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James is all done with his surgery, back home and playing happily. He did great before the surgery, and was unhappy when he first woke up from the anesthesia, but after sitting with Mommy and watching Elmo for a while, he perked up.

It turned out the tubes hadn't fallen out; scar tissue (granulation tissue) had developed that blocked them up and had been causing the gunkiness and occasional bleeding that we'd been seeing. (Nothing's ever simple with this kiddo's medical conditions!) So the doctor cleared out the scar tissue but did not put new tubes in, because he figured that would just aggravate the area more. James may or may not need new tubes later; we'll see how it goes during the fall. (If he gets ear infections or more ear fluid, they'll probably want to do it, if not, then they won't need to.)

The surgery was at the newly remodeled ambulatory care center instead of the hospital.  They have their own parking lot, and not having to deal with the hospital parking garage was a tremendous benefit.  Also, doing it at the care center meant we were less likely to be bumped for an emergency (they don't do major surgery there or transport NICU kids there).  So, it was a much smoother process than last time.