Time flies: 2 weeks after surgery

I can't believe that Gavin's surgery was two weeks ago! In some ways, it feels like a lifetime ago, and in others, it feels like yesterday. He has been recovering like a champ, and sometimes I forget that he even had surgery.

Every night during bath time, while washing his hair, I use a cradle cap brush to gently scrub the incision. While combing his hair after bath time on day 7, I noticed that the majority of his stitches were gone! I know that they are dissolving stitches and are supposed to disappear, but it still took me by surprise. His left side stitches were gone first, but the right side wasn't far behind. These photos were taken 1 week after surgery.

 

We have been working a lot on tummy time and sitting up to try to regain some of the strength that he lost from laying on his back 24/7 while in the hospital and recovering. It's amazing how quickly he has returned to normal! He loves sitting in his Bumbo, especially when I attach the tray and put his toys on it so he can pick them up, throw them on the floor, and then watch me pick them up and put them back on the tray.  He still hates tummy time, so I find myself singing silly songs, making faces, getting the dogs to play fetch - anything to keep him distracted. His new favorite is the airplane: I put his tummy on my shins and lay on my back with him up in the air. 

He will smile and jabber at me, which I love - I just have to watch out for the giant globs of drool that he drops down onto me!

Before surgery, Gavin was sleeping exceptionally well at night. He would go to bed around 7:00 pm with zero fussing and sleep until 3:00 or 4:00 am (if he got up during the night, which he didn't always), eat, and go back to bed until 7:30 am or so. However, he has always been a terrible napper - 30 or 40 minutes max, and he has to be held, rocked, or walked to sleep. Since he was sleeping so well at night (even putting himself to sleep), I didn't want to mess with his groove until he was a little older. After his surgery, he was back on a newborn schedule. He was only sleeping for 2 hours at a time at night, had to be comforted constantly, and was still not really napping. 

Thankfully, my mom and Greg were super helpful so I could sleep, shower occasionally, and do homework. However, my mom had to leave a week after surgery, and Greg had to go back to work. Since Gavin was off of his pain meds on day 10 and had no swelling after 1 week, I decided to give sleep training a go.  It has been a rough couple of days to say the least. The first 2 days were the worst, but I think we are through the worst of it. Thankfully we tried to avoid forming any bad habits for him to break, so we are just dealing with him trying to figure out how to put himself to sleep during the day.

It's been 2 weeks today since surgery, and his scar is looking great! I am so blown away by how well he has handled everything. Here's some photos of how well he's healing.

He acts like the surgery never even happened. Lately, he has started to jabber and squeal more frequently (i.e. constantly), but he still won't laugh. He will open his mouth into a big smile and kind of sigh/squeal, but no giggles. I swear I have tried everything! He did, however, finally roll from his back to his tummy for the first time yesterday. I, of course, had stepped out of the room for 5 seconds, and when I came back, he was on his tummy, and he was not happy about it. He's been able to roll from tummy to back for about a month now, but he only does that because he hates being on his tummy, not because he's trying to go anywhere.

Even 2 weeks after Gavin's surgery, I am still getting phone calls, messages, cards, texts, meals, and gifts. It is so overwhelming to know how many people love and care about us all - our blessings are without number.

Home (Day 4 + 5)

It is so nice being home. We are all so much more comfortable in our own beds - Greg and I especially. Gavin is pretty much back to being himself, which is such a relief. He is quite a bit fussier than he has ever been, and he isn't sleeping very well (it's like having a newborn again!), but he is smiling (still no laughing, dang it!), shoving his fist/fingers in his mouth, and cooing and blowing bubbles.

We are using regular infant Tylenol to try and keep what I'm sure is a massive headache at bay, but we've had to use the hydrocodone a few times when the Tylenol hasn't been enough - especially at night.

His incisions look pretty good, considering. These are photos from day 4 (October 12th).

Since we were finally home for our bedtime routine (he fell asleep on the way home from the hospital the night before), I was able to give him a bath before bedtime on day 4 - thank goodness! He smelled like the hospital to me, and his hair was matted and stringy. The doctor told me to wash his hair like normal and use a craddle cap brush (soft bristled) on his incision. Gavin loves his bath time, and he was content and relaxed while I scrubbed his head. He doesn't mind at all when we touch his head and incisions, and I was able to clean everything up nicely. These photos are from day 5 (October 13th), and with the exception of one spot, there is very little redness or scabbing.

We are back to doing tummy time and sitting in our Bumbo, although he has lost a lot of strength/stamina during his stay in the hospital. He used to be able to sit up for 10 minutes or so in the Bumbo, and he was pushing up on his tummy. Now, we are lucky to get 2 or 3 minutes of sitting and he is only able to hold himself up on his tummy for short periods of time. I decided to put together his jumper, which he seems to like, even though his feet barely touch the ground on the lowest setting. So far, he will only tolerate 5 or so minutes of that.

The hardest part since being home has been sleeping. Before his surgery, Gavin was sleeping through the night at times (8-10 hours) or waking up just once around 4:00 am (6 hour stretches), and would put himself to sleep in his crib at night. Now, I'm lucky if he sleeps for 3 hours at a time, and he has trouble putting himself to sleep. I feel like I am back during the first few weeks after he came home from the hospital, but I'm hoping this phase will pass as he continues to heal. I don't know what I would do without Greg and my mom here helping me!

Gavin is such a trooper, and I am so thankful for the wonderful doctors, surgeons, family, and friends who have made this ordeal so much more manageable. We are surrounded by so much love!

Pediatrics + Home (Day 3)

Gavin's black eye got worse overnight. When the nurse woke him up at 6:45 am to do a heel prick for blood work, he was unable to see out of his left eye, which made him pretty agitated. The nurses all approached him from the left side, so I had to keep reminding them to talk to him so he would know they were there since he couldn't see them. 

Even though he couldn't see out of one eye, he was much more like himself than the day before. The oral pain meds didn't make him sleepy and dazed like the IV pain meds, so he spent longer chunks of time awake, kicking his legs constantly! He spent the morning nursing, sleeping, and wanting to be entertained. He had not, however, pooped since the surgery. He was very gassy from all the medication, and he was visibly uncomfortable as his tummy would gurgle and he would pass gas. To try and "help him along," we asked the nurse for a glycerine suppository.

When the neurosurgeon came in at 1:30 pm to remove the bandages, I was anxious and excited to see the incision. The surgeon cut and removed sections at a time, and Gavin did really well until we had to sit him up to finish unwrapping the gauze. He refused to be consoled, so he cried the entire time that the doctor was giving us wound care instructions.

Since he was already hysterical, we decided to go ahead and have the nurse administer the suppository. I nursed him to calm him down, and at 2:00 pm, he finally pooped. I don't know that I've even been so excited to hear him blow up a diaper while I've been holding him....

He was in much better spirits after having a full tummy and a clean colon, so he started cooing and smiling a little during the late afternoon. Just as quickly as his black eye set in, it started to disappear. By 4:00 pm, his eye was almost completely open and the bruising was fading fast. He started swelling a little more in his cheeks, and his head started swelling as well since the bandage was no longer keeping pressure on it.

The neurosurgeon was so pleased with how the incision looked, his stellar blood work, and the fact that he was eating and pooping while only using oral pain meds that he cleared us to leave whenever we felt comfortable!!! I was so excited!!! The pediatrician on the floor came in at 6:00 pm to do a final exam and make sure we were ok to leave. By 6:45 pm, we had our discharge papers, prescription, and Gavin loaded in his car seat - we practically ran out of there before they could change their minds!

I am amazed at how much his head shape has changed already. The surgeon told us the swelling would obscure and soften the shape for a while, but I can already see such a difference - it's round!  The surgeon has discussed the possibility of Gavin getting a helmet in a few weeks. They completely reshaped the skull during surgery, but there are parts that may not conform as well as others. This, plus the increased chance for plagiocephaly (head flattening due to positioning - like the babies with a flat spot on the back of their head) has made the surgeon consider the possibility. We will have a 2 week follow-up appointment and find out more then.

Overall, Gavin is doing great! We are using Tylenol to keep him comfortable, and it seems to do a pretty good job. He is still pretty tender and sore and fusses almost any time he is moved. I can't complain though, since it is amazing that he is home with us, only 60 hours after getting checked in for cranial surgery!!! He slept for a few sizable chunks during the night since no one was waking him up to check his vitals and woke up acting more like himself than ever!

We are so amazed at the marvels that modern medicine can accomplish and how quickly Gavin is healing. We have had the ideal surgery and recovery (so far), surpassing even the surgeon's expectations! I don't know what we did to deserve so many blessings, but I am so thankful for the never-ending outpouring of love and support from family, friends, and even strangers. We couldn't have done it alone!

PICU + Pediatrics (Day 2)

The Pedialyte and pain meds helped Gavin get through the night with relative ease. He finally went into a deep sleep around 4:00 am. The nurse removed his catheter around 6:00 am and a lab tech did a heel stick for a blood draw, and he didn't wake up for either!

When Gavin woke up in the PICU, he gave me a hint of a smile - not much, but it was good enough for me!!! His left eye had started to bruise and swell a little during the night, but it wasn't too bad (yet!).

At 8:00 am, I was able to give him a bottle of breastmilk that I had pumped. He drank the first so fast that the nurse thawed a second bottle, which he also devoured. Since he was keeping everything down so well, we started giving him oral pain meds. They take longer to kick in, but the effect is longer-lasting than the IV pain meds. Also, the sooner he can just take oral pain meds, the sooner we can go home!!!!

At 9:00 am, the nurse came back to remove the artery line from his right wrist. It had been taking a beat-by-beat blood pressure measurement to make sure that he wasn't loosing any blood internally. Since he had been moving around so much, he had thrown the line out of whack and it wasn't working. The doctor was comfortable with it being out since he was doing so well, so the nurse let me hold him while she and another aid removed it. The line was sutured to his wrist underneath all the tape, so he was pretty unhappy having it removed, but I was so happy to hold him again (even if it was on a pillow) that I didn't mind at all!

 It was a little difficult to hold him with all  the tubes and wires connected to him, but Greg and I spent the rest of the time he was in the PICU holding him. His right eye continued to swell and bruise, but it didn't seem to bother him too much since he could still see out of it pretty well.

At 11:00 am, we were moved out of the PICU to a room in the regular pediatrics unit. We were able to let family members hold him, and his vitals only had to be checked every 4 hours instead of constantly. We kept giving him bottles of pumped breastmilk and the oral pain meds, and he seemed to be able to rest pretty well.

At 8:30 pm, we asked for him to receive the IV pain meds since he was getting pretty agitated. He wouldn't take a bottle and was clearly uncomfortable. When the nurse tried to push the meds through his running IV line in his left foot/ankle, the meds wouldn't go through. They unwrapped the tape to find that all his kicking had pulled the plastic IV needle out a bit and then kinked it. Since the IV was useless, they removed it. They pushed the meds through the standing IV port in his right foot instead. (Thank goodness they left both in after surgery. I think if they had to stick him with another needle I would have cried!) By this time, his right eye had turned into quite the shiner and he was not really able to see out of it.

He was finally able to fall asleep and stayed asleep until the nurse came in to check his vitals around midnight. He woke up agitated, but they didn't want to give him oral meds since he hadn't taken a bottle since 6:00 pm and wouldn't take one when offered. I explained to the nurse that he had never had a bottle before this hospitalization, and she agreed that breastfeeding him would probably be best. Even though they aren't able to measure exactly how much he is getting, he would at least be eating!It took a few minutes for him to get comfortable and latch, but he ate like a champ! It was as though he was so relieved to be nursing again - he fell asleep in my arms. The nurse took the opportunity to remove the heart monitors stuck to his chest, so the only thing left on him was the IV port in his right foot.

The nurse woke us both around 4:00 am to have him nurse again, and he was able to have the oral pain meds again. He went right back to sleep and slept in until 9:00 am!

These 2 days in the hospital feel like they have lasted a week. They have been hard, but all I have to do is walk down the halls of the pediatric unit and I am reminded of how good we really have it. We have been, and continue to be so blessed.

Surgery + PICU (Day 1)

We arrived at the hospital at 6:00 am. His surgery was scheduled for 8:30, so his last feeding was at 2:00 am. I was worried that he would be fussy and agitated since he demands breakfast first thing when he wakes up in the morning, but he surprised us by being happy and playful. He was totally flirting with the nurses that kept coming by to see the cute baby.

Around 8:00 am, the anesthesiologist, the neurosurgeon, the craniofacial plastic surgeon, and the operating nurse all came through to meet us, talk to us, answer questions, and reassure us. They told us to expect around 3 hours for the surgery itself, not including the time to place IVs and do the marking on his scalp and trim his hair. At 8:15 am, we gave him kisses and hugs and handed him over to the medical team and headed to the waiting room.

The operating nurse surprised us by calling my cellphone at 11:00 am to let us know that they were wrapping up the procedure. She said the surgery went exceptionally well and they would meet with us in about 30 minutes to go over everything. At 11:40 am, the two surgeons joined us in the waiting room. They said the surgery went as well as it possibly could have; he lost minimal blood so he wouldn't need any additional units, and he didn't have to have a drain left in.

We met Gavin in the Pediatric Intensive Care Unit (PICU) at 12:30 pm. He was just waking up and had to receive a breathing treatment to reduce the swelling in his airway caused by the breathing tube during surgery. The only tears I shed all day came when I had to stand next to his hospital crib and listen to his tiny scratchy cry while receiving the breathing treatment. After the treatment, I was able to calm him down and the nurse started his pain management regimen to help keep him comfortable. The nurse explained that they try to keep them relaxed and sleeping for the first day after surgery. We spent the remainder of the day standing crib-side, visiting with family who came to support us and helping Gavin to stay still and sleep as much as possible.

At 7:30 pm, Gavin had his first bottle ever when we gave him some Pedialyte. He was able to keep it down and had a little more 30 minutes later. Through the night, we gave him several small bottles of Pedialyte to have something in his tummy so he could sleep. He was up every few hours and had to be comforted to sleep, but he would just suck on my pinkie (still doesn't like pacifiers) and fall back asleep until the next time the nurse had to take his vitals.

One day down, many more to go......

Sagittal Synostosis

Gavin has always had a uniquely shaped head - long and narrow with a bulge in the back. We weren't overly worried at first because we were preoccupied with the bruise and hematoma (giant soft spot) from his birth. At his 2 week appointment, I asked the pediatrician about it, and he told me to give it a little time to even out. He said cone heads take a few weeks to dissipate.

At his 2 month appointment (August 22nd), the pediatrician noticed that Gavin only turned his head to one side while lying on his back. I told him that the shape of his head made it impossible for him to turn his head from side to side - he couldn't get up over the hump. Because of that, he had a favorite side to lay on, and even held his head at a slight angle when sitting up or on his tummy.  Also, the cephalohematoma had calcified into a large bump. The pediatrician said he would refer us to a neurosurgeon to take a look at his head and a physical therapist to help with his neck muscles.

We went to Utah for a week after that for Gavin's blessing, and the pediatrician called and said the neurosurgeon wanted X-rays of Gavin's head before scheduling an appointment. We had his X-rays taken on September 10th,  and the neurosurgeon's nurse called me the next day. She told me the radiologist found no sign of craniosynostosis (early fusing of the cranial sutures), but did remark that his head shape was a little long. She said the most likely course of action would be a remodeling helmet once he was 6 months old and suggested lots of tummy time to strengthen his neck muscles and keep pressure off his head in the meantime. The ever-pushy mom, I asked to come in and see someone in person because I wanted more than an over-the-phone appointment.

On September 15th, we had our first physical therapy appointment. Our therapist was so sweet and showed us stretches to do several times every day for torticollis (tight neck muscles). She commented on how oddly shaped his head was and asked about his history. I relayed the neurosurgeon's message but told her I was going in for a consult the next week.

On September 23rd, we met with the neurosurgeon. He put his hands on Gavin's head and said, "It's definitely Sagittal Synostosis."

What is Craniosynostosis?

At birth the skull is made up of multiple bones held together by seams called sutures. The sutures should remain open as long as the brain continues to grow, enabling the skull to expand and properly accommodate the brain.s growth. Craniosynostosis is a congenital anomaly caused by early closure of one or more of these sutures, resulting in limited or distorted head grown. Craniosynostosis is also called synostosis or cranial stenosis. In rare cases, in addition to abnormal head shape, craniosynostosis may result in raised pressure inside the skull. Eighty to ninety percent of craniosynostosis cases involve a single suture, however craniosynostosis associated with a genetic syndrome may involve multiple sutures. Not all cases of multiple suture synostosis are associated with a genetic syndrome.

Sagittal synostosis

This is the most common type of craniosynostosis. The sagittal suture is located between the anterior fontanelle and the posterior fontanelle. Early closure of this suture results in scaphocephaly, which literally means .boat shaped head.. Infants will often have a protruding forehead, an elongated head, and a bony protuberance at the back of the skull.

The surgeon explained this and launched into discussing surgery and treatment, but he stopped when he saw my face . He went back over the X-rays with me and showed me where the radiologist had missed the fused suture because of his calcified hematoma; it obscured the view. The then spent an hour with me drawing on a little baby skull to show me the procedure and talk with me about the surgery. He likes to do the procedure when the kids are 4 1/2 to 6 months old, but had another surgery scheduled  for October 9th already with a fantastic pediatric craniofacial plastic surgeon and invited us to be his second surgery that day.

The craniofacial plastic surgeon wasn't satisfied with the inconclusive X-rays, so they sent us in for a CT scan the next day, September 24th. The neurosurgeon called the same day and said that the CT scan clearly showed the fusion of the Sagittal suture and that surgery was necessary.

Yesterday, October 9th, we came in and had Gavin's pre-op appointment. He received a clean bill of health, and only had a minor meltdown when they did his blood draws.

Today,  we are here at the hospital, and my sweet baby boy is having a Cranial Vault Reshaping procedure. I am still a little numb, and everything has happened so quickly that I am just trying to stay positive and not get inside my own head. We appreciate all the love and prayers and will post updates here for those who wish to follow.

Gavin Lee McClain

I told everyone we were due on June 20th. My OB estimated the 22nd, but I knew all along we were having our baby on the 20th, so that's the date I circled on our calendar. Greg requested his vacation time starting on the 20th and my mom planned to come out a week before to help me finish getting everything ready - I had it all planned out.

However, when June 19th rolled around, I was not feeling quite so confident. My appointment the week before had been a little disappointing; I was not dilated at all - "tight as a drum" was the phrase the nurse used. My OB tried to reassure me that everyone is different, and the fact that I wasn't dilating early didn't mean that I was going to go past my due date. I wasn't so sure. I had not had any contractions, back pain, etc., so I was sure that our baby boy was never coming out and I would just stay pregnant forever.

 

 This picture was taken after a funeral we attended on June 19th. Note the "not quite so confident that I am going to have a baby soon" smile/grimace.

After the funeral, we borrowed a friend's truck and picked up our new couches in Sacramento. On the way home, I made Greg drive 30 minutes out of the way to get a "Prego" pizza from Skipolini's to try and help my chances of going into labor. 

Salami, Pepperoni, Ham, Mushrooms, Olives, Bell Peppers, Extra Onions, Sausage, Ground Beef, Linguisa, Extra Garlic, Parmesan and Oregano

I don't know if it was the pizza or sheer willpower, but at 1:30 am on June 20th, I woke up to contractions. I woke Greg up, told him I was having contractions so he needed to pack his bag (my bag and baby's bag were packed and waiting), and then started timing them. They were 5-7 minutes apart, so we tried to get some more sleep. Greg had no problem falling back asleep, but I was pretty uncomfortable, so I just lay in bed timing them until about 5:30 am. When the contractions were 3-5 minutes apart, I finally got out of bed, took a shower and started walking around the house. Greg got up and made breakfast while I called the number at the hospital to let them know I was coming in. I had to stop several times during the conversation to breathe through contractions, and the nurse said I was doing great and should stay at home and labor there. With pretty strong contractions 2-3 minutes apart, I told her I was coming in.

We arrived at the hospital at 7:00 am, and by the time the doctor examined me, I was having very painful contractions 2 minutes apart. I almost died/cried/threw up when he said I was only dilated to 2 cm! However, he was concerned because I was in active labor and baby boy's head was stationed very low (trying to descend from my uterus), but my cervix wasn't cooperating, so his head was pressing on my cervix with each contraction - hence the intense pain. He admitted me so that we could start trying to relax my cervix. The admitting nurse took FOREVER to get me settled into my room, and even messed up my blood draw/IV insertion and had me bleeding all over the room. It took until 9:20 am for her to give me Zofran for my nausea, then IM morphine (a super painful shot in my bum). They followed that up with IV morphine.

The morphine did nothing for the pain (not what I was expecting from watching medical TV dramas), and by 1:30 pm, I was still only dilated to 2 cm, despite still having consistent, strong, and incredibly painful contractions. They decided to give me a spinal block and an epidural to try and help my body relax. When the spinal block kicked in, I told my anesthesiologist (a woman) that I loved her. Pain free, I was able to sleep for about an hour. By 3:00 pm, I was dilated to 6 cm, but my spinal block was wearing off, and I was in a lot of pain. For reasons unknown, my epidural did not work and I could feel EVERYTHING. Because I had an epidural, oxygen, and an IV, I had to lay in bed to labor. My only relief was laying on alternating sides. 

When they checked me at 6:00 pm, I was dilated to 9 cm, but my water had moved down below baby boy's head and was pushing him back up in my uterus. At 7:30 pm, they broke my water to encourage his head to drop back down, since I had stalled at 9 3/4 cm. Finally, at 10:15 pm, I started pushing, and it was without a doubt the hardest thing I have ever done. I kept telling everyone that he was stuck, but since I was in so much pain, no one believed any of the things I was yelling (just another lady in labor I guess). Since he was progressing, they just kept telling me to breathe and push. Our sweet baby Gavin was born at 12:20 am on June 21st - after 2 hours of pushing. When the midwife exclaimed, "Oh, he was stuck posterior!," I wanted to flick her right between the eyes. Thank goodness Greg was there to help me keep my negative comments and gestures to myself.

They handed Gavin to me and rushed to stop the massive blood loss I was experiencing.  The long and strenuous labor, combined with his position, had caused several large internal tears. Still with no anesthesia, they spent an hour or so stitching me up. When they were through, my anesthesiologist returned and gave me another spinal block. I told her that I still loved her. 

We spent 3 days in the hospital after he was born. Gavin's head was pretty bruised, and he had a large cephalohematoma from where he had been stuck and pushing against me for so long. Other than a tender head, he was a perfectly healthy boy! We had so many amazing family members come visit us and take care of us in the hospital, but I was so glad when it was time to come home.

There was a photographer at the hospital who did newborn photos, and a friend of mine had mentioned that she loved her hospital photos, so my mom purchased them for us. They are priceless!

 Gavin Lee McClain

Born June 21, 2014 @ 12:20 am

8 lbs 7.4 oz, 22 inches long