And by Mouse Surgeon I Mean Surgically Trained Rodent.

by Alexa on February 21, 2008

This afternoon Simone will be having surgery to close her PDA, an errantly open blood vessel between the aorta and pulmonary artery. This surgery is being touted as The Thing That Will Make Her All Better, and in theory it sounds like an excellent idea. This open vessel is dropping her diastolic pressure and filling her lungs with fluid. It is impeding her progress on the ventilator, and has in fact resulted in increased oxygen needs. Two rounds of medication have failed to change the size of the opening one whit. I have no doubt that a cohort of Magic 8 Balls asked whether surgery is the best option would agree that IT IS DECIDEDLY SO.

Except…she is so tiny. They say her heart is the size of her fist, and her fist is the size of a small peanut M&M. Simone is really not much bigger than the bulbous nosed man on the Operation game board, and as I recall, that game was exceedingly difficult, even when extracting something as large and easy to grasp as, say, the Bread Basket. Admittedly, I did not have advanced surgical training back then (not to imply that I do now, though I have seen my share of televised medical dramas) but I was an uncommonly dexterous child. And today’s operation sounds like the sort of thing that would be possible to perform only via robot or mouse surgeon.

The PDA ligation procedure involves making a small incision in the side/backish area (technical term) of my daughter, lifting up my daughter’s lung to gain access to my daughter’s heart, and either placing a tiny clamp around the open ductus of my daughter or sewing it shut.

The most common complication of the procedure is damaged nerves or paralyzed vocal chords resulting from nicking something unintended during the procedure. Under these circumstances, I would feel much better if the pediatric surgeon would humor me by playing an exhibition game of Operation later this morning before surgery. I would be happy to provide the game itself, and if he can remove even the awkwardly shaped sparerib and the slender pencil without setting off the buzzer, then I will sign the consent forms. I don’t think this is an unreasonable request, seeing as my daughter’s surgeon is not the one up at five a.m. terrified and Googling pda ligation neonatal while holding his thumb and index finger apart to approximate the size of the vessel (or at least I sincerely, sincerely hope not). My nerves are threatening to strike. A reassuring demonstration of agility is the least he can do.

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{ 96 comments… read them below or add one }

Heather February 21, 2008 at 11:06 am

I’ll be sending up a prayer as soon as I post this…

She is a fighter. I have confidence.

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Amanda Hope February 21, 2008 at 11:18 am

aaah and eeeek!!! will be thinking of you this afternoon. and hopefully it will really for serious be The Thing That Makes Simone All Better.

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robin February 21, 2008 at 11:18 am

I am amazed at how well you keep your wit and writing up even in these circumstances. I’ve only been following your story for a short time, but I think you’re a remarkable woman.

Sending thoughts and prayers to you and your family today…

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Leah February 21, 2008 at 11:19 am

I am praying for your family.

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elizabeth February 21, 2008 at 11:20 am

Alexa, it sounds terrifying! I once sat in a waiting room holding my mother-in-law’s hand, while surgeons repaired my husband’s lung. He is a full-grown man, with plenty of room to maneuver in there, but still I was falling apart. Having the life of someone you love being held literally in the hands of someone you don’t even know can’t be anything short of terrifying. Still, surgeons are amazing, and very good at what they do, and most of the time it all turns out wonderfully. I will be praying for you, and Scott, and Simone today, and wishing I could do anything more.

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andrea_jennine February 21, 2008 at 11:23 am

I am praying for you and Scott and Simone and the surgery right now.

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Laurel February 21, 2008 at 11:30 am

Thinking of all of you this morning. I’ll be praying for a quick, smooth, and successful surgery for Simone and a deep peace during the proceedure for you and Scott. And I would hope that ALL NICU surgeons would have to play a perfect round of Operation during their boards, just to make sure…

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Melissa February 21, 2008 at 11:31 am

My godson had his PDA operated on when he was just slightly larger than Simone is now (he was 2# at birth). He came through just fine and the scar is barely noticeable now that he is three years old.

If you want to talk to a mom who has been through this, I’m happy to pass along my friend’s contact information.

Will say the Mi Sheberakh for Simone tonight. Best of luck.

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MsPrufrock February 21, 2008 at 11:51 am

How are you so funny and such a good writer at times like these? You continue to amaze me.

Not to sound casual, as I would totally be freaking out if I were in your shoes, but I have seen programmes where surgeries are done on the tiniest babies and it is amazing what they can do. If it’s on TV, it must be true.

Good luck to you, Scott, and Simone. I will keep you in my thoughts, as always.

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Mandy February 21, 2008 at 11:54 am

I’ll be thinking of Simone today (and you!), and feel certain that a surgeon brave enough to do something like this must be very skilled indeed! I know you must be terrified; think of the great relief you will feel when they let you know that all is well.

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Allie February 21, 2008 at 11:59 am

Hoping, praying, wishing, sending good vibes; anything/everything I can do that might help. Good luck.

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TB February 21, 2008 at 12:00 pm

Alexa, for someone going through what you are to have a wit as sharp as yours is utterly amazing. I doubt I would be able to string together coherent sentences.

I’m thinking of you guys and wishing every good thing for a successful surgery and recovery.

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fisherqueen February 21, 2008 at 12:03 pm

I will be thinking of you as I have been this whole time. My strongest hopes and prayers are headed your way.

Can you ask for more percoset? Drugs for mom sound like a very very good idea right now. Seriously.

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Erin February 21, 2008 at 12:09 pm

Alexa – I’m thinking of you, Scott and Simone all the time, and will think extra hard this afternoon. Hopefully you’ll be able to keep us posted about how things go, but I just know she and the surgeon can pull this off without any annoying buzzers going off!

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Julie Molloy February 21, 2008 at 12:17 pm

Don’t know if you’re OK with this, but I’m taking the liberty of praying very hard for Simone Lee, you, Scott and the surgeon this afternoon.

Take care,
Julie

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Leslie February 21, 2008 at 12:19 pm

Alexa –

I will be thinking of you,Simone, and Scott ALL DAY and praying that everything goes smoothly! And Becky is right – she won’t remember any of this!

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lizneust February 21, 2008 at 12:25 pm

My nephew had his PDA done when he was 2 weeks as well (I don’t remember lbs, sorry). He came through w/ flying colors and is now a happy, healthy, bouncy (really, irritatingly bouncy) little 4 year old with a great sense of rhythm. That may not have been a result of the surgery, though. Prayers, hopes and all good wishes coming your way.

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Stacie February 21, 2008 at 1:01 pm

I am sending hugs to you and Simone. I know how scary opperations are while they are still so tiny. Remember and say this to yourself–she WILL get through this and she WILL be just fine. This WILL help her tremendously.

Simone is a fighter!

Positive vibes to you and yours.

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Lila February 21, 2008 at 1:05 pm

Alexa – these doctors know what they’re doing. They’ve done it before. Your daughter is in the best of hands.

I’ve been thinking of you and your baby all the time and continue to do so. Prayers, energy, positive thoughts from far.

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Stefanie February 21, 2008 at 1:11 pm

Man, the hits just keep on coming, huh? I feel for you like nobody’s business. You will definitely be having some PTSD after this is all over but in the meantime, it’s like war. Just run on adrenaline and be there in spirit for your daughter. She will be okay. When I was in NICU there was a surgery almost everday and they all seemed to go fine. There were tons of babies as tiny as yours and let’s just assume that the surgeon isn’t just doing this for a hobby. Let’s hope he knows his shit. I will be thinking about you.

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MJ February 21, 2008 at 1:19 pm

When I had an epidural I quizzed the doctor on the number of times he’d done it, most common complications, etc. He was slightly amused to see/hear this largely pregnant woman “interviewing” him. So, I think a good game of Operation is definitely in order.

I’m thinking positive thoughts for you, Simone and Scott.

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Jennifer February 21, 2008 at 1:21 pm

Sending lots of good thoughts your way this afternoon. I know any procedure is scary but Simone is in great hands.

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Marti February 21, 2008 at 1:54 pm

Being a medical transcriptionist, I have typed many of those PDA closures. Believe me, the surgeons and team will be excellent and Simone will do very well. They are very careful with these precious little ones. Her blood pressures will become normal, the fluid in her lungs will go away. She will “pink up” nicely. The PDA closes on its own after a couple weeks when a baby is full term, but because there are so many precious premature infants in this world now, the surgeons have to do it.

I have and will continue to pray for this “Flotsam” family.

If you ever want to visit “Neopets.com”, and look around in it, you will find that a Flotsam in Neopet world is another name for a dolphin. Neopets is a children’s website full of games and fun things to do. You can adopt “pets”, which are literal neopets – and they are common animals named funny, childish names. A Kangaroo is called a Blumaroo. A dolphin is called a Flotsam. My grandkids are all involved with Neopets, and that is how I found this website, by putting “Flotsam” into Google. I’m glad I did. :o)

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Adriane February 21, 2008 at 2:01 pm

I think a quick game of Operation is only fair in order to judge and assess skillset. Please know I will be praying for you and Simone today.

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Julia February 21, 2008 at 2:03 pm

Thinking about you often. Very fervent good wishes for Simone today.

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Mel February 21, 2008 at 2:09 pm

I am sending a hug, good thoughts, and much peace. Thinking of Simone today.

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thalia February 21, 2008 at 2:56 pm

thinking of you sweetie. I’m sure that surgeon is quite the skilful person (man/woman?) It must be terrifying, though. Hang in there.

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rockmama February 21, 2008 at 2:57 pm

Thoughts for you and Simone coming your way!

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Sarah February 21, 2008 at 3:04 pm

Hi, you do not know me. In fact, I’m not even sure how I came upon your blog. I am the mother of a micropreemie, born at 26 weeks, weighing 1 pound 5 ounces. I don’t know if you have been given this information or not, but I belong to an internet group – http://groups.yahoo.com/group/PreemieBlogMoms/ – which really helped me throughout my NICU stay and beyond. My son spent 225 days (don’t freak out, extreme case) in the NICU and has been home for 7 months. If you are interested, please join this group. There you will find a bunch of great mommies who have been through what you are going through and can answer any questions you might have. Several members are nurses.

I will keep you and Simone in my prayers.

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cheryl February 21, 2008 at 3:12 pm

peace to you today

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Tash February 21, 2008 at 3:18 pm

Damn wishbone always tripped me up, too. I’ll be awaiting word on the other side. I can imagine the fear of sitting there waiting is inexplicable. Babies are strong little things, they really are. Wishing her the speediest of recoveries, and all of you peace. (Will repeat my “Steady Hands” mantra this afternoon.)

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Orodemniades February 21, 2008 at 3:50 pm

I’ve got everything crossed for you!

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Lori February 21, 2008 at 4:33 pm

Perhaps a blindfolded game of Operation for the surgeon. Then maybe, just MAYBE he/she could be allowed to even consider the honor to work on Princess Simone.

Holding my breath until the next post, and as always, my thoughts and prayers are for you and your family.

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LetterB February 21, 2008 at 4:35 pm

I think your request is entirely reasonable. I hope they had the sense to comply. Hoping you are all okay.

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Cricket February 21, 2008 at 6:04 pm

Sending our love and thoughts. Hoping all is well and surgery was successful.

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Renovation Girl February 21, 2008 at 6:15 pm

Praying for all of you!

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cat, galloping February 21, 2008 at 6:43 pm

It sounds terrifying but also like she is in the best possible hands. Simone has my best wishes for a successful surgery and speedy recovery.

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minneapolis Dan February 21, 2008 at 6:50 pm

Our son Edison had PDA surgery too, though he was a bit bigger than Simone. I can tell you that the guy who did the surgery at Children’s in S Mpls was mid 30′s, and a pediatric cardiac surgeon. These guys do stuff like re-arrange heart ventricles when there aren’t the usual number of chambers, so I think a PDA surgery is about as tough as making a pot of coffee for these cats.

I asked, and our guy (smug as all hell, with decidedly cold bedside manner), said he did something like 3 00 or 400 PDA surgeries the year before we had ours done.

Our kid is now 3, and thriving.

Good luck!

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shayneegray February 21, 2008 at 6:51 pm

I’m thinking of your family and sending good wishes for Simone.

As to the surgeon’s dexterity, my husband is a pediatric cardiologist, and although he’s not a surgeon, he does perform invasive procedures (threads catheters into babies’ hearts to perform ablations to correct arrhythmias). He has the best eye-hand coordination and fine-motor skills of anyone I know–I think the people who reach that level of medical practice must have innate skill to be successful (that is, to even advance through medical training to become that sort of physician). That doesn’t make it any less scary for the mothers and fathers who have to endure it on behalf of their children. But hopefully it’s vaguely reassuring. Best wishes to the whole Flotsam tribe.

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Sarah February 21, 2008 at 7:11 pm

Thinking of you and your baby. Wishing Simone a healthy recovery for this important surgery.

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Mara February 21, 2008 at 7:14 pm

Dear Simone,
I’m wishing you a swift recovery, honey, and easier breathing: just grow, grow, grow! My thoughts are with you, sweet baby, and with your Mom and Dad. I look forward to an update to see how you and your parents are doing post-op.
Lots of love,
Mara

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Kristine February 21, 2008 at 7:19 pm

Please know I am thinking of you, Scott and Simone and sending all my good thoughts your way! Anxiously waiting to hear how all of you are.

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Veronica February 22, 2008 at 3:39 am

Thinking of you and hoping so hard that everything goes beautifully.

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Therese February 27, 2008 at 1:41 pm

Came to you by way of Julie. Baby is quite small but very beautiful and mighty. Good things come in small packages!

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Sarah February 27, 2008 at 9:40 pm

I found your blog via Preemie Blog Moms. Just wanted to let you know I was thinking of you and your family. I too had twins at 25 weeks, we lost Logan after 5 months. His twin Cooper is now 2 years old. I can promise you that although the NICU seems like an overwhelming place, one day it will seem like a distant memory. Keeping your beautiful little Simone in my prayers!

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allison February 29, 2008 at 9:01 am

Hello I came across your blog via A Little Pregnant. I will keep you and your family in my thoughts. If it’s any comfort, I had my PDA fixed 24 years ago and though one bosom is higher than the other as a result, I am otherwise completely well. I wish the same for little Simone (besides the boobs part, but from what I understand, the surgery has come a long way) :) Best wishes to you and take care.

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