Right CI Surgery and More

Yesterday Malachi had his right ear implanted with the Cochlear Freedom internal cochlear implant. It is a different internal implant than the one in his left ear (Nucleus 5).

He also had tubes placed in both ears because he has continuously had ear infections (9-10) since January of this year.

We went through the same process as before, with his left ear implant. We checked in at 6 am and started pre-op quickly. Something happened with our doctor and we were delayed about 20 minutes. There were several things I wanted to address this time around:

-Malachi had a stitch on his left ear incision pop through and it wasn't dissolving. I asked that they cut it down so it wouldn't rub on his processor and get infected or agitated.
-I wanted to make sure that they knew Malachi would wake up angry and would try to rip out his IV. I asked that they give him something to calm down initially.
-I asked that they pump his stomach to help with the nausea from the surgery and morphine.

This experience was a bit different in the sense that I felt a lot more confident at the hospital. I knew what the procedures were. What nurses and doctors would be visiting and talking to us, etc. I felt much more calm knowing what to expect.

Malachi was pretty content and happy on his way to the OR. We had stepped aside and as the nurse was rolling him out she would clap and he would clap back. It was cute to watch him flirt and show so much love to someone else.

After about 2.5 hours of surgery Malachi was finally all done. He received tubes in both ears, and a cochlear implant in his right ear. The ENT told us that his ears were a bit inflamed so they were already starting to get infected after 3 days off of antibiotics! The implant went in great as well as the tubes.

The main difference between the left ear surgery and this right ear surgery is that in the left ear they were able to cauterize thoroughly. Malachi had virtually zero drainage. This time it's different. Because Malachi now has metal in his body (the left cochlear implant) they were not able to use the same tools for cauterizing. The resident told me there would be more oozing and drainage than before. Well there wasn't any before so I was thinking a little bit of liquid. It's been quite the opposite. The drainage is dark pink colored. Mixed blood and the sterile liquid they use to irrigate the inner ear. I had to change the gauze after about 20 hours because the gauze was just saturated and if Malachi leaned against anything he got it wet.

When I first changed it I didn't look in his ear canal, just the incision behind his ear. The incision looks great! It's swollen, but otherwise looks awesome. After several hours later I realized Malachi's gauze was soaked again. This time when I changed it I looked into his ear canal. It's completely filled with liquid and slowly dripping out. It is very disconcerting to see bloody liquid drain out of your child's ear.

I called the on-call pediatric ENT at MUSC and after explaining the situation to her she believes the drainage is well within the normal standards at this point. She was able to give me more specific guidelines for the drainage so I am feeling much better about it.

Hopefully I'll be able to post some pictures soon....when his ear stops dripping!

Malachi's Scar/Incision Left Ear

Warning. Semi-graphic photo of incision site. Don't look if you don't have the stomach for it!

Malachi is still wearing his head gear bandage but rips it off every once in a while. I'm keeping it on for a little while longer mostly  because I'm having the worst time looking at the incision. The outside is held together by Dermabond (skin glue). It looks shiny and wet even though it's dry. It kind of makes the incision look like it's draining and oozing (it's not really). It kind of freaks me out. The incision itself is no longer than 2 inches and runs along where the back of his ear connects with his head. His scar will hardly be noticeable and should be further covered by his processor.

Left CI Surgery

Today Malachi had his first CI surgery.

We were told that we needed to check in at 6 am. This meant Brandon spent the night at Oma and Opa’s house. We woke up at 3 am to leave the house at 3:30. There was virtually zero traffic (duh!) and we even made it there 15 minutes early. After about 30 minutes after checking in I noticed that nearly 6 people that had checked in after us were taken back. Turns out that the scheduling nurse told me the wrong time to check in. We didn’t need to check in until 7:10. So we spent about an hour twenty minutes in the check in room for the OR.

Malachi has some congestion and a little cough so they checked his ears and lungs to make sure he didn’t have an ear infection or wheezing. He passed, so we started with the pre-op.

They put him in a little gown (he looked soo cute). They let him play with some toys on the gurney. First they gave him some Versed, it’s like valium for babies. Malachi got super loopy and couldn’t sit up. Once it was in full effect and we had talked to all the nurses, anesthesiologists, and surgeons we gave hugs and kisses and watched as they rolled our little boy to the operating room.

When we checked in they gave us Malachi’s patient number. In the OR waiting room there was a big screen with the patients’ numbers color coded describing where the patient was. For example “Patient Operation in Progress” would show next to Malachi’s number and was colored orange. It was very comforting to watch his progress through the steps of operation. After about and hour and 45 minutes his nurse called down to the waiting room and told us they were putting in the implant. About 35 minutes later the surgeon came out to us and told us everything went perfectly and as planned.

We were brought back to Malachi about 20 minutes after seeing the surgeon. He was inhaling apple juice with the nurse holding him. I got to hold him immediately. He was REALLY out of it. Malachi had pulled out his IV right after coming out of general anesthesia so they had to put another one (in his foot). He was very bothered by the IV. So much so he wasn’t really bothered by the large bandage/covering on his head and ear. They had given him morphine for pain and it made him sick to his stomach. He threw up everywhere (including on me!). It was a little nerve racking because part of what he threw up was old clotted blood. This is normal though because your ear/nose/throat are all connected and it’s normal for that to drain after surgery.

He was pretty cranky and would drift in and out of sleep. After about 2 hours Malachi was stable and he hadn’t thrown up again so we got his prescription and checked out. Malachi was still pretty out of it at this point. Driving out of Charleston (down town) the roads are pretty bumpy. Every time we went over a bump Malachi would cry. Then he just threw up. Everywhere, again. The throw up looked the same at the first time and I was a little nervous that something else was wrong. They told us it was okay if he threw up a few more times so we cleaned up and went on our way. Malachi slept most of the way home. Brian had to be careful to not hit pot holes or large bumps because Malachi would cry. 

Malachi hasn't fussed over the bandage that much. It annoys him, but hopefully he can deal with it for a little while longer. The doctors said that he needed to leave it on for 24 hours minimum. I'm going to push it for as long as I can. 

So far Malachi seems to be returning to normal pretty quickly. From what I understand he should be feeling like his old self tomorrow.