June 1, 2013

I seriously can't believe it is already June! Time is just flying lately, and summer will be over before we know it. To follow up with my last post, Maksim's echocardiogram results were great! It showed no pulmonary hypertension, no PDA (patent ductus arteriosus), and a small PFO (patent foramen ovale). The PFO will hopefully close on its own soon. Everything else looked healthy and normal. It was a huge relief!

Before I get started on the hernia surgery, here are a few pics as of late. The first is of Milyn earlier this week. Poor girl got a sty in her eye and looked like she had been beaten up! I also took one of her new haircut! And then there are a couple cute pics of Maks without his oxygen on after a bath.














We headed to Boise for Maksim's hernia surgery last Thursday, and surgery was scheduled for 8am on Friday, May 24. We arrived at St. Luke's at 6am and waited and waited. We finally got into the pre-op room about 7:45, and about that time the surgeon came in to tell us that he had an emergency surgery that he needed to do before Maks', so surgery wouldn't be until 11. Maks is so easy-going, but the poor kid got so hungry. He hadn't eaten since 3 that morning.

Dr. Curnow finally finished his surgery and came in the room to talk to us about the procedure. He said he was excited to see us. If you remember from before, we were very frustrated as to why he wanted us to wait until now to do the surgery when we were already in Boise the week prior. It turns out he went to a conference in Spokane, WA the Thursday before Maks' procedure was scheduled and learned a new technique of performing the hernia repair. It is a laparoscopic version that eliminates the risk of compromising circulation to the testicles. It also has a very low recurrence rate. The best part was that they would be able to fix both of his hernias and eliminate the need for another surgery. The surgeon was excited to see us because he knew he would be learning this procedure and that Maks was a good candidate who would benefit from it.

So, he just learned this procedure, and he had never performed it before. Maks would be the first ever laparoscopic hernia repair at St. Luke's. I was somewhat leery of this, but he is the best pediatric surgeon in the state, and Logan and I felt confident in his skills. I was also comforted because I felt like God was watching out for us before, and this was the reason we needed to wait for the surgery. It sure makes you feel like a complete idiot when you doubt The Lord's hand in your life, when, with just a little time and patience, His plans start to reveal themselves.

We also spoke with the anesthesiologist. He said he was going to do the best he could to avoid giving Maks any IV narcotics. He would use a procedure called a "caudal" which injects medications into the caudal portion of the spinal column. He said he was hopeful that it would work, but micro preemies often have a small caudal space, and it may not be possible. He also said, even if the caudal was successful, if Maks' blood pressure or pulse became too elevated, IV narcotics may still be necessary.

We were so pleased to find out, at the end of the surgery, that the caudal was successful and that Maks required no IV narcotics. I can't even begin to say how much of a difference this made! Maks came out of this surgery so much smoother than his eye surgery. He didn't have the sedation in his blood stream, so he quickly came off the ventilator and was breathing on his own with no episodes of apnea or bradycardia. He also had plenty of energy to eat, so no feeding tube had to be inserted.

Here is a pic of him after his surgery. He had four small incisions: one in his belly button and the three along his lower abdomen. He also had a needle puncture site in his left upper abdomen where they filled his abdomen with air for the procedure. You can tell he still has quite a bit of air in his belly in this picture.





After the surgery, Maks stayed in the post anesthesia care unit until he was able to eat on his own. This was only an hour or so. He ate great and was transferred to the pediatric floor. This was the beginning of a very long night for Logan and me. Maks was a champ, and he was a pretty happy baby for most of the time, but he had some pain, and he definitely had a hard time sleeping. I ended up sleeping a good portion of the night in the crib with Maks to help him stay comfortable, and Logan had just a few cushions to sleep on. We survived, though, and we were so ready to leave first thing Saturday morning. Unfortunately, Maks was a little swollen and tachypneic, so Dr. Curnow ordered a single dose of IV Lasix (a diuretic) to be given, and said we would have to wait until at least 1pm to leave.








We were so relieved to get out of the hospital, especially knowing we wouldn't have to come back for another hernia surgery! Thank goodness my good sister, Lindsay, shared her home with us so we could have a comfortable place to stay that night before heading back to Idaho Falls. I am also thankful for her good husband, Mark (a nurse anesthetist at St. Luke's), who recommended Dr. Curnow, and made sure a good team of pediatric anesthetists and anesthesiologists were present for Maksim's surgery.

Maks has been doing very well since the surgery. He travelled well to and from Boise and didn't suffer any major setbacks. He is even maintaining his oxygen tremendously well. He has been on room air while he has been awake for at least the past 3 days, and he has only been requiring oxygen when he sleeps and when he travels in his car seat. We are cautiously hopeful that this will continue, and that he will soon be off the oxygen and monitors for good!

I can't thank everyone enough for your prayers. I know they are being heard, and I know that God is watching out for our little Miracle Maks. He has beaten so many odds, but he still has so many difficulties to overcome. As I work with occupational therapists and doctors and vision specialists, I am overwhelmed by all of his "disadvantages" and "developmental delays." Raising a micro preemie is so different than raising a healthy baby. I remember with Milyn how I was amazed at how advanced she seemed to be. She always seemed to be doing things months before she was expected to. Instead of being excited as new milestones come, I am constantly having to watch to see if Maks can even do the minimum expected for his corrected age (age based on his due date), let alone his actual age. I still keep thinking "I just don't have time to be a good mom to a micro preemie." I feel like I need more time to be able to devote to helping him reach his milestones. He needs so much attention and encouragement, that it is easy to get overwhelmed. Every time the therapist comes, I feel horrible because she is always giving me more assignments or little things to remember to do with him, and I just know I can't do it all.

Things are just different this time around, that's all. I know things will come with time, but in the meantime, the watching, and waiting, and comparing are stressful.

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