As the Rieben World Turns. . .

It has been a tradition in the Rieben family that, when we go into the hospital for what should be "routine" procedures, we end up staying for at least a few days. Now, I realize that any and all surgical procedures carry with them the risk of complications and admittedly, prior to each surgery we have been prepped for potential hospital stays, but I guess the eternal optimist in me is always trying to stay focused on the best-case scenario. After our latest experience I have learned that you CAN pack a hospital bag and still be optimistic!

When I picked Joshua up from the orphanage in October, one of the first things that I noticed when changing his diaper was the absence of his testicles. Upon further examination once we arrived home, it was concluded that his left testicle was likely absent and that the right testicle had simply not descended. We scheduled surgery with the pediatric urologist and on Wednesday we headed to the hospital for the procedure. The procedure would consist of three things. To start, the doctor hoped to do laparoscopic exploratory surgery to locate one (or both) testicles. Upon finding the testicle(s) he then planned to attempt to descend it. If he was unable to descend the testicle, we agreed that it should be removed (as the risk of testicular cancer is greatly increased if a testicle remains undescended). We also planned to have Joshua circumcised (primarily for medical reasons associated with his condition, but also because the other boys in the family are). The surgery was scheduled to take 1 hour 45 minutes or less.

1 hour and 45 minutes into the surgery the doctor called from the OR to tell me that they had been able to locate both testicles, but that the left testicle would need to be removed because it was not functional. He had located it all the way up by his left kidney. He had also located the right testicle and it appeared to be healthy and was "mobile" so he planned to descend it. Unfortunately, because Joshua's anatomy is not completely normal and the doctor was not able to see well laparoscopically, he had to open Joshua's abdomen (so mommy and Joshua now have matching scars). 3.5 hours after the surgery began, Joshua was taken to recovery. The surgery was a success.

Because they needed to do more invasive surgery, we were informed that he would be staying overnight for observation so we were given a room in the "Almost Home" unit of the hospital and Richard and I went up to wait for him. Before heading upstairs, a nurse came to let us know that Joshua had spiked a fever of 104 and that they had given him tylenol. Usually the words "Joshua" and "fever" used in the same sentence give me a feeling of dread in the pit of my stomach, but seeing as he had just come out of a difficult surgery, I took a deep breath and hoped it would come down without further incident.

2.5 hours after he had been taken to recovery, one of the recovery nurses came upstairs to ask us some questions about Joshua and his fever history. They said that they were having a little trouble waking him up and that they had not been able to bring his fever down. The nurse wrote down the phone number for our room and told us she would call us as soon as she knew something. 10 minutes later, another nurse walked into the room to tell us that we could come back downstairs and that they were going to let us go back to recovery to see Joshua. She told us to bring our things with us just in case we didn't come back to the same room. As soon as she said that, I knew we would be going to the PICU.

Once we got to recovery I got the full scoop on what was going on. Apparently it had taken over an hour to extubate him and that, once extubated, he needed an oral airway to keep his oxygen saturation up. They had given him two doses of tylenol, but his fever remained at 104 and his heart rate was extremely high. They decided that it would be best if he spent the night in Intensive Care so that he could be closely monitored. So, after 4 hours in recovery, he was taken to the PICU where he spent the night. His fever went down, his heart rate returned to normal and he was oxygenating at 98-100%. We learned the next morning that the urine sample taken prior to surgery showed bacteria and that he had another urinary tract infection which was likely the cause of the fever and so the doctor decided to admit him to the regular floor for at least one more night so that he could do a round or two of IV antibiotics.

He has done wonderfully and was released from the hospital yesterday morning. Once again, the resilience of children amazes me. He has 3 incisions (a small incision right at his belly button, a large incision in his lower abdomen and another small incision in his scrotum) and was circumcised and he is moving around, happy as a lark, as if nothing has happened! He is starting to sit for short periods of time and I can imagine that, in a few days, he will be tired of just lounging around and will likely take off crawling again. So, despite the post-op scare, surgery was a success and Joshua is recovering beautifully. Now if we could just stay out of the hospital for awhile! Have I mentioned how grateful I am for Aflac. . . .