1st fill up of expanders

Each week we are now going to go back to the hospital and get the three expanders in Phoebe's face filled up with a saline solution. The saline is inserted via a needle into the remote ports placed under Phoebe's skin. They are located 1) behind left ear 2) on top of head 3) right temple. A tube then connects the remote ports to the expanders.
We arrived at the hospital at 8am today. Phoebe was given a nice pink juice (aka pain and drowsy medication combined). Within 20 minutes she was not in the land of nod, but rather the land of the fairies and dancing elephants. The surgeon decided to try putting 10ml (not 5ml as originally planned) into each expander. As the syringes were being filled I did the truely supportive motherly thing and left the room! I did hang around outside the room incase I heard any crying, (although am not sure what I would have done if I did). After 5 minutes (max), the surgeon came out and said all had gone very well. Each expander had taken the 10mls of saline really well and Phoebe had not reacted to any of it. Seal followed the surgeon out carrying a very drowsy Phoebe. It took about 2 hours for Phoebe to be declared sufficiently awake (and off her cloud), to be allowed home. Despite this she still staggered into our kitchen like an old drunk. She has been a bit grumpy but I think that has more to do with the lack of fluids and food than anything else. None the less I will be dosing Phoebe up with a bit of paracetomol for the next few hours.
You can definitely see the size and shape of the expanders now. They have the capacity to hold 70-100ml and currently they all hold 20ml. One expander is round, one is crescent, and the other is oblong. Next week same thing all over again. Seal thinks he can cope taking Phoebe on his own and I will stay home with Freddie. We'll see if my mothering instincts let him!

One week on

Phoebe has handled the expanders very well. Henry has looked upon his sister with a new found fascination. By Friday Phoebe right eye was extremely swollen, to the extent that Phoebe could barely see through it. The white of the eye (called..?) was very blood shot and around the temple and corner of her eye it was starting to show signs of deep bruising. By Saturday Phoebe's eye was green-ish, much to Henry's amazement. By Saturday afternoon it was a burgundy. Henry was frequently giving us updates on Phoebe's changing skin colours (his clever sister the chameleon). The whole of Phoebe's face has bruised up to some extent or another but by day 7 this is all yellow-ish and definitely appears to be on it's way out. By day 6 I stopped all Phoebe's codeine and occasionally give her a bit of paracetomol if I think she needs it. I am not sure if I mistake 20 month old tiredness and general grumpyness with pain or discomfort. Phoebe has proved to be very resilient and adaptable. For example she knows she cannot face plant the sofa, so instead chest plants with her head arched back. Henry has done incredibly well in altering his play to suit his now rather delicate sister, although he had a relapse on Day 4 when Seal caught Henry holding his sister in a head lock.
Phoebe has had to adapt her sleeping to suit the fact that she has 3 expanders and 3 remote ports in her head. She has been a bit unsettled in the night (but if I think back no more than usual really, I just blame the expanders now and not teething). Phoebe is in a cot still and it did occur to me one night when I caught her using a rather large teddy to lie on, that perhaps she needed a pillow. Well the look of delight I received when we went and found her a pillow was priceless and worth the look of dismay on Seals face when he realised I had given Phoebe his pillow! Her nights sleep seem to have been much calmer and quieter as a result. Yipee.
We went to hospital for our 7 days post op check up and all is progressing nicely. The tapes on Phoebe's face were changed and the small incisions where the expanders were inserted have healed amazingly. Perhaps this is just the amazing rejuvenation of young skin. The plan is one more check up at day 14 post op and then the first fill up will commence the next day.
A funny little story; we took Phoebe to a local DIY store on Sunday. She wore her usual (extra large) floppy pink hat and her bright red sunglasses. As we entered the store there was more than the odd look from fellow shoppers, which was to be expected I guess. When I looked at Phoebe I had to chuckle, with her get up and face bandages she reminded me of some old Hollywood filmstar just returning home from her face lift surgery and trying to be incognito.

Day 1 and 2 post op

We managed to bring Phoebe home at 9.15am on Thursday morning after clearance from the Surgeon. Her face was a little bit swollen but we were not sure if that was mostly expander or swelling from the facial trauma she had been through. She seemed perky enough. Phoebe tried a little jog from the car to the house and stopped in her tracks to hold her cheeks and say "oooohhch', guess it must feel pretty odd. Phoebe ate little bit of toast at home and at 12.30 went to bed for 3 hours. She woke up groggy but fine. Henry was very nervous about seeing Phoebe when I picked him up from Kindie and kept staring at her and asking why her cheeks looked '..so fat..?' It did not last too long before they were interacting as normal (about 5 minutes). It is going to be one heck of a challenge to stop those two play fighting for the next 3 months, or Phoebe from doing her stage dives off the arm of the sofa.
Phoebe had a good 2nd nights sleep despite my concerns on how she would sleep with all that paraphinalia in her scalp. I think the codeine and paracetomol are doing their jobs brilliantly. Today though her swelling is greatly increased. Phoebe's right eye is very small and the right cheeks is shiny and very bloated. I think we can guarentee this is not expander as such but post op swelling. I am sure her eye is going to turn black over the next couple of days.

Expanders are in

The French purchased tissue expanders have been put in. Phoebe was an absolute dream prior to surgery, she skipped round the wards and was generally little Miss Show Off for all the Dr's. We were first on the Surgery List for that morning so by 8.30 we were up in the Pre Op Room waiting collection. [NB: The surgery was nearly a non event when the expanders were put on a two day delivery from Auckland on Monday. The expanders arriving by courier less then 5 minutes before the start of surgery.] Phoebe loved her surgical gown and without any fuss breathed the strawberry gas for the nice Dr and went to sleep. Her surgery was due to last 2 hours but ended up being about 2 and a half hours long. This time Seal and I did not leave the surgery waiting room and so were instantly there when she came to recovery. Phoebe has had three expanders put into her face. One oblong one on her forehead and two half moon shaped ones on either cheek. The cheek ones have been filled with 10mls of fluid already and the one on her forehead with 5ml. The incisions for the expanders were made at the edge of Phoebe's Nevus, the incisions for the remote ports (through which the top ups will occurr) have been made behind Phoebe's ear and at the top of her head.
Phoebe was very groggy for most of the day. Seal and I took it in turns to cuddle our sleeping beauty. As the day progressed her face did seem to swell somewhat but nothing that caused Phoebe any apparent distress. She did wake at one point and poke her cheeks which is both large and squishy at the same time. Phoebe has been given morphine and paracetomol but will be put on codeine from Thursday onwards. Phoebe ate a huge dinner of chicken, mash and ice cream and then fell into a deep sleep on her bed. At this point I left to take Freddie home and put him to bed. Seal has stayed in hospital for the night with Phoebe.
Currently the plan is to bring Phoebe home on Thursday (so not a 3 day stay as originally suggested but an over nighter instead). Fingers crossed. We have to see the Plastic Team for weekly checks and after 2-3 weeks we will start filling up the expanders. Phoebe will be sedated and either the Consultant, Sally Langley or her Registrar will do the fill ups. The plan is to perhaps do weekly fill ups of 5ml rather than 10ml fill ups every 2 weeks, but this will all be dependant on how responsive Phoebe's skin is.
That's all for now. Will keep you posted.