Amelia went through the pre-surgery assessment at Great Ormond Street Hospital on 11 June 2009. The hospital was preparing her second open heart surgery on 26 June 2009. The purpose of the second open heart surgery was to relieve her right ventricular outflow obstruction in her heart. In other words, Amelia’s heart valve was narrowing and this made her get tired easily. She did not like to walk. she relied on her scooter or her buggy when going outdoor.
Pre-open heart surgery assessment
Her pre-open surgery assessment includes the following:
(1) ECG or Electrocardiography
Amelia has 10 sticky patches spread around her body – on her legs, chest and arms. These sticky patches are connected to the ECG machine which takes the reading of Amelia’s heartbeat. The test was very quick – only a few minutes and it was painless.
After the ECG, Amelia was sent to the X-ray department. The doctor asked her to stand in front of the X-ray machine and stand still for a few seconds. She was moving about so mummy was asked to hold on to her shoulders. The doctor was pleased that she managed to take the X-Ray and gave Amelia, a pink sticker read “Very Good”.
(3) Blood Sample
The nurse put a magic cream on Amelia’s hands half an hour before taking her blood sample. The magic cream makes the process of taking blood from Amelia’s hand painless. There were three nurses involved in this process; one was distracting her by doing the interactive storytelling. One was holding on to her hand and the other was taking the blood sample.
Amelia did not even realize the nurses have taken her blood and she was so happy when the nurse put a cartoon plaster on her hand and she was being given another sticker it said – excellent!
(4) Height and Weight
Amelia’s height was 96.1cm and weight was 14.5kgs.
(5) Saturation and blood pressure
Amelia saturation was 100% and her blood pressure was normal.
(6) ECO or Echocardiogram
Amelia was not required to do her ECO scan because her last ECO scan was done within the last three months so GOSH can use the last scan. The last scan was done in March 2009.
(7) Questions and Answers Time
The nurses asked of Amelia’s health in the past a few weeks whether she has been well, was she on any medication? or any kind of sickness should be made known to them.
They also briefly explained the process after her surgery such as Amelia will be given morphine as the painkiller and will be sedated for a few days.
Mummy was asked to bring Amelia’s favourite toys and things she likes to play with to the hospital. Amelia likes her DVDs and her favourite movies are Alvin and Chipmunks, Underdog, Transformers, Spiderman, Kung Fu Panda etc.
(8) Surgery Consent
The Surgeon explained Amelia’s surgery procedures. The objective of the forthcoming surgery is to remove the outflow tract obstruction developed underneath the valve of Amelia’s heart. The surgeon explained the risks involved and other possibilities that may happen.
Amelia last ECO scan showed that the possibility of Amelia having to have her valve replaced is low and the surgeon will do whatever necessary to fix Amelia’s heart.
Mummy signed the consent form for the surgery.
Amelia was given a book titled Operation to fix it. The story is about a little boy named Tom who has to have an open heart surgery to fix his heart when he was a teenager/ The book was about his life before his heart surgery and the friends he made in the hospital.
The nurse encouraged mummy to read the story and explain to Amelia nearer to the surgery date about what is going to happen to her. Concurrently, explain the benefits of heart surgery to Amelia.
The surgery Date
Amelia’s operation was scheduled to happen on 26.06.2009. For this purpose, a nurse from the hospital will make contact the day before the surgery to go through the fasting procedure for Amelia. At the same time, the hospital will confirm the timing of the surgery whether it will be in the morning or afternoon on 25 June 2009. Regardless, Amelia is to arrive at the hospital at 7.30 am.
Second open heart surgery day
Amelia was admitted to Great Ormond Street Hospital on 26 June 2009 for her second open-heart surgery. The surgery was to remove some muscle underneath her pulmonary valve so as to remove the outflow tract obstruction. The outflow obstruction has caused Amelia to get tired easily. To put it simply, the surgeons going to scrap away some muscle underneath her narrowing valve. They would like to save the valve now and at some point in the future, she would require a valve replacement.
The surgery took about 4.5 hours. She was sent into the operating theatre at 11.20 am. Later, she was admitted to the Intensive Care Unit (ICU) after her surgery completed at 3.45 pm.
Amelia was at GOSH Day Care Ward settling down to the hospital environment. She was playing on the bed. While waiting for her surgery, the nurses gave stickers and activity books to occupy Amelia. It was important to keep Amelia relax and calm before the surgery.
Amelia was recovering at the ICU and she was half-conscious. Most importantly, she was breathing by her own with only the help of the oxygen mask. This was great news that she did not need to rely on the ventilator to breathe for her. She was given morphine to make her feel painless.
Amelia very irritable and she was constantly asking for water. Unfortunately, she was not allowed to have water because the anaesthetic and the morphine will cause her to vomit.
Amelia’s heart rate was 140-148 and her saturation was 95-100% and the doctors expect her heart rate to go down to 110-115 bpm. There were times where Amelia was screaming and crying due to pain, this caused her heart rate increased to 180++. the doctor increased the morphine intake (controlled amount) to calm her down.
Picture 3 (2nd day)
On day two, Amelia was fully awake and was allowed a small amount of water each time she asked for it but no food was allowed yet. She was calmer and was able to tell the nurses that looked after her not to touch her chest wound, no more medicine going in the tube on her hand because it hurts her. She saw a boy in the hospital bed next to her, his mum was peeling his chest wound dressing off slowly and the boy was screaming in pain.
When the nurse wanting to change the dressing on Amelia’s chest wound, she told the nurse this “please don’t touch my scar, it hurts, do you know that? at the same time, her hands would try to push the nurse’s hands away from her chest. It took lots of persuasions to convince her the nurse would be gentle.
She also asked the nurses questions after questions about this and that and why this and that. The nurses said Amelia can talk all day.
Picture 4 – 5 (3rd day)
On the third day, Amelia was transferred to Lady Bird Ward, her chest dressing was removed and all the lines and morphine dosage was stopped completely. She was given Calpol as the painkiller instead.
Picture 6 – 7 (4th day)
On day 4, she starts eating and drinking normally. She has had all her X-ray, ECG and Eco Scan done on the same day (29 June 09) and the results were promising. For this reason, the cardiologist was happy to allow Amelia to go home. On the way home, Amelia saw an ice cream van, and she asked if she can have one. Of course, she would get one. She was very happy and enjoy her ice-cream.
The cardiologist suggested to give Amelia’s Calpol every four hours if she complained of chest pain. Most importantly, she must take a good rest at home until she is well enough to go out to play.
Chest wound infection
While recovering at home, Amelia’s mother noticed her chest wound produced yellow fluid (suspect of infection). She was taken to a local hospital on 07 July 2009 to assess her chest wound and she was admitted to the hospital straight away. She was on 48 hours antibiotic at the hospital. Further 5 days of oral antibiotic at home.play.
Life goes on after my second heart surgery
Amelia’s heart rate was slightly higher than normal at the rate of 130-140 beats per minute. However, she was doing well physically. A year later, she was swimming in the swimming pool. The surgery has allowed Amelia to engage in a variety of physical activities more comfortably. She could cycle, swim and run around with other kids without feeling tired easily.