Jon

Leo is home. The operation yesterday went well, although Leo lost a little more blood than the surgeon would have liked. For a while, we weren't sure if he'd have to stay overnight in the hospital for observation, but the blood test came back with a good enough result that they released him.

We took him back to the surgeon today for removal of the surgical drain and the dressing. Leo screamed bloody murder during the removal, although he was happy to go up and down on the elevator. His back looks great, too: the giant mole is all gone. He will of course have big scars from the incisions, but there's no way to tell now just how bad they will be.

He's uncomfortable. We have Tylenol with codeine syrup, as before, but it tastes really foul, and we can't get it into him. The one time we were able to, we had to pour a dose over a slice of leftover birthday cake and, in addition, put an M&M on each forkful.

Lauren and I are really getting on each others' nerves.

Leo had surgery yesterday, inserting set of tissue expanders in his back. He's sleeping at the moment, but he's certainly been in more pain this time than after some of the prior operations. Lauren and I are very tired.

Leo's other tissue expander somehow became infected last weekend. The surgeon saw him today (after having seen him on Easter Sunday) and has decided to operate first thing tomorrow morning to remove the tissue expanders early.

I'd go into more detail, but I'm very tired, and I have a lot of work to do.

I just got back from our appointment with Leo's surgeon. It appears that the tissue expander can stay put, barring changes in the situation such as are inevitable now that I've made this post and jinxed it. Tissue expansion will resume in two weeks.

In totally unrelated news, the night before last, I dreamed that a huge cockroach was flying right at me. In my dream, I swung my arm wildly to fend off the murderous insect. Unfortunately for Lauren, I also did so in real life.

One of Leo's tissue expanders may have to be removed prematurely. We are all kinds of upset.
( Cut for the easily disgusted. )
So, we have an appointment with the surgeon first thing in the morning. He says that there's only about a 20% chance that we can save the expander, but that's better than no chance. The problem, he explains, is that bacteria have come in contact with the tissue expanders. Because the expanders are foreign objects inserted into our child, they have no blood supply, which means that the antibiotics have no way to get to them.

Unfortunately, removing the expander would mean subjecting Leo to procedures over and above what we had expected:

1. One to remove the infected tissue expander;
2. One to remove the remaining expander and to excise part of the giant nevus;
3. One to insert another set of expanders; and
4. One ring to rule them all and in the darkness bind them to remove the last set of expanders and excise the last of the giant nevus.

We had, of course, been expecting operation number 2 on the above list, but we expected that would be the last one. I'm upset and, as usual, tired. Lauren's taking it very hard, especially in combination with the seeming collapse of our grand scheme to get an apartment. But that's a nightmare for another discussion.

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¹I like Leo's surgeon a good deal, but he's one of those surgeons who is so utterly focused on surgical matters that other things—such as, for instance, when he's actually going to perform the surgery—often get by him. He's also very much a WASP, with more middle names than might be considered strictly necessary.

He and I are are both Yale grads, and we seem to have bonded over that, but we come from Yales of different eras. He went to Yale at a time when they limited the number of Jews they'd admit because they were afraid we'd take over. I went to Yale at a time when they were glad to have all the Jews they could find because we were the only thing keeping the Asians from taking over.

Leo's fourth operation has just been scheduled. It will be Tuesday, February 28, which is three days from now. We learned this two days ago.

Leo's plastic surgeon has a taste for surprises, it seems.

Leo had his third operation today.

This was not what we had expected. His last procedure took place on September 15, during which four tissue expanders were inserted under parts of his back that weren't covered by the mole. At the time, we were told that expansion would take about three months, meaning that the next procedure would take place in mid-December.

About two weeks ago, when Lauren took Leo to the surgeon for a saline injection, the surgeon asked us to make an appointment for surgery on November 15. Lauren pointed out that this would be only two months after the previous operation, but the doctor said that he thought Leo was ready.

Then, four days ago, on Friday morning, the surgeon called us at home. He had been lying in bed all night, he said, "thinking of his favorite patient." Leo's expanders were close to perfect, he said, and he didn't want to risk Leo's bruising or otherwise irritating the skin. "Schedule the surgery for November eighth," he said. We were surprised and anxious, but we did as we were told.

The operation took about two and a half hours. The surgeon removed all four expanders and most of the mole. He said afterwards that everything had gone very well.

Leo is in the hospital tonight with Lauren. (Lauren stays with him in these circumstances because, when Leo gets really upset, he wants his mommy, not me. I go home and sleep so at least one of us can be rested.) We were told that this operation should be a lot less painful than the last one, and Leo seems a lot more comfortable than he did last time. He comes home tomorrow.

The next procedure, we have been told, will take place three to six months from now, when Leo will get his second (and hopefully final) set of tissue expanders. That will in turn be followed by his fifth and final operation, the removal of the last of the giant mole.

Lauren and I are exhausted, physically, mentally, and emotionally. The crises continue.

Post-Surgical Video (2.2 megs, Quicktime required)