One More Time, With Feeling

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So … I guess I never officially updated everyone regarding the outcome of Bean’s tear duct probe in April. It didn’t work. Gah.

The local ophthalmologist advised that we should see 100% improvement in three weeks. I was supposed to call him if things hadn’t completely resolved, at which point he would refer us to a pediatric ophthalmologist at Children’s Hospital. I think I waited like seven weeks before calling. I was really, really, really hoping that she would just magically wake up one day and it would have worked.

So what happened, right? Well, the local ophthalmologist, Dr. H., advised us the morning of the surgery that if the probe “got stuck,” meaning he got to a point where he couldn’t pass it all the way through, that he would stop. He didn’t feel comfortable trying to push it through. That sounded reasonable.

Well, that’s what happened. He got about 75% of the way through and stopped. Not being able to pass the probe completely through dropped the success rate down closer to 50%. Double gah.

In June we moved on to a consult with Dr. R, a pediatric ophthalmologist at Children’s Hospital. This man has a wonderful reputation for being extremely skilled. He and his associate are also in great demand, which is why I waited 45 minutes after my appointment time to see him, and then the appointment lasted about an hour longer than it was supposed to. They failed to tell me that they would have to dilate Bean’s eyes (AGAIN. THIS WAS THE THIRD TIME!), which takes 30 minutes to take effect. Oh for the love. And why they don’t have toys for the children to play with, in the waiting room at a Children’s Hospital clinic, is beyond me. It was a really long appointment.

Basically, I advised Dr. R that while I had seen some improvement, the issue was definitely not completely resolved. He thought it seemed reasonable to give it a couple more months to see if it would continue to improve on its own before scheduling the second surgery, which involves placing a silicone stent in her tear duct to keep it open. Dr. R said that sometimes as children age and grow, their face structure changes and these things can open up on their own.

So we waited three months. And nothing really changed.

I finally called in September to schedule the surgery when I realized that Bean had already met her deductible for the year and was only $1,300 away from meeting her out of pocket max, and there ain’t no way that surgery is costing less than that. Suddenly I was in a mad dash to get that sh*t taken care of before Dec. 31, 2011. Plus, guess who gets sick in the fall? EVERYONE. Especially kids. Especially kids who have older siblings who are now IN SCHOOL.

And they don’t let you have an elective surgery, with anesthesia, when you’re sick. Something about your lungs and making it harder to breathe and ending up with pneumonia and OMG don’t even mention anesthesia and fever in the same sentence. It’s grave. Very grave. It involves serious and grave things like dying.

So I call in September and Dr. R only does surgeries on Tuesdays which put us at …. oh … November 22. Seriously. Prime sick time, and leaving basically no time to reschedule before the end of the year if Bean happened to get sick. I told Dr. R’s LOVELY assistant L, that if there were any cancellations to PLEASE CALL US and that we would DROP EVERYTHING to make it work.

She called Tuesday. WHOO POO! Bean is scheduled for next week Tuesday, November 1.

After I accepted the new, earlier date on Tuesday, Bean woke up with a gunky nose and a slight cough on Wednesday. My instructions for surgery said to call to reschedule if they developed any sickness, including a cold.

I just looked up and said, “You’ve gotta be joking, right?”

But I called L and she said as long as she doesn’t have a junky cough (meaning in the lungs) or fever, it would be fine. “These anesthesiologists don’t even think twice about a cold.”

So Bean had her pre-op physical yesterday and her pediatrician concurred that she was perfectly fit for surgery, and that if anything came up I could bring her back in Monday for one last check.

So I am praying that Bean stays status quo (NO FEVERS) until Tuesday morning at 6:30 a.m. when we have to be at the surgery center, very far away from our house. It’s gonna be an early morning, folks.

Because, seriously, you know they already gave away that November 22 date, right? So if for some reason she does end up getting really sick we’re totally screwed in terms of rescheduling it yet this year. (You might be thinking that I’m overreacting a bit to the whole rescheduling because of being sick thing, but we did actually have to reschedule Bean’s initial tear duct probe because she got sick.)

Not to mention we had to practically move heaven and earth for Husband to get the day off of work to come with us, and Monkey has to spend the night at her Nana and Grandpa’s house on Monday night, and her Mimi (my mom) has to pick her up from school on the Wednesday after Bean’s surgery when I have to truck back down to the clinic for her post-op follow-up appointment. It’s these moments where I really feel for my friends who have to regularly move heaven and earth to accommodate frequent trips to Children’s.

In retrospect I wish I would have asked more questions of the local ophthalmologist, Dr. H. about the steps for Bean’s treatment.

I was under the impression that if a probe didn’t work and we would have to move to placing this stent, that we would also have to schedule a follow-up surgery to remove the stent. As it turns out, likely not. Dr. R said that he usually just pulls the stent out of the patient’s nose in his office at a follow-up appointment. So no second procedure (=anesthesia) required.

Also, what Dr. R usually does, and what he’s planning to do with Bean, is try the probe first. Unlike Dr. H, who is not a pediatric ophthalmologist, Dr. R does feel comfortable “pushing it,” and may be able to get the duct to open, and no stent would be required.

However, if he can’t, he’ll just go ahead and place the stent. So basically, Dr. R could have done what Dr. H did, except better, plus he’s capable of performing the second procedure, whereas Dr. H isn’t (at least with a kid). So if we had asked for the referral to Children’s right away, Bean would only have had to undergo anesthesia once, and we would have only had to pay for one surgery.

Ugh.

I really wish we would have just asked for the referral right away. Which is nothing against Dr. H — I really like him and he was super nice — I just think that if given the option of choosing a “pediatric” provider again, we’ll probably just do it because it likely will save us time and money in the long run.

Live and learn.

On the upside, I’m not nearly as apprehensive about the procedure this time based on how absolutely uneventful her initial procedure was. It was almost like a joke how fast it went. They took her back for surgery at 7:30 a .m. and within 10 minutes the doctor was coming out to tell us how it went. We were home by 8:20 a.m. No joke.

Overall, Bean handled it beautifully. Before they took her from us the nurse gave her Versed, which is like an amnesic drug that relaxes you and makes you a little loopy. The nurse said that she wouldn’t remember being separated from us (so no screaming and crying as they took her away, as I had envisioned). And when the anesthesiologist came to carry her (not wheel her away strapped down), she didn’t cry one bit. I guess she did wake up crying and wouldn’t let any of the (female) nurses hold her. She only allowed the (male) anesthesiologist to hold her, which all the nurses thought was wildly funny. By the time we got to her, she really wasn’t crying at all anymore. She was perfectly fine the rest of the day and since Husband had off of work we picked up Monkey, went out to lunch and went to the park!

I’m hoping that next Tuesday goes similarly.

So … that’s the scoop. I’m extremely grateful to anyone who might take a moment to send up a quick prayer that Bean stays healthy for her surgery, and that it goes well, and that it works!

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3 responses »

  1. I’ll say a prayer that everything goes smoothly for Bean. Like you, I really wish the professionals would be upfront w/ everything in the beginning instead of requiring everyone to jump through a million-and-one loop holes. Also, grrr…that they don’t get how this insurance thing works for the average American, or grrr.. that the do get it and they simply want more money :oP Either way grrr…at the whole process. I will say that we are super lucky to have such a wonderful hospital w/ such top notch doctors so close to where we live. We are super lucky! Thinking about all of you on Tuesday and praying for status quo :o)

  2. Oh geez!! I didn’t even see this post until TODAY because I didn’t get an email! Sorry. :/ I’ll pry right now and make them go back in time! I do hope everything went well for Bean! It’s funny because I was actually thinking about her the other day and wondered how her eye was doing.
    I don’t think you could have said it any better. “Live and learn.” I don’t think anyone really knows all the questions to ask or understands all of their options when dealing with their child’s healthcare. That’s why Children’s is such a fantastic resource for families. You know they’re some of the most skilled pediatric professionals in their respective fields. That’s a huge comfort for parents! I’m AMAZED at how much I’ve learned sine having the girls almost 8 months ago. Even though I’m going there regularly, I feel like I still have a lot to learn. Even so, I know that they’ll have an answer for me 99 times out of 100. That’s also a huge comfort for me. It’s funny how you said you were all worried the first time and it went SO much better than you anticipated. The two hour surgery Peanut went through at Children’s had me in an UPROAR for about a week beforehand. Now, I’m like you, I think for any future surgeries I’ll be MUCH calmer. Oh… and thank GOD for Versed, right?!

  3. Pingback: (No More Nukie) WOW OH WOW! « On the Night You Were Born

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