Tuesday, October 11, 2011

Bracing Ourselves

First, yes, I know I owe a few posts and photos. We were at the beach with Shrike's family from Saturday through yesterday, so I've got a bit of catching up to do. I will, of course, fake the dates on those posts, so scroll down to see if they're there yet. If not, check back soon to see Peeper in the ocean!

And, now - Peeper has her next round of dental work scheduled for tomorrow, under general anesthesia again.

I'd like to say that it will all work just like the first time (about a year ago), but there's one fairly big difference (or at least it's seeming very big to me right now).

This time, instead of being allowed to nurse up until four hours before the procedure, she has to stop nursing at the same time she stops solid foods, eight hours before.

I went all the way to the anesthesiologist himself, arguing that both times that she's had anesthesia in the past - including at this very hospital last year - the rule was four hours.

Yesterday, when the nurse told me that they allowed it for babies, I figured that they had a sheet of instructions for infants and a different sheet for older kids, and that breastmilk just wasn't mentioned on the older kid sheet, but he said that they only do that for babies under a year old, and that last year "was an error."

All the research I've done (and I did a lot before her open-heart surgery) says that breastmilk is a "clear liquid" and three to four hours is plenty of time for breastmilk to clear out of the stomach, and makes no distinction about the age of the child.

The anesthesiologist gave me some line about how it's a risk because it "turns to a solid in the stomach, and might still be there at the time of the procedure," but I don't see how that could be true for an almost-three year old, but not for a three month old.

Furthermore, I am almost certain that when she had her open-heart surgery done (at a different hospital) their was one univeral instruction sheet (or at least univeral for pediatric patients, I don't remember specifically) and the cutoffs were as follows: solid food - 8 hours, formula - 6 hours, breastmilk - 4 hours, other clear liquids - 3 hours.

Until I talked to the anesthesiologist today, everyone was telling me that I had to cut her off from solids and breastmilk at midnight tonight - despite the fact that her procedure was scheduled for noon!

(It's since been moved to 11. Or 11:30. Or 11-something-I-can't-remember-shit! I will plan for 11, but call and check when we get up. Which may mean she stops nursing 30 minutes earlier than necessary.)

Which is ridiculous.

If midnight is the cutoff for a 7 am procedure, how can it also be the cutoff for noon?

He said that it's actually eight hours, although he did ask, a bit snidely, "Are you going to get her up at 3 am and feed her?"

Well, no, but I am damn sure going to stick a boob in her mouth at 3 am, and get her all goodied up.

And if she wants it after that (which she may or may not, until it's time to get up - that's a crapshoot and changes from night to night), it may get ugly.

It may also be very ugly when we wake her up in the morning to get her diaper changed and put her in the car.

Before I talked to him, I was thinking that if this was our answer, we'd reschedule for an early morning, but given the 8-hour rule (versus midnight) I don't guess it matters as much what time the procedure is, and we would just as soon get it over with.

I was thinking, too, though, that it would be better to have a little more time to prepare Peeper for going goodyless for half a night and all morning, but when Shrike and I were discussing it, I finally just said, "Okay, let's ask her."

I explained it to her, and told her that she can have "special! apple! juice!" during the night and for breakfast (she never drinks juice, so it's automatically special) instead of goody, and she seemed okay with the idea.

I've since remembered that popsicles and jello are also clear liquids, so we went to the store this evening and let her pick out some of each.

We paid extra, I'm sure, for the apple juice boxes with Big Bird on them, but we bought the cheapo "popice" popsicle (the ones in plastic tubes that don't have to stay frozen) and some strawberry jello.

I let her nap (and joined her, actually) from about 3 - 5:30 pm, so at 11:30, she's still going strong, and that's actually okay, because I want to feed her something substantial (if she'll have it) as late as possible, right before she goes to sleep, and then give her a dreamfeed at 3 am.

(God help us all if she's not asleep by 3 am, though!)

I will put a juice box beside the bed mostly for appearances, but if she really wakes up in the night wanting to nurse (I doubt she'll wake all the way up, but on the other hand, she always nurses back down.) I'll offer her that.

Of course, the doctor seemed to think that was a perfect acceptable strategy, "So if she nurses until 8 hours, she can have clear liquids until three hours before, so that should hold her."

I said, "Well, if apple juice came out of my breasts, that would be a great plan, but I don't think it's going to fly."

But, I have told her she can have apple juice in the night if she needs something (teeth be damned, right?) and that she'll have "special apple juice, and popsicles and jello for breakfast instead of goody."

And, we have one other ace in the hole, wich is a Bert doll that I sneakily bought while we were at the beach. He was going to be a birthday or Christmas gift, until I realized that we really needed a "prize" for tomorrow. I will put him in the diaper bag, or maybe in a gift bag, and we'll pull him out when we need him.

I suspect that will happen when I first wake her up, and she's crying for goody. My plan is to lure her out of bed with "a surprise in the kitchen!" and give that to her and then take him (and Ernie) with us to the hospital.

Oh, there she is now, out of the bath and ready (I hope) for a midnight snack.

(Awwww - After crying about "More Sesame Streeeet!" when we made her get in the tub (which Mommy supervised tonight) she just told me "I had a fun bath!)

1 comment:

  1. Fingers crossed that it all went well. I'm sure she loved the Bert doll.


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