Considering what cranial vault remodeling entails, we assumed that Holden’s biggest post-operative challenge would be pain management. We quickly discovered that was not true. The worst side effect was actually the swelling.
Think of a time when you cut your finger or scraped your knee. The area around the wound probably started to swell. This swelling is part of the inflammatory response and it occurs because your body sends fluids and white blood cells to the injured area to help it heal and protect it from further damage. Since Holden’s surgery involved such a large incision into his scalp and a craniotomy (surgical opening of the skull), his inflammatory response slammed into overdrive.
Within a few hours of Holden’s surgery, his head started to expand. He looked like someone had hitched a bicycle pump up to his head and started steadily filling it with air. If you left the room for 30 minutes and came back, you would be in awe of how much his head had grown in such a short time.
Thirty-six hours post-op, Holden’s swelling hit its peak. His head had grown as big as a watermelon. He was so engorged with fluids that his eyes were swollen shut and resembled two giant prunes. Due to the the massive swelling, his eyes remained shut for two full days.
I can’t begin to imagine being 16-months-old, coming out of major skull surgery, in pain and unable to see, wondering what is happening, but lacking the vocabulary to ask your parents, “Why the HELL did you do this to me?” It seems needless to say, but we spent the remainder of our time in the hospital with an extremely frustrated and grouchy little boy.
It is interesting to note here that 24- hours after surgery, Holden’s pain was sufficiently managed with only Advil and Tylenol. It’s also interesting to mention that Holden’s surgery was on Wednesday morning in Dallas, TX, and we were pulling into our driveway in Austin, TX, around 3 p.m. that Friday.
I am still in awe of what unfolded when we arrived back at home that sunny afternoon. After spending the better part of two days infuriated and blind, Holden started to move forward. It was like he decided, “Well, if I can’t see, I’m going to figure out how to do things anyway.” He was climbing on the furniture, finding his favorite toys and hiding behind curtains playing peek-a-boo with me. And, he started smiling again. I have never experienced resilience like I saw that day, and it was coming from my tiny, brave boy.
That night, as I was getting Holden ready for bed, I noticed a small slit opening in his left eye and I knew we were through the worst of it for now. The next morning both of his eyes were slightly ajar and he was “all systems go.” He and his big brother played all day long, carrying on as if nothing ever happened. And, honestly, for Holden it has been that way ever since his eyes reopened – like nothing ever happened.