The details on Kendra

Yesterday was an incredibly long day.  We had to leave here at 5:30 AM, to arrive at WRAMC for her "show time" of 8:00 AM.  They finally came for her for the surgery (we were waiting in the surgery waiting room, talk about your cattle call) at 11:00. 

From there they ushered us into another waiting area, in which she was placed on the gurney, the IV was started, final information was taken and received.  Anesthesia was started just before 11:45 and I was sent off to the waiting room.  I was anticipating the surgery to be 3-4 hours long.

The surgery lasted until 5:30 PM.  The surgery was for the removal of bladder stones. Kendra is susceptible to growing bladder stones because her bladder was augmented with bowel tissue.  This bowel tissue continues to produce mucus and the mucus becomes an irritant to the bladder.  The bladder then secretes something to bind up the mucus and eventually a stone is developed (think pearls in an oyster). Much of this can be avoided if the patient flushes out the bladder routinely to remove excess mucus, but Kendra doesn't do this as often as she should.  Normally we catch this problem early enough that they can go in and pluck these things out through a catheter.  But this time these stones had been less painful for Kendra and had reached the size of eggs.  And there were several of them in there. 

Dr. Cartwright wanted to try to remove them intact (without breaking them up with lasers) to try to avoid leaving any "sand" behind to become new stones.  But once she made the incision, she discovered that they were even too big to slip through the opening she had made and she didn't want to make the opening any larger (not wanting to compromise a lot of the work that has been done over the years), so she had to resort to breaking up the stones.  AND there were far more stones in there than she anticipated. So the whole thing took longer. 

In post-op because of the size and composition of the stones, Dr. Cartwright is worried about infection as well as whether they did manage to get all the "sand" out with the stones.  By breaking them up for removal, the stones became less stable, so when they were nabbed to be brought out, they would break up even further.  Kendra currently has a supra-pubic tube in place (this is because of the surgical opening of the bladder, it allows for everything to heal before she uses her stoma again.  The tube is large and Dr. Cartwright intends to have Kendra's bladder flushed with saline through out today to hopefully bring out any residual "sand".    When Kendra does come home, she will have the supra-pubic tube still in place, making school attendance uncomfortable and darn near impossible. 

So.. what started as a "quickie" surgery has become a rather complicated situation.  Before I head back up to the hospital today, I need to call the school education office and see about arranging a tutor for Kendra for next week when she is finally home.  If there is any paperwork required from her doctor, I need to know this now, so that I can get it from her while I am there today.