday Emma was a new child. No apparent pain and throwing herself around our bed! How these kids feel so better so quickly after being in so much pain - it is a real wonder.