Ryan and I knew we would circumcise Gage. It wasn't even a question. We did not consider that there may be risks. We thought like most young parents that it was standard procedure. No worries. Boy were we wrong. Gage was originally scheduled for circumcision two days after his birthday while we were still admitted to the hospital. Most circumcisions are completed within 12 to 48 hours after birth for obvious reasons. We met with Gage's doctor prior to the procedure where he explained how it would be completed. Ryan and I were told at that time about a condition in some infants known as Hypospadias. Hypospadias is a birth defect in male infants that causes an abnormally placed urethra. In most cases, we were told, the infants foreskin is misplaced as well so the doctor is able to diagnose the defect prior to circumcision. Circumcisions are not completed immediately on infants with Hypospadias. The foreskin is removed later in life and then used as a part of plastic surgery to correct the defect. The doctor did not foresee that Gage had this defect, but warned us that if he noticed any abnormality that he would stop the procedure to preserve the foreskin. They took Gage for this minor surgery and told us he would be returned to our mother baby room in about 15 minutes. An hour later we still had not seen the doctor and Gage had not been returned to the room. Just as I started to send Ryan for a nurse, the doctor came in. He told us when he started the circ, that he noticed a problem and that it did appear that Gage had Hypospadias. So he had stopped. An incision had been made but the foreskin still remained. He let us know that a urologist would be looking at Gage and that the urologist would be in shortly. Another hour passed. Gage was still not returned to our room. Finally the urologist visited our room. She told us a much different story. Gage did not have hypospadias. He was completely normal. The problem was that the doctor who made the incision has only cut thru part of the foreskin, and had not gone through all the layers. Because that doctor was unaware of the error he had made, he noticed an abnormality. The doctor created the problem. We were told that the circumcision could not be completed at that time and that we would have to follow up with a pediatric urologist. We immediately made an appointment.
At our first visit to the pediatric urologist, Gage was only 6 days old. The incision from the attempted circumcision was still in the process of healing. He was still swollen. The urologist let us know that he would still not be able to complete the procedure due to the swelling. He informed us that there was a possibility the circumcision could be completed at a month under local anesthesia. The more likely possibility was that the circ would be completed at 3 months or later under general anesthesia. He let us know that since the odds of the procedure being completed at one month were so low, we could just schedule the procedure at 3 months old. We opted for optimism and scheduled a follow up at one month. Neither one of us wanted our baby boy to be under general anesthesia, and we prayed for a month that the initial incision would heal well and allow the new procedure at one month old. We visited the pediatric urologist last week and were happy to hear that our prayers had been answered. The circumcision would be scheduled for July 13th, and it would be completed just as any other newborn circ with a local anesthetic.
We arrived at the hospital yesterday morning around 10:30 am. We quickly checked in and were sent to a pre op room where the nurse met with us and informed us that it shouldn't be long until the procedure was started. Then the doctor met with us and went over all the risks. The risks that had not been explained to us during the first attempt. The risks that had they been explained, may have prevented us from making the decision to have the circ completed. We no longer had that choice, as we could not leave Gage with the scar from the first incision. We also thought he had already been a part of the 0.5% statistic that had suffered from a complication. They took Gage for the procedure and moved us to a waiting room. After about 20 minutes the doctor visited us and let us know the procedure had gone as planned with no complications and that Gage was well and in post op. He let us know what the after care requirements were and stated that we may notice a couple drops of blood. We were taken to see Gage. He was bundled up in a heated hospital blanket and seemed content. The nurse asked to take a look at the circumcision and made a comment about how swollen he was, but replaced his diaper and informed us that we were free to feed him and then go when we were ready. I fed him quickly and we packed him up and drove home. We were elated to finally be done with the whole ordeal.
As soon as we arrived home, Ryan and I took Gage to his room to change his diaper and take a look at the area. When we opened his diaper we were surprised to see a lot more than a couple drops of blood. His diaper was soaked with blood. His penis was even more swollen than when the nurse had taken a look. We wiped him clean and quickly noticed that his penis and leg were bloody again. He was actively bleeding, it wasn't just normal blood in the diaper. I cleaned him off several times just to be sure we weren't mistaken. Ryan kept saying over and over, this is a lot of blood. We doubled up his diaper and Ryan called the doctor, while I fed him again. After holding for a few minutes Ryan spoke with the nurse, who told him to get Gage back to the hospital as soon as possible. We headed out immediately. Upon arrival at the hospital we were taken back to the doctor immediately. He took Gage out of his car seat and took off his diaper. This diaper was soaked with blood as well. Three nurses and the anesthesiologist stood watch as the doctor examined Gage. The doctor said Gage had a hematoma. The swelling that the nurse had seen initially and that we noticed was the hematoma. The blood was pooling underneath his skin. There was also the continual bleeding outside of the skin. The doctor placed constant pressure on the hematoma for 5 minutes. He explained to us that he was trying to get the bleeding to stop with the pressure alone. Ryan held Gage's legs down and I comforted him during the ordeal. After 5 minutes, the doctor removed the pressure and the bleeding had not stopped or slowed down. The plastibell that had been attached for the circumcision had fallen off due to the pressure applied, and there was now more bleeding. At that time the doctor asked the anesthesiologist if she could put Gage under. She remarked that she would have to. She started asking us questions, when did he last eat, does anyone in our family have a history of problems with anesthesia, has Gage been healthy, when was he born, was he a full term baby. The doctor explained that they would have to put Gage under general anesthesia to find the exact source of the bleeding and stitch it up. The anesthesiologist tried to reassure us that they use general on newborns and neonates all the time. But she was concerned that the Gage had just eaten, and let us know they may use a breathing tube. Then Ryan looked right at the doctor and said "what are we waiting for, lets get it done!". They brought us paperwork immediately to authorize everything and took Gage back to the operating room.
The next hour was the longest hour of our lives. I cried and prayed and held Ryan's hand. I cussed the doctors and nurses in my head. I cussed the system in my head, why had they sent him home so soon after the first procedure. I cussed the doctor who first messed up his circ. But then I would remember to pray. I knew it wouldn't help to be angry. The doctor finally arrived and let us know that Gage was fine and in post op. Praise the Lord! The doctor let us know that the source of the bleeding was a small blood vessel on the top of Gage's penis. He thought that this blood vessel should have clotted or retracted easily and was concerned that Gage may have a blood clotting disorder and had ordered labwork. They had made a continual stitch all the way around the penis, and the stitches would dissolve within 2 weeks. He brought us to Gage, where the nurse informed us we would have to wait while they observed him for an hour. After crying for about 10 minutes, he slept in my lap for the rest of the hour. At the end of the hour the nurse and doctor reexamined him and there was little to no bleeding. We were given discharge instructions again and sent home.
We have been home for over 24 hours now. Gage is doing much better than we were told or expected. His tummy has been upset, and he has spit up quite a bit more than usual. We were told to expect his tummy to be upset from the anesthesia. Hopefully that will pass by tomorrow. He seems almost unaffected by diaper changes. The swelling has gone down dramatically and there is still just little to no bleeding. We do not have the results of the blood test, but I am not going to worry. I am hoping that a blood vessel was just broken due to the shot of the local anesthetic. We should find out the results tomorrow.
We know now not to assume anything about any procedure being done to our family, whether or not we think it may be routine. We need to know the risks and be well informed. We have lost a lot of trust in the medical system, but hopefully we can find a new pediatrician who will restore our trust. We are very happy to have our son home and okay. I have never experienced that kind of fear. But I guess it comes from the same place as that unexplainable love. The kind that you don't know you have until you hold your child in your arms. We had a lot of prayers and support yesterday, and appreciate all the love of our friends and family. Thank God that Gage is okay.
