More about surgery...

As I wrote last night, I ended up cutting the post much shorter than I had originally planned because I was so tired. So today, I'm hoping to give a little more information about the surgery on Monday.

We do not know what time it is yet. Because the doctor is coming in on a day he does not normally do surgery, there was no operating room slot reserved for him. They were going to work us in to the OR schedule, and we're waiting to hear today when that will be--mostly likely in the morning. The surgery will take about 2 1/2 hours. He will remove her encephalocele, any brain matter in the encephalocele, and then sew up the skin. He will not be putting any plates or anything to close the hole in her skull. The reason he will remove brain tissue is that the part of her cerebellum that is in the sac has not been getting proper oxygenation from blood flow, and it has been extremely pinched coming out through the opening in her skull--so it is already non-functioning. He will not be putting a plate in because she is still growing (obviously!), and they do not want to put anything artificial onto bones that are still developing. When we asked how the hole will close, he said it will naturally close on its own, once the brain tissue protruding through it is removed. He reminded us that the soft spot on the tops of babies' heads are also holes in the skull, and they naturally close over time.

She will go into a recovery room after surgery, and they will try to wake her up enough for me to nurse her. Then she will go to the ICU, until she's stable enough to be in a regular room. Once she's in a regular room, I will be allowed to sleep in the room with her for the next few days. We are anticipating 3-4 days in the hospital.

Once at home, David and I will keep an eye on her. We will be looking for signs of hydrocephaly, and the two main indicators to look for will be leaking of fluid from the incision (spinal fluid coming out), and bulging of the wound (indicating increased pressure). If either of these two happens, we will go back up to Indy, and she will have a shunt put in to relieve the pressure. We have not done any research on shunts yet, and only know what he told us: that a shunt is a lifetime thing, and it will need maintenance, attention, and replacement over the course of her life. They will not do the shunt surgery on Monday, with the hope that she might not need it. We are praying that she does not need it, but because her encephalocele has grown so much, the doctor thought it was very likely that she will need it.

The mortality rate on the encephalocele surgery is very low--they have never lost anybody in their practice. He said that because she is about 10 pounds, her blood loss will be minimal, and he was not worried about it. The shunt surgery is slightly more risky--about a 2% mortality rate. While this number is very low, we know that we can only trust in God for Hope's safety in both of these surgeries. He has seen fit to protect her thus far, and we know that He carries her in the palm of His hand.

I do have one piece of very exciting news from our visit yesterday: they measured her head circumference, and it came in at 37 centimeters. When I plugged this into an online growth chart, it came back as being the 40th percentile for head circumference. What a miracle! The last measurement, two weeks ago, was in the 10th percentile. I know that there is probably some human error in both those numbers accounting for some of the difference, but I watched the nurse measure her head yesterday, and she certainly didn't slip with the tape measure. It makes me cry to think that she has gotten so much bigger over the month, and I cannot help but praise God, who has given us one more little miracle in this process!