Surgery

Erica in her room on Tuesday

We arrived at the hospital at about 9:30am on Tuesday morning, ready to be admitted and take some routine tests. We got shown to our room, which was a shared room. I had said at the previous consultation that I didn't mind a shared room, I'd stayed in Japanese hospitals before and knew the drill, so no worries. Plus it saved money. There was only one other boy in there, and his mother. However, they left before the day was out, so we ended up in there alone anyway. And I heard the doctor asking on the second night, after the surgery, if we were in alone, I think he thought we would need to be alone to cope with her recovery.

Height, weight, blood, heart and x-rays. Only the blood tests they did without Mummy or Daddy there, and she came back to the room, walking hand in hand with the nurse sniffing a bit from crying. She told us all about it, garbled sentences (she still doesn't speak very well) with lots of 'doctor' and 'here' and 'ouch'. So I was glad we got to accompany her to the heart test and x-ray after that. Then the doctors came to talk to us, and we signed consent forms and admittance forms and got explanations of the hospital routine and Erica's 3-day schedule.

Only parents, grandparents and kindergarten teachers were allowed on the ward, siblings had to wait in a family room just outside the nurses' station. So we were constantly going from one room to the next, checking up on the big girls, then back to Erica's room to wait for the next nurse or doctor visit. Fortunately it was all over before lunch, and Kanji took the girls home after I took them out to lunch at the restaurant next to the hotel (down-home Japanese cuisine - crowd-pleasers like tempura and other teishokus, oden, spaghetti, and a nice bakery attached where I stocked up on bread for dinner) . Then Erica and I were left to fill the long afternoon!

In the playroom

We watched TV, and colored, and read books, and played in the big play room and watched a video in there, the Jungle Book, which Erica has been longing to see since she read the book at kindy - but which was not available at either of the DVD stores in town. We had a bath in the middle of the afternoon, it seemed a nice way to pass the time. Dinner was early, she didn't eat much. I had my ham and cheese bun and a basil roll. Then I read a book and played games and read magazine on the ipad, while she watched TV and finally fell asleep. We didn't sleep to badly considering the narrow bed! I knew to bring a pillow from home, all you get is a sack of stones.

On her bed Wednesday morning; we're a little more settled in now

Doing puzzles in a kids' magazine, using her left hand for the last time in a while

Wednesday morning of course she wasn't able to eat before her operation. The deadline was 6am so I got up at 5:30 and gave her a bowl of the cereal I had brought for my own breakfasts and the last of my milk (no good to me since hot drinks were not allowed on the children's ward). She also ate some biscuits we had bought the day before at the convenience store in the hospital. She was allowed drinks until 10am. We did the same as the day before, played with a kids' magazine, watched TV, played in the playroom. I was pleasantly surprised at how well she coped with the no eating - she didn't even ask for food. That was one less stress for us to cope with. We also had a bath again, which helped distract her.

Finally Kanji and the girls arrived, and the countdown began. She was scheduled to start at 12:30, so they came to change her clothes and take her temperature once last time at about 12:15. I carried her down to the O.R. Only one of us was allowed to go in, and it was me. We didn't wait outside the OR, we waited outside the whole ICU unit, by the elevators. I went through one foot-controlled door, and put on a gown and cap, then through another to the surgery suite. Erica's room had a Anpanman poster on the entry wall. And there was a colorful towel blanket covering the table, and a big Winne the Pooh and three smaller toys on the blanket. This simple technique actually worked very well at distracting her from the big room with all its scary equipment. She just zoned right in on that Pooh Bear! Actually she then chose the smaller toys, and hugged them along with her own teddy bear that she was allowed to bring in. You got the feeling that they've done this before with little ones, which is very reassuring for the parents as well of course.

They allowed her to sit on the table while she got monitors put on her chest and toe. She was very reluctant to lie down, finally I had to scoop her up and lay her down. She resisted a bit, but not much, I held her shoulder gently with one hand and stroked her temple with the other as they put the mask over her face. She fought it a bit, but the drugs worked very quickly to sedate her and she relaxed. She fought sleep too, as I told her it was okay, she could sleep now. As soon as she drifted off, I left, with her teddy bear, to wait it out.

We were asked to always have someone waiting outside the unit. We took turns going up to see the older girls, who were still in the 6th floor West Wing family room. The surgery unit was on the 4th floor East Wing. I went first to get my bag and phone and book. Then he went for about 40 minutes, then I went, and took the girls to the same restaurant we had gone to the day before. I didn't really feel like eating, but I knew Erica would not be eating for at least six hours post-op, so I thought I should eat something then.

And then I headed back, and Kanji went up for another 30 minutes. When he came back just after 3, to let me go up again, I didn't want to go, as I thought she might come out soon. The actual surgery was scheduled to start at 1pm, and to go for two hours. The nurse who took us to the OR explained that with the surgery, and waking her again, it could take up to 3 hours total. I started counting that 3 hours from 12:30, never forgetting the initial 2-hr estimate, and Kanji started counting at 1pm. So I started getting hopeful at 3pm, and started to get concerned at 3:30. The doctors did not emerge until nearly 5pm, so it was a hellish last hour! No, no-one came out to tell us anything, which made it worse.

During the time she was in, four others were wheeled past into surgery... and out again, including one poor fellow with bandages on his head who was wheeled out twice for CT scans (clearly don't have scans available on the surgical floor) and back in again, but no Erica.

Finally the doctors only came out, which startled me again as we were ushered into a side room. The head surgeon looked exhausted, was sweating and his hands (such small hands he had!) were shaking. They said it had been more difficult than expected, but everything was fine now. Phew! They then showed us photos of the progress. These were, of course, awful. I'm glad he showed us the photos of the hand immediately post-op, with the black nasty stitches, during our last consultation as that gave me some warning. Other pictures of her hand reminded me of nothing so much as her hand how it looked about a week after she burned it, still not healed. The foot I was less prepared for the foot, it looked awful with the flesh torn off. I recognized it as HER foot, and could see the rest of her leg and body in the background - and THAT upset me more than anything! So they explained what they'd done, which was as he'd previously explained to us - cut out the hypertrophic scar on her hand, zigzag the edges of the wound (because a straight line is less likely to turn into a hypertrophic scar), cut a thick piece of skin off the foot, and put it on the hand, then cut thinner pieces of skin from around the cut on the foot, and graft them onto the site of the thick graft (domino graft) to help the donor site heal better.

We then had to wait another 20 minutes for her to come out of the general anesthetic, and we HEARD that before we were called to her - screaming in shock and pain, it was awful. I had imagined she'd still be groggy from the drugs, and she was I suppose, but that grogginess alternated with screaming. I managed to sooth her off to sleep again, but every bump of the stretcher on the way back to her room set her off again, then for the next hour she woke every few minutes complaining of pain, until the pain killer they gave her after the general wore off started to kick in. Slowly, the periods of time she slept in between waking in pain and crying grew longer. Kanji and the girls had to go home, so it was just me again taking care of her. She had a drip in her right hand, a pulse ox on her right toe, and I had to hold an oxygen mask near her mouth as she woke up and panicked when it touched her face.

After a while I only held up the oxygen when the monitor said 96-97! It was tiring! They said she needed it for the first three hours after surgery, to make her recovery more comfortable, so I persisted. So at 8pm I stopped that. I slept soon after - I figured I had a long night ahead of me. She woke many times of course, then she woke for a longer period at 1:30am, and I called for more pain relief for her then. That got her through to morning.

She woke early, quite alert and said she was hungry. I called the nurse and they said she could have yogurt or purin and then eat more if that didn't make her sick. That had been the plan for 8pm the night before, but she slept through so we didn't try to feed her. Now, in the morning, as the nurses told me that, but made no move to get any food, I finally realized they meant *I* should provide the yogurt or purin. I was annoyed that no-one had thought to tell me that, and of course I didn't have any. She was asleep again by then, so I ventured down to the convenience store (at 7am) but it did not open until 8am, the same time as breakfast came, so that didn't solve my problem. I did get coffee for me though from the vending machine.

Thursday morning, getting ready to leave for home

So I fed her crackers, what my mother had always advised as a good start for a nauseous stomach, as they are dry. She ate about six, plus water to wash it down as she sat back on the pillows watching TV. Then she ate half her breakfast rice. Kanji was trying to get there early to be in time for the doctor visits, but he didn't make it. They came pretty early, both of them between 8 and 9. The nurse removed her drip, the receptionist turned up with the bill (85,000), we packed up and were home by lunchtime!

A few spare photos - her hand before surgery, the 'view' from the hospital window (6th floor no less! That's the East Wing we can see). And Shrek busting Romeo and Juliet.