Sunday, 15 June 2014

Princess Poppy's 2nd Eye Operation

On the 30th May 2014 Poppy went back to King's college hospital for her second operation.  As you will know if you have followed our story from the start, her first operation was when she was six weeks old to remove the cataract that she was born with in her left eye and also to have the artificial lense (intra-ocular lense or IOL as it is often referred to as) fitted.  Since then she has had two issues with her eye: it started to turn in and scar tissue (sometimes referred to as a "secondary cataract" as this scar tissue can occlude the visual field if severe enough) began to grow.  In the last 12 months the scar tissue has not become any worse.  It does, however, occlude a large part of the vision in her eye and leaves her with a gap at the top left of her pupil that is not covered.  The ophthalmologist has for now said that as it is not totally occluding the visual field then they will delay surgery to clear it for as long as possible.  I understand the reasoning behind this as you have to weigh up the pros and cons.  As soon as it is cleared more scar tissue could just form again and so the doctor wants to minimise the amount of surgeries as there are risks associated with general anaesthetics.  Anyway, it was discussed at the beginning of the year that what was needed next was surgery to correct the severe squint that Poppy had developed since her cataract surgery. 

So on Friday 30th May we travelled down to London with Grandpa for her eye muscle surgery.  We had to be there for 7.30am so it was an early start!  Poppy was not allowed to eat anything past 2.30am so I gave her a snack before going to bed at 8pm.  She was then allowed water up until 6.30am.  I was really dreading this part, not being able to give her any breakfast.  Anyway, it turned out we were second on the surgery list that day, which meant that she didn't get to go in until 11am.  For the first few few hours she was brilliant.  She sat in the bed in her gown playing with all the toys that I had packed in a bag to keep her amused.  She kept getting off the bed and having a little walk or dance around.  There was a little girl of a similar age in the bed opposite and they both amused eachother for a short while, both sitting in their buggies and babbling to one another.  By about 10am Poppy was starting to get impatient.  She was obviously hungry and thirsty and kept asking me for milk.  It did start to get a bit stressful at this point, this was one of the things I had been dreading as I'd really hoped we would be first on the list.  The little girl that went before us must have been a couple of months younger than Poppy and the list is done youngest first so that was just the way it was.  So at 11am I walked through the theatre to be with her while she was put under the anaesthetic.  There were two male doctors there and they asked me to sit her on my lap and get ready for a struggle, saying that sometimes it takes three people to hold a child down.  I felt horrified at this, it must be so difficult to do that as a parent.  Poppy, however, did not put up a fight at all.  I think she was tired from the amount of time we had been waiting and I sat her on my lap, holding her tight and kissing her head, reassuring her saying, "Mummy is here, it's okay", over and over again.  The doctor put a mask over her mouth and within seconds her limbs had gone limp.  I gave her one last big hug and said I would see her again very soon and lay her down on the bed.  She looked peaceful like she was just sleeping.  I gave her a kiss and left the room.  The fact that she didn't fight it I think made the while process easier for me. 

The operation took around an hour and a half.  I was convinced I could hear her crying and screaming as she was in recovery.  I just wanted to run in to her but knew I couldn't and figured they would bring her out very soon.  It all went quiet and then it seemed like a long time until eventually she was brought out.  A nurse was carrying her and she put her in my arms.  This moment was an immense relief.  Her eye was totally blood shot and she had a little blood and graze around her lip from the tube, but she was back and she was going to be okay.  I am still nursing her and so of course she just wanted to latch on.  She was extremely sleepy and would have just stayed latched on in a half sleeping state all afternoon if she'd have had her way!  I was aware though of the fact that the nurses wanted to see her eat and drink something and have a wee in her nappy before they would discharge us.  I was also aware of the fact that we had a car journey of around 3 hours (depending on traffic) so I couldn't let her lie there all afternoon.  I sat her up on the floor while I got her change bag out.  She was so sleepy she was closing her eyes while sitting up!  I changed her nappy and got her out of the gown and back into her clothes.  I tried giving her sips of water but she didn't want any.  She did decide though that she would like some flapjack and had half a carton of juice, so after just around an hour and a half  the nurses were happy with her and we were discharged armed with eye drops and ointment to apply 4 times a day for 4 weeks (plus liquid paracetamol to give every 4 hours)  She slept on the journey home, in between waking up to eat a cream cheese sandwich!  We got home around 6pm and were greeted by Daddy and her siblings who were all very pleased to her!  I was surprised that there was no shield or dressing put on the eye and it was quite difficult to look at it to begin with as there was a lot of blood but it was obvious straight away that it looked so much better, it looked almost completely straight.  We are realistic and we realise that because of the nature of Poppy's eye condition it is most likely that the eye will start to wander again as it is so weak in comparison to the stronger eye, and so this operation may need to be repeated a few times in the future. 

It is two weeks on now since the operation.  There is a little bit of blood around the corners of the eye but it is looking a lot better now.  We gave her the liquid paracetamol for three days post op and after that we didn't feel she needed it.  The morning after the operation she sat up in bed and said, "hurt" and pointed to her eye.  That was the first time she had said that word.  I felt proud about how her vocab is expanding at such a rapid rate but I wish she hadn't have had to go through that to learn that word my poor baby!  So when she stopped saying hurt or crying for no particular reason we figured the pain must have subsided.  We are still going with the eye drops though, 4 times a day.  It was more difficult to begin with than it had been when she younger as she fights it more!  However, the other day instead of forcing her eyelids apart I said to her, "open your eye" and she opened her eye and I just used my fingers to keep it open as I popped the drop in, and so that is how we do it now.  We hadn't used the ointment before so that seemed strange to begin with to put that on the bottom eye lid but I think that is actually easier as you just have to pull the lower eyelid down and at least the ointment stays there instead of dripping out like the drops do!

We gave her a week off patching while her eye was recovering.  We have started back this week and I was a little disappointed that it has not seemed to really help with the battle that we have with her keeping the patch on!  The thing is she still has the scar tissue so the vision is still limited whether the eye is straight or not.  The first few days back at patching were tough.  We didn't make it past 2 hours and she seemed to be tolerating it even less than before the operation.  I think it was the fact she had had the time-off and so we had got out of the routine.  I had days where I said to my husband that I was going to tell the doctor we're giving up with patching because it is just too stressful!  But then I keep reminding myself of how the doctor told me the single most effective thing that can be done to help that eye is to patch!  And then I read success stories on my Facebook cataract support groups and I know that patching works so the stress has to be worth it.  I have to remind myself to just take each day as it comes...if we have a bad day forget about it...try to have a better day tomorrow and most importantly, never give up.

In two days time Poppy and I are making another trip down to London for her follow-up appointment.  We are hoping that the doctor will be happy with her progress so far, so will keep you updated!  Will finish with some photos of Poppy over the last month before her operation, on the day of the operation and after the operation:

PRE-OP:



 
 
OPERATION DAY:
 
 
 
 
POST-OP:
  
 




 
 

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