R.O.P.

Eliza's surgery is tentatively on the schedule for Thursday afternoon, just two days away. Of course that means it's time for something new to come out of left field and throw us for a loop... and as usual, life does not disappoint.

After Eliza's last eye exam a week ago, the ophthalmologist said there was "some tissue" in her right eye that didn't look quite right and would need to be monitored closely. After the followup exam this week, we have been told that Eliza's right retina has hemorrhaged some and looks to be at risk for retinal detachment. This was a real shock, especially since three weeks ago we were told that her eyes were looking great. Her left eye is still looking good, but the right eye... not so much.

The ophthalmologist wants to have a retinal specialist come by to offer an opinion on whether they can keep monitoring Eliza's eye for now, or whether she will soon need a surgical procedure called a vitrectomy... Apparently they've done all they can with lasers at this point, and the next step if her eye needs it is actual (invasive) surgery. Ugh. From what we're hearing, and from what we've seen online, if her retina does detach and/or a vitrectomy is needed, the outlook is not good for the vision in that eye. Unfortunately, said retinal specialist (while highly rated - apparently babies come to Duke from across the state for her to treat) is currently out of town and won't be back and able to take a look until Monday, which means we've got most of a week to worry and wonder before we can get any more definitive answers.

The extra wrench in the works is the concern over Eliza (possibly) having two surgeries so close together. If things go as planned on Thursday and she gets to have her bowel surgery, but then the retinal specialist takes a look on Monday and decides that they should operate on her eyes ASAP, this would be less than a week between surgeries - which they really want to avoid since that would be really hard on her health, and she might not even be stable enough after the first surgery to safely go back for the second one as soon as she might need to do so. Plus there's apparently a small but real risk that the stress to her system from the bowel surgery might cause her retinal condition to deteriorate further... so should we postpone this week's surgery until after we know more?

On the flip side, though, we have no way of knowing if or when the retinal specialist will recommend surgery, and if we postpone her bowel surgery, not only is there the possibility of a lengthy "wait and see" observational period for her eye (during which time of uncertainty, sending her off for bowel surgery would probably not be recommended), but also there's the question of how long it would take to get her back on the surgery schedule once she got the go ahead - given how long it took to track down the surgeon and get her on his schedule this time, who knows how long the next time will take.

So we're really stuck between a rock and a hard place. All of the reasons for going ahead with the bowel surgery as soon as possible are still in place (infection risk from PICC line, digestive difficulties, ostomy swelling and prolapse, liver damage from IV nutrition, etc.), but now we have to counterbalance that against the risks to her eye and vision if we don't delay the surgery. Most of the doctors and nurses seem to feel that it's still in her best interest to go ahead with the bowel surgery now, and we feel the same way, but it's a very tough decision to make - we really hope we're doing the right thing for our baby girl.