Life 'n Legos: Mikey's Surgery

On Wednesday, Mikey had surgery on his hand to remove a ganglion cyst. I noticed the cyst when he was around 9 months old and it has taken this long for Tricare to get their stuff together to do something about it.

I noticed a hard little bump on his hand when he was around 9 months old, but it didn't seem to hurt him or affect his hand function at all. I did decide to ask about it at his one year check-up and the pediatrician referred me to an orthopedist. We first saw a PA at Triangle Orthopedics who was essentially clueless. He called in the MD who was also pretty clueless. He said that 90% of masses in hands are benign, but masses in the hands of 12 month olds are also extremely rare. I told him that if this was something that was going to have to be removed I would rather do it in Raleigh than Oklahoma, so he ordered an MRI. He wasn't comfortable with children and said he wanted to see Mikey's exact anatomy before going any farther. Tricare approved the MRI about 1 week before we moved back to Oklahoma so I just didn't have an opportunity to get it done there.

Upon returning to Oklahoma I called Tricare again to see if my referral for the MRI could be changed to here. Since I had to change regions within Tricare it couldn't be and I had to start the entire process over again. So I went ahead and scheduled an initial appointment with the pediatrician. She said that since we had already done this process she would refer us to both the orthopedic surgeon (who would be pediatric surgeon and and hand specialist) and for the MRI. We got our appointment with Varsity Orthopedics almost immediately and couldn't get our MRI scheduled until 6 weeks later. Thankfully, the staff and doctors at Varsity Orthopedics (in Dallas) were wonderful and told us that we did not need to do the MRI because they knew exactly what it was and gave us our treatment options.

She told us it was indeed a ganglion cyst (see description below) and it was actually probably pretty painful for him. She said that she could remove it surgically and it would not come back so we got onboard with her plan. About 3 weeks later we headed down to Dallas for the surgery.

Mikey's surgery was at a pediatric surgery center, so everyone working there was specialized in peds. The staff was all wonderful, they were all very engaging with Mikey to make him feel comfortable. The rooms were all painted for children and there were TV's in all the bays playing disney movies. Once they took Mikey's initial vitals they gave him a few drops of Versed in his nose. Seeing a toddler on benzodiazepine is hilarious. He was all loopy and acting drunk. He had the cutest smile on his face too. Once he was to an acceptable level of loopiness the nurse and anesthesiologist picked him up with his blankee and lovey, put some George on their iPhone, and carried him away. He didn't care at all, he was so excited to have someone handing him a cell phone that he didn't even look and me or Brian.

The surgery lasted 45 minutes on the dot (just like Dr. Quatro had told us). While Mikey was waking up she came and told us the surgery was smooth and successful, gave us post-op care instructions, gave us pain management instructions, and talked about a post-op appointment. She said the cyst was small in comparison to other ganglion cysts, but was large in proportion to his hand. He has 4 very small stitches in his hand and was wrapped with gauze, and Ace bandage, and then had a protective brace on. They also put a sling on him to keep his hand elevated...he HATED it.

Mikey was fussy and groggy while we were waiting to go home, but once we got into the car he was happy as a clam. We turned on Toy Story for him and gave him some crackers, french fries (since he was signing that he wanted to eat), and an applesauce pouch. After his tummy was full he conked out the rest of the trip home. He has been so good and hasn't really needed any pain medication. I gave it to him around the clock for the first 24 hours just to keep him pain free, then gave him ibuprofen around the clock until bedtime for the next 24 hours. He WOULD NOT wear the sling. Yesterday I didn't need to give him anything at all for pain and was able to take the bandages off. His hand looks wonderful. There is hardly any swelling or bruising and he is able to move his fingers pretty well. The only issues we are having are unrelated to the surgery (he woke up at midnight throwing up and woke up this morning covered in diarrhea). Right now we just have a bandaid over the sutures and put the little brace back on to protect him from falling on it. We go back to Dallas on Monday for his post-op appointment, but everything is looking great!

Ganglion cysts are noncancerous lumps that most commonly develop along the tendons or joints of your wrists or hands. They also may occur in the ankles and feet. Ganglion cysts are typically round or oval and are filled with a jelly-like fluid.

Small ganglion cysts can be pea-sized, while larger ones can be around an inch (2.5 cm) in diameter. Ganglion cysts can be painful if they press on a nearby nerve. Their location can sometimes interfere with joint movement.