Procedure to drain fluid in her Abdomen.

Hello Ava followers. Sorry for not posting an update in a few days. Ava has been very uncomfortable. Saturday she rested most of the day. Sunday morning she had a very strong stabbing pain on her right side that made her bend over. The rest of the day she seemed okay and then about 6:30 we went to the movies as she wanted to do something that would take her mind off her belly pain. We got about 20 minutes into the movie and I turned to see her shirt up and she was holding her right side. Brian and I talked and decided we needed to leave. She seemed to be in a lot more pain. She described it as "sharp" pain. We debated taking her to the ER. Our local hospital was the place we had taken her two days before. We talked about going to Iowa City. Once we were in the car she seemed to get really emotional. I asked her if she wanted to go home and evaluate her to see exactly what we should do. She was pretty adamant about going to the hospital in Iowa City... however Brian and I knew that once we got up there if she wasn't a lot worse they would just send us home. I did call the hospital and talk to the surgeon resident on call. He thought we were doing all the right things and that if she got worse to let them know. I made her lay down and we hooked her up to the pulse ox machine. I took her temp and she was normal. Her vitals were all normal. She took some ibuprofen and began feeling better so we decided to watch her and see how things went. I woke her early in the morning to keep on top of the pain with medicine.

Monday the clinics were closed so we just kept giving her pain medicine. I also began to chart... I  measured her belly, temperature, and medicines. We really wanted to get her seen but there was no way unless we took her to the emergency room. The resident called me back and assured me they would get her in on Tuesday. Ava seemed to be handling the pain pretty well. She was not her normal flying around self but she still smiled and made jokes so I felt fairly confident in our decision to just watch and see.

Tuesday the doctor's office called me a little after 8am and asked if Thursday would work for her to see Dr. Shilyansky. (Her surgeon) I told her we had to come that day. This could not wait. She talked to the surgery team and got us an appointment to see another surgeon. I was so relieved. We drove up and picked Brian up at work on our way. Ava was so happy we both could be with her. We sat and waited for the surgeon she told us we were going to see. Ava was really uncomfortable and was moving around in the chair. The resident doctors came in and asked us a bunch of questions. After over an hour after that, a nurse came in and told us she was so sorry for the delay but that Dr. Shilyansky was just finishing up a meeting near the hospital and he was on his way to see Ava. We were so relieved. He knows Ava's body. He's done about 3 abdominal surgeries on her.

Dr. Shilyansky was happy to see us but was very concerned with what her CT from Friday showed. He was puzzled about what could cause this free fluid to accumulate in her abdomen. I asked how much fluid he thought was in there. He shocked us by saying around 700cc's. That is about 24 ounces. He agreed that we needed to figure out what this was. He didn't think by what he saw on the scan that it was blood or infection more of just a "collection of fluid". He was glad that she didn't have any fevers and that she could still eat, drink and go to the bathroom. He asked us if we wanted to drain it and try to make her more comfortable and figure out what this fluid could possibly be. We all agreed. They described what would be done in the procedure and how Ava would be sedated. We felt good about it.

This morning we went up to the University of Iowa Children's hospital to have the paracentesis procedure done. Ava didn't seem nervous at all. The resident called right before we left and informed me that the plans had changed slightly and that they would just be using light sedation on Ava as the radiologist felt that fully sedating her might not be the best option. I told him I was fine with that but to please hold that information and not to let Ava know so that she wouldn't be scared. She was adamant yesterday that she wanted to be asleep during the entire thing. (Says the little lady that did an entire heart catheterization with just laughing gas!) When we went to check in a nurse came to us and told us that "the plans had changed and that they were not going to do full sedation." I looked at Ava waiting for her to respond. I was a little surprised that it didn't upset her in the slightest. I was not happy that instead of doing the procedure in the Children's they walked us over to the University hospital. I was so anxious that this was the right decision for Ava. It seemed like they were just "working us in". We waited for about an hour and a half and finally, a nurse called her name. She took us back to a nice room. She took Ava's vitals. She said that another nurse would be in shortly. Stephanie was Ava's nurse and she was a sweetheart. She answered our questions and immediately won over me with her kind spirit. I felt a peace that God had changed the plans for reasons I did not understand however I was more than fine with the direction things were going. Ava is so tall she didn't even fit on the bed. (It was an adult bed too!) 

She looks a little scared in this picture but I can assure you she was doing just fine. I was so proud of her. 

Yes, I had to get our pictures with Ava!

The resident doctor came in and explained the procedure. He told us that they would be removing some and if it looked infected that they would test it. If it showed infection they would drain as much as they could and leave a drain in Ava. If it did not look infected they would extract as much of the fluid and then send it off for testing. Ava seemed good. I signed the papers and a few minutes later I was saying a little prayer and kissing her on her forehead telling her I loved her. I can't believe she is thirteen! These halls we had been to before for major testing when she was 2 and 3. Who could have imagined she would be doing this test?

Brian and I went to the waiting room. I couldn't sit still for long and began pacing back and forth saying a prayer in my mind. She was in good hands. God was with her and that everything was going to be okay. It took an hour and fifteen minutes. I was so happy to see her. We laughed so many times as she was so loopy. The nurse asked her how she felt before we came in and she said, "I feel like my mom when she flies on an airplane." She is a character. (And yes I have to have anxiety meds to fly.) We taped some things she said... she sure LOVED the graham crackers. I think she had 5 packages. Oh and the Coca-Cola. Brian got Emeline on a video call and Ava was so funny and happy to see her sister.

The doctor came in and told us he thought it was lymphatic fluid. They extracted 650 cc's of fluid and that it did not look infected to him. He told us she did extremely well during the procedure. We thanked him and can't wait for answers.

Yes, I took a picture of the fluid... because well you want to see it too right?

She was so goofy for a few hours. She was starving so after waiting for about 45 minutes they discharged us. She requested Olive Garden... soup, salad, and breadsticks. She said her abdomen still hurt. I thought she would feel less pressure but she said it still felt not right.

We got home at about 5pm. Ava was very tired but couldn't seem to settle down. She complained that the incision (tiny it didn't even need a stitch to close it) hurt. I gave her more pain meds but she insisted she still hurt. Finally, about an hour ago she fell asleep. Please pray she will heal well and that we will get answers to why this fluid was there. We are thanking God tonight that it all went so smoothly. Thanks for checking in on Ava. She was sad the other day because no one (especially her friends) had asked how she was doing. I reminded her that people are sometimes afraid to talk about situations like this. It's not that they don't care they just don't know what to say. God bless. -Terri