Did your stomach drop when you read that? It's been 13 hours since I learned that this is how Verity reacted when she was given fentanyl during a simple, outpatient tenotomy surgery. And my stomach is still churning.
Let's back up a bit and start with the easy part: the tenotomy portion went well. Verity is sporting purple casts attached to a wooden bar. The casts are to keep her Achilles tendons flexed, and the bar is to keep the hip abductors positioned just so. Both sets of tendons underwent this lengthening procedure. Verity will wear the casts/bar for 4 weeks. (Note to self: Call to schedule the cast-removal appointment. My brain could not handle making that phone call today.)
I knew Verity would be completely under anesthesia for this surgery. She has been under twice before (once for her g-tube placement and once for a sedated hearing test), and both times she had zero issues.
What I did NOT know was that fentanyl was part of today's protocol. I had asked upon arrival what the pain management plan was, and a couple different nurses assured me the doctor would go over that with me. It was about 45 minutes between when I asked and when it was surgery time. They allowed me to carry Verity to the operating room and be with her while she went under, and then someone whisked me away. Honestly, I totally forgot to pursue the medication question...(trust me, I've carried the weight of guilt because of my memory lapse)...I had realized that Verity's feeding pump and supplies had fallen out of her diaper bag, and I was anxious to grab them and return before they called me back.
It probably took me about 15 minutes to retrieve those supplies from my vehicle...15 minutes during which I had NO IDEA an anesthesiologist was doing the work of breathing for my daughter.
I had hardly sat down in the surgical waiting area when it was all over: an attendant walked me to the post-op room, where I found a very sound asleep Verity and got the run-down from the post-op nurse.
I did not hear about the fentanyl.
We waited and watched Verity. Her sats and heart rate were good, respirations were low (10-11), but that was to be expected, they said.
Verity slept. And slept. And slept.
The anesthesiologist came by to check on her. He said nothing about the incident. Nothing at all about the fact that my baby had stopped breathing while under his care.
Verity continued to sleep.
The surgeon came by to check on her. He said nothing about the incident. He did say he only recommended ibuprofen for the pain.
Verity continued to sleep. And as the two-hour mark approached and she was still sleeping, we tried some creative measures to wake her up. We got close...and then she would go right back to sleep. I wondered if I should be getting worried, but her color was good and by this time she no longer even needed the blow-by oxygen.
The post-op nurse has 40 years of nursing experience, and she was pretty calm. But I think by this point she was getting a little concerned herself. The nurse talked out loud as if reassuring us both that it wasn't too surprising that it was taking longer for Verity to wake up...after all, she's definitely a "lightweight." After all, it was only a little bit of fentanyl that made her stop breathing for 15 minutes.
WHAT?!
I have learned I am not very quick on my feet when things like this happen. It really took me all afternoon to process all of this: I wasn't told my daughter--my almost-21-month-old, 17-pound daughter with special needs--would be given fentanyl, a drug that has killed children in the Trisomy community. Furthermore, the doctors who had my daughter in their care...literally held her life in their hands...did not tell me that she stopped breathing for 15 minutes. The only reason I learned this happened was because the post-op nurse made a passing comment. I had spent nearly 2 hours with her and even SHE did not mention this staggeringly important detail!
Am I crazy to think this is a rather vital detail to be left out of the post-op narrative?!
I have contacted our PCM and received a reply from his nurse right away--she wants me to call the patient advocate at the hospital to get it documented and request a call back from the provider. I do wish I had been able to say something while I was there in person...I think I was so stunned, and then I also needed reassurance that it was in fact all right for me to take Verity home after all this had happened. She did wake up more or less "for good" about 3 hours after surgery, and we have monitored her all day and she has done better than expected, actually. I anticipated a rough few days and nights...she napped well this afternoon, and though the evening was a bit difficult, she is resting well now with her pulse oximeter on and nasal cannula in place.
But let the records show...fentanyl will NOT be given to Verity AGAIN!!!
Thank you, Heavenly Father, for protecting our precious girl today. May she (and we) ever glorify you no matter what...
