Nasolacrimal Duct Probing and Intubation

ie.... "Crawford Tube"

Isaac was born with obstructed tear ducts in both eyes.  That means he produces tears normally but the drain pipes are clogged.  The effect is goopy/"mucusy" eyes all the time.  They are so bad that when he wakes up in the morning he can't even open his eyes because of the dried mucus "welding" them closed.

He has had them probed twice since he was 6 months old.  That procedure is done by a Pediatric Ophthalmologist in their office without anesthesia and take literally about 1 min per eye.  He got upset and didn't like it but was fine about a minute after they were complete.  It was successful on the left eye duct but not the right.

The next step was to do a Nasolacrimal Duct Probing and Intubation (also called a Crawford tube).  In this procedure they are put under general anesthesia and a small tube is threaded through their bottom and top ducts and are sutured to the inside of their nose.  It is left in place for 3-6 months and removed in the Ophthalmologists office.

Isaac had this procedure done today.  We arrived at Clear Lake Regional Hospital at 7am and checked in/filled out paperwork, etc...  We went to the pre-op room where we met with the Anesthesiologist and the Pediatric Ophthalmologist.  They took him from us at 8am and we went back to the waiting room.

About 50 min later the Ophthalmologist came out and told us the procedure went well and we could go see him. We went back to the recovery room and found a nurse holding him while he was screaming.  Not just sad crying, but the kind of screaming that you lose your voice over.  His nose was bloody and he still had his IV.

I took him and he was arching his back and throwing his head back.  It was clear he was in pain.  I asked the nurse to get him pain meds if she hadn't already.  She left and about 15 min later came back with a syringe.  She tried to put it in his IV but decided it was either kinked or clotted and couldn't get it to push in.  They talked back and forth about trying to reinsert his IV.

I'm getting frustrated and interrupt by saying "Why can't we give him pains meds by another method?  Like an injection?"  I said it in my "work voice" (as Bryce calls it) which is stern and authoritative.  They kind of give me a surprised look and start scrambling.  Keep in mind Isaac is screaming this entire time.

Fifteen minutes later they come back with an oral pain reliever.  We give it to him and he finally settles down about 20 min later.  He falls asleep on my chest and we wait about 30 min before signing the papers and leaving.

I obviously understand that surgery is not fun and we shouldn't have been surprised that he was upset.  I AM upset that the nurses didn't have their act together.  No one could make a decision... why did I have to get after them to take care of my kid's pain?  Shouldn't it be obvious if one method doesn't work you try another method?  I wanted them to stop trying to fix the problem with little comments that "he will get better"... I'm telling you he is in pain so give him something!  When Isaac was in the NICU at Children's Memorial Hermann I was very confident in the abilities and decisions of the staff... not the case here.

I was apprehensive about taking him to this hospital.  We went back and forth on the decision to take him here or Texas Children's (we live about 45 min away from Texas Children's which made the decision difficult).  We decided we really like the Pediatric Ophthalmologist and she had rights at Clear Lake... but we didn't consider the nursing/support staff in that decision.

So I am feeling like a horrible mother for taking him to this hospital.  The procedures has a 95% success rate so hopefully we are done.  If by some unfortunate circumstance, we have to do it again, I will be going to Texas Children's.

Sorry to vent, but I was not happy.