Nehemiah's Surgery

Nehemiah Bill Dunham just after he was born.

On March 31st, our sweet little Nehemiah was born. He weighed 6lbs 8oz and was 20in long. It is hard to believe he is already 4 months old, and it has been quite a roller coaster. Of all our kids this has been our hardest transition in welcoming a new baby. Everyone, myself included, has always said the more kids you have the easier it is to bring a new baby into the family. Well, Nehemiah is destined to prove us wrong. He is different in every way, and his journey is already much different from the rest of our kids.

Dave reading a blessing to Nehemiah at his dedication to God. (1 month old)

Family picture on Mother's day. (1 month old)

 By the time Nehemiah was 2 months old we started having some concerns for him. Our precious niece, Heidi. was born 6 days before Nehemiah. We know every child is different, but seeing the two of them together we were noticing some milestones Nehemiah wasn't hitting. He was still going cross-eyed the majority of the time and when he wasn't cross-eyed the two eyes didn't seem to align just right. He also wouldn't make eye contact, and would avert his eyes from us when we would try to get in his line of sight. His left eye seemed to be slightly smaller than his right, he wasn't smiling or cooing yet, and he didn't like being put down or snuggling.

 At Nehemiah's 2 month check-up I expressed my concerns with our pediatrician. She referred us to a UC Davis ophthalmologist to get a closer examination. She suspected that he had a weak left eye and would need some patch therapy to strengthen it. She emphasized we needed to see them ASAP because if he was getting 2 different images from his eyes his brain might shut off vision to the weak eye. As for the social delays she guessed it was because of his issues with his eyes that was delaying the milestones. We had a 3 month check up before we saw the ophthalmologist and by then Nehemiah was smiling and even starting to coo. He still wouldn't hold eye contact, but was starting to look at us for a brief second. The pediatrician said he was doing great and is just a little slower than the average child.

 When we finally saw the ophthalmologist and later had an ultrasound. We found out that Nehemiah's left eye has cataracts and a stalk attaching the back of the eye to the lens. We have learned that a normal eye while in-utero has a blood vessel that attaches the back of eye to the lens. Once the eye develops the blood vessel detaches and goes away. The stalk the doctor found is that blood vessel, and since Nehemiah's eye stopped developing in-utero it didn't detach. This caused the cataracts and the left eye to be smaller than his right eye. Both the cataracts and the stalk were blocking light  from getting to the back of the eye. The best chance for him to be able to have sight in the left eye was to remove the lens with cataracts, snip the stalk and remove it or at least hope it would fall to the side of the eye allowing light in. Surgery wouldn't give perfect sight, but was his best chance at getting vision to his left eye. The doctor related it to having a working spare tire. Nehemiah's left eye wont ever work perfectly, but will hopefully be a good help to his right eye. 

On Nehemiah's left eye can you see the white spot that is on the right side of his pupil? That white spot is the stalk.

On Monday, July 27th, Nehemiah had surgery. It was a hard, horrible day and still we could see God's hand in it all. Nehemiah had to stop eating at 4:00am, 4 hrs before we were to arrive at the hospital. Nehemiah doesn't enjoy drives and then being hungry as well should have resulted in crying for the whole hour and a half drive. By God's grace Nehemiah fell right to sleep in the truck and slept the whole way to the hospital. Once there they took us back fairly quickly to pre-op, but we had to wait 2 more hours before surgery. At this point Nehemiah was getting really hungry and fussy. We tried his pacifier and praise God he actually took it. Nehemiah has always refused his pacifier before this and still hasn't taken it again since surgery. When it was time for Nehemiah to go back to surgery I was able to walk him half way. Then I had to hand him over to the anesthesiologist. It was extremely hard to hand him over then walk away. Again, by God's grace, my fussy little boy who cries when most people hold him was happy and content in the anesthesiologist's hands. This gave me a little comfort, but was still extremely heart wrenching to walk away. The nurse advised we go get food as she has had nursing moms not eat and then pass out when they go back to nurse their child post-op. We ate and waited about 2 hours before our doctor came to us to share how surgery went. She said Nehemiah did well, was coming out of anesthesia now, and was hungry. She went on to explain she was able to remove the lens on the left eye. She couldn't remove the stalk as it was strongly attached. She felt messing with it too much could cause more harm than help. She removed part of it and what is left isn't in his primary vision. She also found that Nehemiah's optic nerve where it attaches to the retina isn't fully developed. Because the optic nerve is damaged we aren't sure how much his brain will be able to understand of what he sees. This is something we wont know until he is older, monitored more, and able to express what he sees. Since the doctor started this whole conversation telling me Nehemiah was hungry, I only heard and understood a portion of all this. When she finally took us back to Nehemiah we could hear him screaming as we walked through the doors. He was swaddled with wires and tubes coming out of him in all directions. He had an eye patch and shield taped to his left eye. I held Nehemiah, sat down, and tried nursing, but he refused. He never opened his eyes, and continued to cry and fuss. We could get him calmed down for a few seconds, but he would just start crying again. He seemed to be swallowing hard and I wonder if his throat was sore from the breathing tube he had in. I continued to try and get him to nurse. I knew he had to be starving. I craved the closeness of nursing and comforting my boy, to feel like everything would be alright. I also knew we had to get him to eat and see if he kept the milk down before we could leave. After about an hour of this crying, getting him calmed down, trying to nurse, and then crying some more the nurse gave him some morphine. Once he was calmed down again he nursed lazily as he slept. About another hour later Nehemiah was starting to act more like himself and we were finally able to leave. 

In pre-op Nehemiah was such a trooper. Here he is getting his blood pressure taken.

Nehemiah actually took his pacifier. Praise God!

After surgery calming Nehemiah down. Praying he is alright and that he will nurse soon.

Finally able to leave the hospital. Nehemiah had the patch on till the next day. 

 Now we are focused on his recovery. It will take around 3 weeks for his eye to heal from surgery. He has antibiotic drops as well as dilating drops. Once his eye has healed he will get a contact lens that we will be putting in every morning and taking out every night. He will also have patch therapy to force him to use his left eye and strengthen it. Once he is walking he will then be getting glasses as well. This is just the start of the journey that will be on going for the rest of his life. I praise God for the care and wisdom of our doctor, that surgery is over, and Nehemiah is recovering well. We don't know, and only in time will we find out, how much he can even see from the left eye, but we do pray for God to heal and restore sight to this eye.