Follow-Up

Micah is eight days out from surgery, and today was his follow up appointment with Dr. Choe.  Fortunately the surgical coordinator made the appointments for us weeks ago, so we were ahead of the curve.

The fluid behind his right tympanic membrane is gone; thank you Children's Sudafed.  And there was no debris in the canal.  He's still wearing his left BAHA.

All is well with the new ear and we're now back to instilling five drops twice a day onto the sponges/into the canal.  Minor drama getting the prescription filled, with no help and misinformation from our local CVS: "It's nowhere in the CVS system."  I picked it up at the CVS on Nassau Street at 7:30 pm, so the pharmacist who made that statement is not going to be appearing on my Christmas card list any time soon.

Meanwhile, laptops are giving major grief.  The Windows XP Security malware made an appearance on my work laptop, locking me out of Internet Explorer and creating pop-ups that got in the way of Intergy.  My annoyance grew to major proportions around midnight, and after finishing my chart notes I made a trip to the office at 1 am to drop it off, and I picked up my personal laptop, which is having power cord issues but those are easier to manage, for now.

So between the computer problems and the pharmacy idiocy, I have been a crab today.

Next follow-up with Dr. Choe in one week, on April 7.

Photo Update - Micah's Surgery

6:30 am at the Ambulatory Surgery Center, Englewood Hospital - not quite clueless, but in a good mood.

In the PACU, still somewhat dopey, but croaking, "I want Mommy."

Ice pops, on the road towards being discharged.

30 hours later.

Just before the dressing came off.

The new ear canal with the Merocel sponges in it.  The marks in front of the ear are surgical markings.  There is a small bruise on the right side of his mouth from a clip for facial nerve monitoring.  Compared to August, the incision is much smaller, and tucked behind his ear cartilage.

Day After Surgery

Tesh came over to work in de-cluttering the garage.  I wish I had taken before and after photos, but 'before' would be too mortifying to share with the general public, and 'after' is still a work in progress, though a million times better than what it looked like at 9:30 am.

Got to love Tesh, who took a lot of stuff off for donations, to FreeCyclers in the Princeton area, especially the lady who came six minutes after I put up a Curb Alert for two tricycles.  Gone.  Big plastic race car bed.  Gone - though it didn't go until some time after 4:30 pm when Micah and I went off to Target.

Meanwhile, the boy who 24 hours prior was under anesthesia was riding his bike in the driveway, digging up rocks in the front yard, 'helping' sweep in the garage (if you count sweeping the dust and leaves back IN instead of out). We got a call at 9:00 am from the anesthesiologist, checking on Micah and how his temperature is. (Normal.  No fever, nothing.)  Then a 3:00 pm phone call from Englewood Hospital to check on Micah - again the concern was touching, but he was napping and oblivious.

We unveiled his new ear at dinner tonight.  The incision was closer to his cartilage so there isn't a big line of steri-strips behind his ear.  The Merocel sponges are poking out more, so I have a bandaid over them, but other than that, it doesn't look like much compared with the previous surgery.  The skin graft site this time is a bit more leaky, I've already put one piece of Tegaderm over it, and its managed to get a little dislodged by Micah constantly being in motion, so we have a little bit of watery/bloody fluid leaking onto his underwear.  Nothing that a run through the washer and a little detergent can't handle.

All in all an uneventful day.  And uneventful is good.

Surgery Day

August was the perfect storm of perfect circumstances.  Fast forward six months, and history is not going to repeat itself.

First, Micah is aware of what's going on, and he started immediately upon arriving home with ranting that he didn't want to go to the hotel, hospital or basically anywhere that I was going. . . .

The drive up the NJ Turnpike in the rain was less than pleasant. . . . .

The hotel put us in a room just off the elevators, next to an event room where there was something going on that involved chanting and keening, which managed to come through the wall. . . .

My watch battery is giving up the ghost. . . .

I am wearing green scrubs (to take Micah back to the OR scrubs are required) and when I went to go take them off, the nurse just said "Oh, leave them on" and shipped me out to the waiting area.  The extra layer is keeping me warm, but I feel like a dorky green bean.

Micah is the only pediatric surgery today, so instead of being ushered into a pediatric recovery room to sit and wait, I am out in the regular waiting area with the TV blaring.  With three TVs blaring actually. . . . .

Micah curled up on my lap after we put him in a hospital gown and had big, fat tears rolling down his cheeks, and then started outright wailing on the walk to the OR - he didn't even want to drive the cool car like last time, I had to carry him. . . .

Fortunately the crying means increased respirations, but it still took him longer than last time to go out . . . .

I did get a call from the circulating nurse to let me know his ossicles were good and that the facial nerve was well out of the way of the area the surgeon is creating Micah's ear canal.

I have about an hour, maybe 90 minutes until I can see my baby again, and this time, I will put a towel on my lap so he doesn't pee on me like last time - and I brought extra pull-ups along, too.

I hope the surgeon doesn't make the gauze turban too tight, last time Micah looked like he had had a facelift instead of an atresia repair.

Three Days and Counting

. . . until Micah's second atresia surgery.  Nothing really exciting to report.  The pre-op visit with Dr. Choe was Wednesday.  The Princeton area is still recovering from the previous weekend's storms and the power lines and trees that were knocked down.  We've been without River Road, our primary access to Route 27 and Route 1, Thea's school - just about anywhere, until Friday afternoon.

It seems like there was one area that was hit harder than ours, Bergen County.  Exactly where Englewood and Micah's doctor are located and where we needed to be at 12:50 pm on the 17th.

And right on Grand Avenue there was a police car blocking traffic so that a very, very large tree could be cut up and removed from the road.  Thank you GPS, but the re-routing made us a few minutes late for the appointment. 

Micah went back in the book for a pre-op audiogram, which was similar (for the left ear) to his previous audiogram.  Moderate conductive hearing loss on the left, mild conductive hearing loss on the right.  This time though he did the test without any of the gimmicks used on younger children; he just sat in the chair with the headphones on, talking with the audiologist and repeating the words she said and then listening for the beeps.

Dr. Choe's check of the right ear canal found fluid behind the ear drum, so Micah is now on Children's Sudafed to see if that helps with helping his eustachian tube to drain. 

Paperwork signed, more copies of the pre- and post-op instructions, the one-week follow up appointment confirmed and we were back on the Turnpike and heading home.

Since I was off from work, I got to go to the kids' swimming lesson at Can-Do.  It's the start of the new session, but since Micah won't be able to attend the make-up session for the snow day (scheduled for May) he was allowed to attend the first day of the new round.  It's going to be hard for him in the coming weeks to see Thea continuing with lessons while he's waiting for his ear to heal.  The previous surgery was at the end of August and he wasn't cleared to submerge his head until December.

Tonight, while working on my charts, I flipped to Discovery Health and watched a segment on a child's right microtia repair with Dr. Reinisch. It was interesting, but right now Micah wants to keep his 'little ears'.

Family Fun Night

Friday night we all went to Micah's school for Family Fun Night - it was our third time, though Steve's first, and Micah's first now that he attends school there full-time.  Poor kid had to ride an hour to school, an hour back and then 90 minutes later turn around and do it all over again.

The evening consists of  a gift basket raffle, a clown show, a puppet show, face-painting, crafts and snacks.  The first year we arrived a little late for the basket raffle, the second year we won nothing.  But this year we finally cleaned up, at $10 per sheet of 26 tickets, I purchased 208 reasons to win SOMETHING.  Do the math.  Thea took one sheet and doled out those tickets and then abandoned me in favor of hot dogs and popcorn.

Our lucky numbers were 1399883, which won us four tickets to Sesame Street Live: Elmo Grows Up (frightening concept though that is) on April 3 at the State Theater in New Brunswick.  I was quite pleased with myself.   Thea got to go up and claim the prize, which thrilled her just a bit.

So I nearly missed it when a few minutes later 1399882 was called.  Thea and Micah brought back a big basket of Bath & Bodyworks products.

I can almost count on my hand the number of times I have won anything:  four tickets for the IceCapades from the Ranger Hal Show (circa 1965, and there was a blinding snowstorm the night of the show, and I remember my father stopping at the end of my grandparents' street to pick up my grandmother because his Karmen Ghia couldn't negotiate their street in the snow), two tickets for Bob Seger (in the mid-1980s) in concert at the Cap Center (from 107.3, for knowing that 1 in 9 people surveyed had had sex the night before - finally a piece of trivia from the pages of People magazine proved useful, the seats were in the nosebleed section and the people in front of us were happy stoners who wouldn't sit the hell down for most of the concert) and that's about it. 

So this was big stuff, Micah has been asking about Elmo thanks to the billboard up the road from the gas station I stop at on the way home from work.  Unfortunately he doesn't get the concept of waiting, winning Elmo means, in his mind, he gets to see Elmo now.

The other 'fun' part of Family Fun Night was seeing Micah totally in his element, amongst his friends, just having a ball - and he got to see his friend Cormac (who is now an alum and whose family's appearance on the Rachel Ray Show I taped and then deleted a few weeks later because Micah asked to watch the Cormac show way past my tolerance levels of the ever-perky Rachel Ray), run around with Natalia, Quentin and Samantha and talk to all the adults he knows from school.

I checked the ticket bags for 'my' baskets with the quilts, books and stuffed animals and we had quite a few people vying for them, so my first foray into gift baskets was a success, and I confess to putting a couple of my own tickets in for them.

Power-less in Princeton

Yesterday I worked in the morning, and despite a driving rain that didn't seem to let up all that much we saw a number of people.  After everyone went home, I finished charts and it was just me and the couple who were in the office to strip and wax the floors.

After a stop at Target, I got on the road for home.

Quaker Road was closed due to flooding.  No big deal, any sort of heavy rainstorm seems to close that road.

Province Line Road to Route 583.  583 was closed due to a downed tree or powerline.

Back to Province Line to Route 206.  206 was closed at some random residential street, so back through that neighborhood and back onto 583, beyond whatever problem that closed it.  Trees and branches down everywhere.  Streets are tree surgeon's and wood chipper's wet dream.

Big back up beyond Princeton Battlefield waiting to turn onto Lover's Lane (a short worthless street) and back onto 206.  More trees down.

206 to Elm Road.  Had to dodge around a downed tree blocking my side of the road, but uneventful until I got to Mountain Road.  Downed tree, low-hanging power line. 

Elm becomes Great Road.  Total misnomer in general, but today moreso than ever.

Onto Cherry Valley, more of the same but fortunately it's moving and there are no blockages or back-ups.

Until I get to 206 and Cherry Valley, where traffic was diverted into the CVS Pharmacy/TD Bank parking lot due to downed power lines on 206 and no signal.  Which was OK, because I wanted to go straight through the intersection and onto Princeton Avenue after a quick stop at CVS.

Which was dark, oh so very dark.  So was the bank.  I should have had a clue by then, but it took getting to the driveway and pushing the garage door opener before all the synapses clicked.

Holy moly, it's a power outage.

Back before the dawn of my nursing career, I lived in Washington, DC and periodically the house would lose electricity during violent thunderstorms, but it was usually a matter of no more than a few hours and Pepco would restore power.  And if it lasted any longer, I could hop in the car and drive to my parents' house - and this was in the day before cell phones, laptops, Palms, Nintendos, Bluetooths.

This morning we woke to a house still without electricity, so we did what I used to do 15 to 20 years ago, we packed up and went to Mom's (or Oma's).  All of us.  Today was a planned trip for me - my mother's final chemo is tomorrow.  I actually like the drive down, it gives me four hours to organize my mental sock drawer.  No luck today, three of my 'socks' were in the passenger seats, and there was hardly a moment of quiet.

Micah wanted "The Princess Song" over and over and over again (Track 9 off of Taylor Swift's 'Fearless' CD, I don't even know it's real name.)  It's not a bad song if one overlooks that Ms. Swift is rewriting the Romeo and Juliette saga with a happy ending, which I can do when I see the look of pure be-bopping happiness on Micah's face.

Thea was absorbed by her new DS game, Pokemon HeartGold, which provided us with additional background noise (she doesn't like the earbuds, unfortunately).  Before hitting the road, we stopped at Target to pick it up and she actually contributed $18.50 of her own money towards it.

And since I worked this weekend, I am also on call - and there were a few calls during the drive down.  The good thing was I had my Bluetooth and I had Steve dial the numbers.

So we're at the Sleep Inn.  The kids got 90 minutes in the pool tonight after dinner at Oma's, so they were happy little dolphins.

Creepy Crawler, Part II

Now I'm mad, which I admit is sometimes difficult to differentiate from the normal me.  It was bad enough to have some corporation's geek for hire or some alien computer crawling my blog, but today our home voice mail was invaded by a representative from the lab that drew and processed Micah's blood work.  The name of said company shall remain un-typed to prevent further crawling the aforementioned corporate entity through this entry, but let's use the initials QD for simplicity's sake.

This is MY blog, for me, for family and friends and a few others who happen to wander in who might be interested in atresia/microtia.  Not for some corporation to be acting like an electronic proctocologist in its own self interest.

Sooooooo. . . . . .

Go away, QD, leave me, my blog and our voice mail alone.  I'm not talking to you by phone, email or any other means, even if hell were to freeze over or if I were offered one million dollars (I might reconsider the latter, perhaps in light of the future relocation, private school tuition for one kid and having to find a good preschool for the other kid by September 2010 - and I could use a cleaning service.)

Butt out, QD, if you didn't  read or understand my meaning the first time.  I am permanently unavailable for any further discussions.  Go away, far, far away, leave me alone, bug off, be gone, vanish.

Which doesn't mean I don't like QD - it's the one lab we use at the office because its competitor never managed to be able to interface with my employer's EMR software and its results went off into the ozone constantly. QD has done a good job with its results going into the patient's EMR records. No complaints there, at all.

But in this instance, I have been seriously annoyed, I have a mulish, Teutonic stubbornness that is not to be messed with - test the concept and I will win.  In stubbornnes, I am only out-shined by my lovely daughter. 

I have had a crappy week, thus far and the lashing out at QD is quite therapeutic.

And I am one step closer to going toward a restricted reader list, where interested parties will need to ask to be added to the list.  Kiss the hit counter good-bye, kiss the flags good-bye, I'll toss it all to keep this from happening again.

Creepy Crawler, Part I

Today the number on my blog's hit counter went up astronomically, at least for this particular blog in a single day.  A jump of two dozen may not raise anyone else's eyebrows, but it's an event in this small niche in the blog-o-sphere.  So I went to look at the page that tracks the visitor information, and most of them had a questdiagnostics.com web address.  How very Big Brother Is Watching: Quest must have a web crawler that hunts down references to itself and it doesn't just come looking one time, it returns again and again and again. . .

So while I was temporarily excited a cracking 1,900 hits (proof I'm working too much or need some other form of diversion if something as trivial as that gives me any sort of a thrill), when the reason was known it creeped me out.  Go away, Quest Peeping Toms, you've aggravated me enough for the past 24 hours!  The title for the previous post was changed.

And BTW, Micah's blood work was fine, and I managed to find time at the end of the day to fax it to Pre-Admission Testing at Englewood Hospital and put a hard copy in the mail as well.

Two weeks from today at about this time we'll be home and Micah will be at home almost back to his usual full of energy self - with another gauze turban around his little head.  Another to-do list item, buy Conform gauze for when (not if) he pulls the bandage around his head off and extra Tegaderm for his skin graft site so I'm not making a spur of the moment run to CVS.

Quest-ing, Quest-ing, Quest-ing

Once upon a time Thea's photograph was featured in the Quest Diagnostics 2004 Annual Report because of an email I sent to the company complimenting the two phlebotomists at the Princeton location who drew Thea's blood when she was just 14 months old.  It is her small claim to fame, aside from meeting former president Jimmy Carter on her first day in the United States on our flight from San Francisco to Cincinnati.

I don't think Micah will be smiling out from the pages of the 2010 Quest Annual Report.  The Quest drawing station in Somerset on a Saturday is nothing short of semi-organized chaos and the waiting time, even with an appointment, is deplorable.  But we survived, and life moves on.

So this morning I arrived at my desk, powered up the laptop, pulled up Micah's chart in the EMR and there was no lab report.  It was a CBC (complete blood count) and a CMP (comprehensive metabolic panel), not exactly a strain on the system.  Most of these drawn at my office are 'resulted' as the lab calls within 24 hours.

And me being me, promptly went to the lab and asked one of the medical assistants to call Quest and find my kid's blood work, drawn two days ago.

The answer was that no report was available because the specimen was just being processed today.

You. Must. Be. Joking.  48 hours later?  Really?

So I still am shuffling around Micah's pre-op clearance form, waiting for that lab report, seething all the while.

Quest can bite me, and as soon as I can put it in more polite terms, the corporate office will be hearing from me.

Weekend Stuff

Micah (and I) survived going to Quest Diagnostics in Somerset yesterday for his pre-op blood work.  The little waiting area was packed with every chair taken.  I signed him in (having made an on-line appointment I was hoping that there would be some preference given over the walk-ins.)  Micah started whining that he didn't want to have his blood drawn, but the nice woman who sat next to us started to talk with him and distracted him out of fretting mode.  She was especially kind because I left him sitting with her a few minutes after I had heard a staff person call out, "Mitch!" with no one answering.  The light bulb in my head was on a two-minute delay before the thought burbled to the surface, "Could somehow, in some universe of mispronunciation, this person have meant Micah?  And oh yes, she did.  So I had to sit at the desk doing paperwork, while this nice stranger quizzed Micah on his Thomas the Tank Engine trains and other hot topics for four-year olds.

The difference between pre-op blood work in August 2009 and now is that instead of just whining, he can now fully express his annoyance and fear.  Last time it was just me, Micah and Freddie the Fast Phlebotomist (his real name).  This time it was two Latina phlebotomists, who kept telling Micah, "It's ok, Papi" while he was saying, "I DON'T WANT you to take my blood.  Please, DON'T TAKE MY BLOOD."  Fortunately, whichever one actually did the sticking was successful on the first try.  Thirty seconds, one gauze bandage and a few stickers and we were out of there.

Naturally for pain and suffering endured an appropriate bribe had to be offered, so we went off to the Toys-R-Us in Somerville (much nicer than the Princeton/Lawrenceville store).  Micah had $8 worth of coupons from his birthday, and I had to get something to make up gift baskets for Micah's school's fundraiser.  I have two nap quilts, but I wanted to put stuffed animals and a few books or puzzles to fill it up a little more.  Lucky us, Animal Alley was having a buy one, get one free special that day: one giraffe, one kangaroo/joey combo in the cart.

Then Micah and I made a donut stop at the drive-thru Dunkin Donuts in Hillsborough and we headed home.

For the afternoon, Steve took the kids to see his mother, so I had time to go to the post office, grocery store and Michael's for more supplies to finish off and decorate the gift baskets.

I also drove past a house for sale in West Windsor that is in one of the school districts that Princeton International Academy Charter School will be drawing from. . . . .more on that later.

Thea has been asking, asking, asking for stuffed peppers, so for Saturday's dinner I made four stuffed peppers and extra stuffing (which is how Thea likes it: stuffed peppers without the pepper, which seems perfectly logical to her).

Today Thea needs a haircut and has homework to finish, the house needs vacuuming and organizing, most of which will probably not get done (the home stuff, the haircut and the homework are non-negotiable.)

Movin' On Up

On Monday when he goes to school, Micah will be moving from Miss Margie's room to Miss Karen's room - the room that is usually the last stop before graduation and kindergarten.  We were notified by Summit School that the school does not anticipate Micah being enrolled in Fall 2010 because he has met his speech and language goals for his age and needs to have more exposure to normal-hearing preschool peers.

To say that that I was stunned is beyond an understatement. Not exactly what I was expecting to hear: Micah won't be eligible for kindergarten until 2011.

Though a bit of a bolt from the blue, this news is a testimony to Micah and how well he is doing with language acquisition, to the school and its staff for what they do for the children who are fortunate to be enrolled there, and to all those who have in any small way been a part of Micah's speech and language development.

But then, let's re-focus on the shock and awe of it all; it's like being kicked out of the nest a year earlier than expected.  Summit School is such a wonderful environment for students and their families, it feels a bit like Linus's blanket.  And by leaving, we're left to figure out what to do with Micah for the upcoming school year.

 I had indigestion for the entire afternoon after we got the news, without a Tums in sight.

Amongst all the possibilities, I'm not so sure about the school district's preschool, and it probably operates like its kindergarten: half day sessions.  Four hours of school is little use to working parents.  It will take a lot of convincing for me even to consider that as an option.  Micah seems to want to learn Chinese like Thea, so YingHua International School might be an option.  Beyond that, I need ideas and soon.

Meanwhile I'm working on getting ready for Micah's surgery.  Today I mailed off the forms to the Pre-Admission Testing Unit at Englewood Hospital, Saturday Micah will have his CBC drawn at Quest.  Next week I need to get one of my co-workers to do a quick exam for Micah so another pre-admission form can be sent in, then we have some downtime until the pre-op appointment with the surgeon on the 17th.

That downtime that will be filled with Family Fun Night at Micah's school on the 12th, another chemotherapy session for my mother (her sixth and final!)on the 15th, working and being on call for two weekends, having a senior nursing student shadowing me at work tomorrow - and the usual swimming lessons, homework harangues and other nonsense.