Emerie Summer Eye Update

Almost a year ago today we were headed to the surgery center for Emerie’s first eye surgery, to remove her cataract and hopefully improve use of her left eye. Today we are back for her third eye surgery (second strabismus procedures), and fourth overall surgery, in 365 days. It’s been quite a year and little did we know what was ahead of us as we walked into the center last June, but we’ve made it through with resilience and minimal scrapes and bruises.

Unlike last year, medical processes have changed a little to accommodate the worldwide pandemic. We’ve waited several months for this procedure while the medical field responded to the current COVID-19 crisis; i.e. it wasn’t on the approved, non-emergent surgery list. For us, this meant continuing to patch a few hours a day and convince Emerie to wear her glasses as much as possible, which is easier than this time last year, but still a fight.

All doctors appointments this spring only allowed one parent to attend, wearing a mask, with an attempt to keep all patients far apart to lessen the risk of spreading illness. The specialist appointment in late April was encouraging, with Dr. Winkle noting that he would determine which eye muscle to tighten once he was in there. Her eye was trending inward about 20%, as opposed to wandering outward as it did prior to October’s adjustment.

Unfortunately, when I took Emerie to her pre-op appointment last week, her left eye alignment is now trending inward at 50%, a significant change in about a month. This means that both muscles will likely need adjustment and he has shifted his prior surgical plan accordingly. When I asked why such a change in a short time period, he said sometimes this happens and there’s really no good explanation. If he had never done the first strabismus surgery, her eye would still not be aligned correctly (since I asked!). It also means that she is on the more severe scale for pediatric cases and will likely require additional surgeries going forward. Needless to say, I did not leave that visit feeling as optimistic as when we arrived.

Like a pro- post nose swab

All surgical procedures require a negative COVID-19 test within 48 hours of going in. I expected some screaming rage at the nose swab and had snacks and juice at hand as well as Bear and a wubbanub, but she did great! It was unexpectedly easy- we didn’t have to get out of the car and the nurse came down to our parking spot for the whole thing. She explained swabbing adults was more extensive than younger kids, and just swabbed her nostril and talked sweetly, evening producing a half toddler smile before heading back into the office. We found out right before surgery that her test returned negative, as we expected.

Emerie was ready to take on the day this morning. Little did she know where we were headed, but after Craig pulled her out of the nursery she was chatty and running around, even with our shhhhh’ing to not wake the other two.

We’ve had three prior surgeries at the surgery center and yet I’ve never noticed the pre-op playroom before today. Needless to say, Emerie much preferred exploring the enclosed room full of activities rather than be confined to my lap in the tiny pre-op space. Only one of us could go back into the area due to COVID-19 rules, so Craig waited in the waiting room out front while I went back with her. I gave her the purple, surgery monkey to cuddle with, which is almost as big as her, and she snuggled it, “changed” its diaper, and showed it the puppy book.

Bracelets in her sisters colors

After the Versed kicked in she wanted to read her book on my lap, under her moose blanket. Adorably, she was super ticked off that she couldn’t shut! the door IN the book and kept repeating it. When I informed her we couldn’t shut the door, she told me no.

Also, the CUTEST thing ever….she wore two bracelets for her adventure today and look what colors they are! One pink and one blue, i.e. one in Harper’s color and one in Reagan’s. I melted when I noticed that! She is definitely the jewelry wearer of the three.

Dr. Winkle explained that the procedure would take a little longer the second time around, probably about 45 minutes versus the 25 previously, usually due to minimal scar tissue. He came out with an update about 40 minutes after I put her in the wheelchair and they wheeled her off.

The doctor noted that he was pleased to see part of the reason for the eye drift and decided to only tighten the outer muscle and not mess with the interior one as originally planned. He said she developed a type of scar tendon, about 5mm long, that was pulling the eye inward. This is actually good news, because he removed it and tighten the outer muscle, which was simplier than having to work on both sides. Hopefully this will keep her straight for a while.

Another hour passed before our surgical buzzer went off, allowing me to go back and see her. We actually saw Dr. Winkle come back out after his next procedure, looking surprised to see we were still waiting. The nurse told me later that they gave her a different type of sedation so she was coming out of it slower than her prior surgeries. I went back to find her still out. It took another 20 minutes or so until she started to come out of it. The interesting thing is that she caught me by surprise; she was out one second and trying to roll off the bed in quite a fluster the next. This is more-or-less how our naps go…fully asleep one second, screaming and wanting up the next.

Now that she is a bit older and more talkative since her surgeries at 19 months and 21 months old, she can better communicate her feelings and it is intriguing to see. Her first word was owie, of course, and reaching for her eye. The nurse asked if she wanted a yummy and handed her a lime popsicle, which for a few minutes fully distracted her pain and she laid on the bed, eyes closed, sucking on the popsicle calmly. At some point, about halfway through the popsicle, she noticed that the paper towel previously wrapped around it was on the sheet and frantically commanded trash! at me several times, then went back to owie and booboo, pointing to her eye. And repeat.

Eventually we made it home, after she threw away her popsicle wrapper in the trash without my assistance, had her blanket tucked on her, monkey and binkie in hand in the car, and we did our usual surgical routine of taking a short nap to settle and let more Advil kick in. She definitely went to sleep easier today than back in December and didn’t fight it or cry. As I write this, she’s down for her normal nap, although her eyes on the crib camera tell me she is fighting this one hard while Harper and Reagan are both out.

Thank you, everyone, for the prayers. Our littlest triplet was very brave today and behaved great! <3<3<3

Two Year Eye Update!

Last week we took Emerie to her eye specialist visit, that was conveniently scheduled out far enough that it wasn’t canceled or postponed due to COVID-19 closures.

Such a big girl!

The doctor’s office required I wear a mask and only one parent accompany the child. The one-to-one ratio is pretty fantastic and when the kiddo is well behaved, it’s even better! Emerie was a pro and you can tell that she likes Dr. Winkle. Not only did she sit very still on my lap while he checked her eye, but he also managed to get a few smiles, almost chuckles, out of her with some animals sounds. She took out on of the tools on the eye machine and nicely handed him his “toy” upon request.

The good news. She was great at her appointment and the eye patching is strengthening her eye. The bad news? Her eye muscles will require another surgery later this spring. Typically the over correction of the eye muscles accommodates the loosening over time, so that the eye ends up looking nice and straight. Since October’s surgery, her eye still trends inward a little more than it should and by now it over correction should be fixed. Dr. Winkle noted he would decide once she’s in surgery if the inside muscle requires loosening or the outside should be tightened.

I am hopeful that much of this quarantining will be passed us before she goes in, so her immune system doesn’t have to fight off any other potential invaders. Current rules also state that only one person is allowed back with a kiddo and that can be tough with a very unsettled and in pain toddler.

Harper and Reagan received their two year eye checkups with the specialist this week, more-or-less to confirm that no strabismus issues are present like their sister. The doctor did not appreciate that they were dressed alike, but did think it was funny! Both passed with flying colors and no longer need specialist eye care. Going forward, unless something changes, we will just monitor their eyes at the pediatrician. Great news!

Not often her mood with the patch on, but big smiles for Em!

Harper did well with the dilation drops and didn’t fight the doctor for the visit. She sat still on my lap and he examined those beautiful blue eyes without too much effort. (Random fact: light colored eyes like blue react easier to dilation!). Reagan, on the other hand, feels the way Harper feels about the dentist. Screaming, crying, trying to hold those eyes shut. She did not appreciate the drops and had her eye exam with arms held firmly down by Craig and her eyelids pried open by the doctor. Maybe we should be more appreciative that Emerie doesn’t respond to all the doctor visits like this.

They both had dilated eyes for the rest of the afternoon, but still enjoyed playing out in the sun and going for a family walk.

Bright light didn’t stop afternoon playtime.

All in all, things are pretty good in terms of the Douglet eyeballs. We will continue to patch Emerie two to three hours per day and encourage use of her weaker eye, much to her dismay. The next plan is to purchase another pair of glasses with larger lenses and see if she likes them more than her current ones or if they improve her mood. We are also thinking outside the box…maybe getting a yellow pair instead of her usual purple! Either way, we know they will be cute on her.

Keep those prayers coming; and we will keep you all updated on her progress.

Emerie Surgery #2 Update

With an opening in the doctor’s schedule for Emerie’s upcoming surgery, we pushed it up to today instead of the following Tuesday. The first procedure in June corrected her blurred vision by conducting a lensectomy and removing the cataracts in her left eye. The surgery then added a new lens and we’ve worked with patching to improve her eye use.

Today’s surgery, called an eye recession and resection, focuses on the muscles that control her left eye and will correct the lazy eye effects still hindering her. This is not considered a cosmetic surgery; while it repairs the look of a lazy eye and makes it less noticeable, it more importantly encourages her brain to use the damaged eye more and improves its focus and function. That is far more important than simply making it less visible to others, although that is a perk! The exterior eye muscle will be loosened and the interior one tightened to draw the eye in and minimize the wandering. The procedure is less invasive than the prior one but does result in a red, irritated eye for a couple of days.

There is a possibility she will need a third surgery in the future to do the same correction, as lazy eyes often shift back to some extent. With the nature of her eye issue, this is something that can be likely, but we won’t know for a while and it doesn’t happen to everyone. For now, straightening things out will hopefully assist her brain in using the bad eye even more than it currently has. We will continue with two hours of patching (of the stronger eye) each day and hope visibility improves.

Being silly with dad while the meds kick in.
Getting some early morning steps in

As I wrote this, Dr. Winkle came out with an update that everything went well and she is in recovery. She went back with him about 7:40 and was done by 8:25. Pretty quick! Just enough time to get donuts… after another hour we headed back to post-op and helped settle her before going home for the day.

Emerie was much more active this time around, so we wandered around the lobby when we checked in, she even helped me with my purse. Back in the pre-op area she did not want to sit still or be contained, even with the Versed medicine. In typical Emerie style, she spit some of that medicine right back in Craig’s face as he wrestled to give it to her. He can tell you that it doesn’t taste very good. She eventually became woozy from it, but still wanted to move around. Last time she just snuggled!

After her meds she sucked down a tiny cup of water. That plastic cup entertained her for a good 15 minutes, making her giggle as it crinkled against her teeth. It made for some silly pictures (see below!). She would not let the nurse take her forehead temperature, fought the anesthesiologist on checking her heart and lungs, and decided the pulse finger machine was permanently hers. In fact, the pulse machine went back with her into the operating room because she was literally not giving it up. She also got to walk back there with the doctor, not a nurse like last time.

I made the mistake of sipping my coffee thermos in front of her that was not appreciated, especially with the no food or drink rule before a surgery with anesthesia. Mental note for next time: don’t do that in front of her!

The dog walkers took Kalli and Koda for some adventuring this morning while we were out, hoping to tire them enough for calm puppies the rest of the day while Emerie settles in. Harper and Reagan get nanny and grandma playtime while I snuggle with Peanut.

For now, we are home. She was much happier in post-op than last time around. Instead of upset and crying, she was snuggly and very sleepy. She slept on the car ride home and is now totally out on my lap in the nursery.

Thank you everyone for the prayers and encouraging words for Miss Emerie. ❤