Monday, 18 March 2013

Inguinal Hernia Surgery

As mentioned previously, C had a large lump on her groin that kept coming and going.  I suspected it was probably a hernia. In January we took her to see our GP and although the lump was not visible for the Dr to examine, the photo I had managed to take a few days before was convincing enough for him to refer us to a Consultant Paediatrician at our local hospital. Unfortunately he was spread across all the hospitals in our region and only available in our local hospital once a month. We were therefore warned that it may be a couple of months until we got to see him. 

We eventually received an appointment date of 22nd March.  In the meantime I was noticing C’s suspected hernia more and more frequently. In seemed most visible in early afternoon after a bowel movement however didn’t appear to be causing her any distress.  

A couple of weeks ago, a week after her 1st birthday, C was being grumpier than normal.  This soon deteriorated into howls of pain.  Nothing I could do would soothe her, it was quite distressing.  I should stress again that at no point until now had her hernia caused her any noticeable distress, therefore it was just a passing thought to check her groin at this point. I was shocked to see a lump swollen to the size of a golf ball and rock solid.  I ran into DH’s room where he was on a conference call and gesticulated wildly at him. After making his excuses to his colleagues and taking one look at C, we are in the car on the way to A&E.

C howled all the way there in the car, and for the next 45 minutes at A&E while waiting to be seen.  I was hoping when they saw her distress then we might be seen sooner, however apparently not.  We were lucky that the nurse in triage was a paediatric nurse and on seeing C, bought the Dr straight in to see her, rather than sending us out to the waiting room to wait our turn.  The Dr concluded that she needed urgent attention and we were sent out to the waiting room to await a surgeon’s opinion.  So many chiefs!

I can’t remember how long we were waiting. C had exhausted herself and sat muted on my lap. Eventually we were called in and the surgeon examined her. Apparently she “definitely had a hernia”. Gee! How much was he paid to repeat what I, DH, the triage nurse and the Dr already knew? She would need an operation and the sooner the better.  Waiting for our outpatient’s appointment in 2 weeks time was not an option.  Unfortunately our local hospital does not operate on under 3s therefore an ambulance was called to transport us to the Evelina Childrens Hospital in London.

By now C had fallen asleep in my arms and I was able to transfer her to the ambulance without waking her. I was strapped onto the stretcher in the ambulance and she was to sit on my lap.   DH and the paramedic sat in the remaining two seats.  The journey to London took about an hour and we were handed over to the Children’s A&E at St. Thomas’ Hospital (who triage all emergency cases).  I’ve never been in an ambulance before but I cannot stress enough how caring and compassionate the ambulance staff were.

After waiting another half an hour, we were seen by the triage nurse at St Thomas’s who handed us over to one of the paediatric registrars who had been expecting us. By now C was awake again and her hernia was looking much less swollen. Based on this, the registrar made the call that emergency surgery would no longer be required that night.  She had been concerned that it was C’s ovary that was protruding through the muscle and if still trapped this could have serious consequences.  They would however, make us a priority case for the next day, subject to no emergencies coming in overnight.  They also planned to investigate the other side of her groin to make sure there were no holes that side.
We were transferred to a ward in the Evelina overnight and DH left for home to collect supplies for the following day.  I was allowed to sleep in a pull down bed beside C.  She appeared to be the youngest on the ward by quite a way.  I gave her a breastfeed and she must have been exhausted as despite the unfamiliar surroundings  and strange noises she fell asleep almost straight away.

We were awoken early the next morning as C needed to have breakfast before 7 if she was to have surgery early afternoon. Apparently she was first on the list and there had been no emergencies come in overnight.   Soon afterwards DH arrived with a change of clothes for me and C, and some things to help C pass the time that morning. He had booked a local hotel for that day and the following night.

I was able to breastfeed C at 9am, 4 hours before surgery, which was a godsend as meant she was less hungry for lunch at midday. She then was allowed water until 11am.
They came to collect C for surgery half an hour earlier than expected. DH was not yet back from lunch and I was sure he’d be angry that we had to go down without him. I carried C down to the anaesthetic room and hugged her tight while the masked was placed over her face to put her under. I was impressed how composed I managed to remain throughout this procedure and even as I laid her on the table and walked away.  I knew the operation needed to be done. There was no other option! 

We were informed the operation would take 45 mins to an hour which I had comforted myself in not being very long at all. By the time I got back to the ward, DH was back, and luckily was not angry about missing C.  We sat down and waited….. and waited….. 45 mins… hour…. an hour and 15 mins….. an hour and a half….. Until now I had remained very calm but I was starting to get nervous. What could they have found that meant it was taking so long? What had gone wrong? I asked the nurse to phone down to Recovery and see if she was out yet….. Nope! Not yet!... The nurse seemed surprised which didn’t help things. Even DH was beginning to look a bit uneasy.

After 1 hour 45 mins we finally got the call from Recovery to say she was out of surgery. Apparently everything was fine.  DH and I went with the nurse to collect her. She was sat of a nurses lap having a drink or water grizzling quietly to herself.

Once we got her back to the ward, C lay there quietly for a while before drifting off to sleep again. DH took the opportunity to go back to the hotel and rest.  The surgeon who performed the operation came round and said everything had gone like clockwork. The ovary had not been trapped only bowel, and there was only a problem on her right side. I did not dare ask him why it had taken double the amount of time he said…. There are some things best left :-). Assuming she recovered well over the next 4-5 hours we would be allowed home that night.

By 7pm C had eaten and had a wet nappy so the nurses were happy to discharge her. We gently carried her to the nearby hotel where, still groggy from the anaesthetic, I fed her and put her straight to bed.  Although expensive, that hotel was a lifesaver and took the stress out of carrying a delicate C across London that night to catch the train home.

We were up early the next day as needed to be back home in Kent for the funeral of my friend Jennie’s (Edspire) 9 month old daughter Matilda Mae who had tragically died of SIDS. I knew she would have understood if I was unable to make it after the events of the past few days but I was determined to be there with her.  I also needed to be there for myself, to say goodbye.

C was brilliant on the train home and passed the time playing with her beloved beakers.  The effects of the anaesthetic had worn off and apart from being a little unsteady on her feet, she was in good spirits. My parents were waiting for us when we got home and kindly looked after her for the day while we were out. I did feel bad leaving her but she was fine and realistically I knew there was nothing I could do for her that my parents couldn’t.

Within a couple of days, C was running round the furniture and back to her normal self. It’s amazing how quickly little ones can bounce back. The 3 incisions in her stomach are healing well and hopefully will be invisible in a few months. Although it was a stressful few days, part of me is glad it is now out of the way and I can stop worrying about it.

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