Like many PE operations, this was done in a children's hospital and Gina checked into an adolescent ward. Her drug dosages and care were of course adjusted to take into consideration her near-adult size. In retrospect, I think it was a real bonus to have gone through the whole thing in a children's hospital, as parents and family were welcome to stay and help look after the patients, there was plenty of nursing attention, and all the staff seemed to have the relaxed and friendly bedside manner you'd hope for in a place that cared for children. I was able to stay with her the whole time, and we even ended up with a room to ourselves, right opposite the nurses' station. (I slept on a fold-out bed/chair.)

We checked in at 7am the morning of the op, left our gear in the ward she'd return to, and returned to pre-op where she got ready. This was probably the most nerve-wracking time for Gina and was when the enormity of what she'd committed herself to really hit home. The anaesthesiologist came out and talked to her, explaining especially about the epidural that would be inserted during the op for post-op pain control, and describing the countdown that would happen next as she went into surgery. Once she had conked out, her dad and I went to join other parents in the waiting room next to the recovery ward. We knew a 3-hour operation was likely -- but even so, it was hard not to just sit and watch the clock.

In the end the operation lasted five hours! I wondered if the extra time meant Dr. Stokes was using two support bars, a possibility he'd mentioned. Finally he emerged, looking and sounding pleased with his work, and described how the op had gone. He'd done an extensive correction, involving the following:

When we saw her shortly afterwards in the recovery room, she was just beginning to wake from the general anaesthesia and had an oxygen mask on. As we soon found out, it's a common reaction that a patient coming around after a general shakes uncontrollably. Still, this was the hardest time for me as a parent -- watching her go through that just as she was becoming aware of the pain, and my not being able to help! The shaking soon stopped though, they wrapped her in a heat blanket to keep her warm, and began to try leaving the oxygen mask off to see if her breathing was strong enough to keep her blood saturated with oxygen. She had all sorts of tubes and monitoring devices hooked up -- to measure oxygen levels, blood pressure and pulse; the epidural drip with painkilling drugs and a saline drip for rehydration; and of course the two tubes draining the chest (these were attached to clear plastic bottles hooked to her bed). An X-ray was taken to check for any residual air that might have been trapped inside. Finally, about 2 hours after the operation ended the oxygen mask came off and she was wheeled back to the adolescent ward.

Two and a half hours post-op she was able to talk a little and drink some water. The correction Dr. Stokes achieved looked terrific, with one nurse commenting that if she hadn't read the chart, she wouldn't have known anything had been wrong with Gina's chest. Watching her closely over the next few days, I could see that the most perfect-looking state occurred when she was lying flat, and especially after a night of unconsciously fuller breathing. This made us realise how important to the eventual healed ribcage shape full breathing and good posture would be!

She could feel some soreness in the upper sternum area, but most of her chest felt heavy and numb. Theresa had also described feeling as if a great weight was on her chest at first. This, plus concern not to put pressure on the incision, made Gina avoid deep breathing and move stiffly. Add to this all that lying only on her back, and muscles began to cramp. A nurse suggested gentle massages with a scented oil, which we tried -- and which worked really well to prevent foot cramps and help her fall asleep.

The tiltable hospital beds are a godsend for helping people who've had chest surgery get upright! Physiotherapy began that evening -- with a simple blowing of air into a tube whose end was in water -- like a giant straw -- the water pressure making her work hard to produce bubbles. These blowing exercises had to be done every few hours to keep the lungs clear and prevent any post-op pneumonia. We noticed she was breathing out anaesthetic fumes all that day and the next.

She had some slight congestion that caused her to cough, a painful experience. The physio showed her how to hold a pillow firmly across her midsection and "cough against" that. By early evening she was feeling nauseous, a common post-anaesthetic effect, and that first day she had nothing but water in hopes of stopping short of vomiting. She continued to drink water but wasn't hungry.

The epidural was excellent for pain control! The drugs were fed through a very fine soft tube inserted between two upper thoracic vertebrae, T7 and T8. It's not at all uncomfortable to lie on, and is taped to lie flat and securely. It was hooked to a drip containing fentanyl and bupivicaine. The flow was adjusted by the nurses (who checked on her every hour) as needed to keep her pain control good. Each time, Gina was asked to rate her pain on a scale of 1 to 10.

A friend warned us that nausea was often an after-effect of general anaesthesia, and that if this was a problem, post-op medications worked as well taken as suppositories as orally. Gina felt nausea building throughout the first afternoon so didn't eat that first day. When she sat forward and did the physio she'd feel achey afterwards from the movement -- so the nurse suggested she take a Panadol tablet (paracetamol) beforehand, which did ease the aching. Because of the nausea she took it in suppository form, and this worked well.

Another common post-op effect is running a low-grade fever -- and, sure enough, by that evening Gina had a temperature. This diminished during the first night and continued to drop slowly until it was normal again on Day 3.