Simple Tonsillectomy….

Katy made a heart transplant look like a cake walk, however a simple Tonsillectomy caused my girl to need a crash cart.  I know I should always be prepared for Katy to react in true Katy fashion.  But, I have to say I did not expect what unfolded in the PACU on Friday afternoon.

Katy was scheduled for a tonsillectomy due to her enlarged tonsils that resulted from her viral infection back in February that caused her to go septic. Transplant patients are at risk for EBV =The Epstein Barr Virus better known as Mono.  This is one of the most common viruses that most of the population has.  However due to Katy’s compromised immune system due to her anti reaction medications she is unable to fight this virus and left untreated can lead to PTLD which is also known as Transplant Cancer and usually is fatal. 

Of all the complications that one can have post transplant (and Katy has had most of them) you never want to hear PTLD Lymphoma.  We heard those words and I nearly died… I could NOT believe that we were facing that diagnosis… and we weren’t YET.  But the EBV virus lives in her tonsils and they needed to be removed ASAP and would be sent for biopsy.

I hope that clarifies that this was not just a routine elective surgery… this was completely necessary and needed to be done ASAP. 

The morning of the surgery the surgeon decided that it made sense to add an adenoidectomy… due to Katy’s snoring etc.

The surgery took less than 45 mins and we were back with Katy who was feisty and demanding apple juice. She was given Tylenol and morphine for pain.  The morphine made her sleepy and her sats were dipping so she was put on blow by to keep her sats up.  After about an hour Katy became bright red and extremely sweaty…no fever.  Sats were now dipping while on blow by. Our nurses demeanor changed and I knew something was up.

The attending from anesthesia was called and could not get Katy to respond…he immediately called a Code Blue Respiratory  arrest on our baby girl and everything became a blur as they were bagging my girl and yelling out meds Nitric Oxide and I am not sure what else… all in an effort to wake Katy up.  I am sorry to say… but I lost my shit and was rocking in a corner of the PACU praying…begging and pleading with God not to take my baby. I really thought that Katy was gone… I didn’t and I don’t know how this tiny little 35lb baby can keep bouncing back… how she can keep fighting. But she did and I heard her scream from across the room.  Once again our prayers were answered. 

WHAT happened and WHY? Well it seems that it was most likely the perfect storm.   The combination of the dose of Morphine with the residual meds used in Anesthesia during surgery and Katy’s uvula was HUGE from swelling which was blocking her airway.  Katy was retaining Co2 her blood gasses showed her Co2 was 160 and it should be in the 40’s.

Katy was given meds to help with the swelling in her throat and was put on Bipap… and we prayed that would work and she would not need to be intubated.

We were then admitted to the CICU and Katy woke up again and wanted the mask off… we took it off her sats were holding well on blowby…until she fell asleep and then she had a few episodes when she would dip into the low 70’s… her airway was blocked again and she was not moving air. She was put back on Bipap until early Sat morning 5AM when she was wide awake and held her own all day even while napping after being given a dose of oxycodone. She woke up and was eating (chicken Fingers… cheese its) and drinking.  We said we were ready to leave and the team agreed.

Friday Code Blue… Saturday home! That is how Katy rolls.