Wednesday, June 13, 2012

The details of yesterday

Ok, I wanted to give you more details so this is what went down yesterday.... we got there at 7 a.m. and she went back at 11 a.m..... 4 hours of entertaining and she did AMAZINGLY well.  She never even noticed that she had not had food or drink since the night before.  We walked, we played in a car, played in a ride on toy, waved at everyone, etc.  Drs. came by intermittently to meet us.

Enter in Dr. Conklin ( I highly recommend him!)... he took 25 minutes to talk to us and walk through all the possibilities.  Her surgery was one that you just can't fully know what you are going to do until you get in there.  The two options for hips are an open and closed reduction..... open meaning they cut you open and closed meaning they don't.  As we talked to him, I'm realizing how little I listened at the first meeting.... oops.  The plan was to put her to sleep.  Once her muscles were relaxed from anesthesia, they would try and pop the hip back in.  (To understand where her ball was, picture pulling your leg down then out to the side and then shoving up, with the ball resting on the outside and up of where it should be which made that leg shorter.... so to fix, pull down, over then push up.)  Without boring you with too many details, he found the likelihood of that happening was slim because of her age.  At 19 months, the ball would most likely be firmed up in place (can't remember the term he used but something like calcifying).  And even when you can pop it back in, there are many times it doesn't "feel" right to the doctor and he just knows that blood flow to the head of the ball won't be good or it will pop out again and so on.  Lots of reasons that even if you can do it, they might still opt to operate.  The downside to closed is that the body cast is 3 months.

Onto open reduction.... that would involve cutting bone & muscle to get it in and possible shaving off some of the femur, putting in a metal plate and screws (requiring another surgery to get out) and the possibility of another surgery to stunt the growth in the good leg down the road because of having to shorten the femur of the bad one  (all kids are different so these options were based on the shape of MS's bones, etc.) .....  We felt confident that an open reduction would take place but didn't know the full extent of what all would be done.  And the dr. said if it was a close call, he'd err on the side on open, which we agreed with.  The only plus side is the body cast is 6-8 weeks (because they can patch the muscles in a way to secure the hip more.)  Then lots of PT would follow to get it all working again.

So that was it.  A funny aside but during the wait, we saw some "pirates" doing face painting on kids in the lobby and we wondered aloud what MS would do if we got painted up like pirates and that was what she saw when she woke up..... I'm sure she would be terrified but we got a good laugh out of the possibility.

The doctor said it would take 3 hours.... 2 hours later they paged us.  The doctor and his fellow came out and said "we did a closed reduction" to which I said "I'm shocked" and they both said "so are we!"  He said that he pulled and it slid back in with such ease that they both looked at each other and said "did that really just happen? Could it really be that simple?"  So he called in another ortho to ask his opinion and he thought it looked awesome.  (The question would have been if it really fits well/ won't pop right back out/ doesn't need any internal tweaking).  They moved it all around and it stayed in.  That's when he said the comment "when you are given a gift like this, you take it."  Even the structure of the socket looked better than what they originally thought..... so he thinks it will heal up nicely.  And another great thing was that because we had the CT of her skull scheduled, they were able to also do a CT of her hip to really look and see how great it looks.  The doctor said I won't say that this was lucky but this was beyond our control for it to go this well.....  Did I say we loved the doctor?

So the next question is, why was a closed better than an open since the cast is longer??  Anytime you don't have to cut through muscle or bone it is a plus!  Because there is no incision, he said there was virtually no pain (other than anger over being trapped!) so she went home on motrin.  (there is one small incision that both open and closed reductions have to clip a tendon near the groin area but it is so tiny and required no stitches)  There is also no swelling to make her uncomfortable.  And because there was no cutting, there is no need for PT in the fall when she comes out.  When you have 4 kiddos, the idea of even scheduling PT for one feels overwhelming so that was music to my ears.  I'm now having dreams of her being able to actually go to Mother's Day Out in the fall and me going somewhere, anywhere all alone!!  The doctor ended with telling us there was really nothing to monitor on her, so would we like to go home?  Um, yes!  It was a big blessing for her to not have to sleep in a strange place/bed and to not try and coordinate everything for the other 3 kiddos.

Waiting for MS to come back to the room was like waiting for christmas morning.  I was beyond excited and anxious to see her.  I felt like a windup toy bouncing around the room, peeking out the door 50 times, and even punching derek in the stomach some to get some energy out.  MS only cried when she saw us.... they said she had been fine in recovery.  She seemed a bit zoned out for the rest of the day but was still smiling at moments.  To see her calmly in sitting in one place all afternoon was something we are not used to being that she is such a busy body.... I know she was slightly drugged and in a cast but it was kind of nice for a change (if that isn't terrible to say!)

My excitement yesterday may seem funny since she still has to have the body cast..... in the short run, it will be hard but in the long run, this is a much better path for her.   Yesterday, we were simply amazed by the fact that God allowed them to do something with her leg that should not have been possible.... a little miracle in her life.... for us to witness as well as the doctors.  Ever since we were matched with Mei Sims we talked about wanting her hip to simply pop back in but I always said it with a bit of a laugh like "wouldn't that be nice, but I know it won't happen."  He heard our prayers and moved in spite of my lack of faith.  This little miracle will provide me with encouragement in the months ahead when it gets long or hard.  I just love that He cares about details..... of all the people and all the situations in the world.... He cared enough in that moment to move.  I can't express enough my thankfulness for all of you who have been in this with us!

So now she sits like a frog in a big purple cast.  She is awkward to hold for most but by God's grace, the position of her legs, fits perfectly on my frame!  She goes in between being very mad and then happy so really no different than before the cast.  Last night, sleep was hard to come by but she will adjust.  I think she is just scared when she wakes up and realizes she cannot move so she wants to be reassured that we are there.  The biggest challenge is diapering so praying against diarrhea these next months!  So far so good.  Also praying that the socket will form well around the ball of the femur as she heals.  Finally, praying for my back these next weeks.  She and Henry are just heavy and I'm not the strongest/largest mom around.  Enjoy the before and after photos from yesterday.

The car we used to pass her off to the nurses.

We passed a lady in the hall who said "well, he is too pretty to be a boy!"  To which I replied "She actually is a girl so that is great!"  

She was zooming around on this which she has never done at home.... she was adding new tricks right up to the last minute :)
Just back in the room.

In the carseat headed home.  It is made for spica cast and was passed along by her friend Mary Graham :)

Best photo I have so far of cast.  It comes up to her armpits.  There is a newborn diaper tucked into a cutout in the cast and then a big diaper on the outside.... everyone seems curious about this aspect!


Fliss and Mike Adventures said...

So glad all went well... One tough cookie of course....

Angie said...

All I can say is....praise Jesus! Our God is sooooo good!!!

Tara and Julian said...

I couldn't quite imagine what the body cast was going to look like, so glad you posted a couple of pictures. Looks rough, but I was also imagining her arms being tied up too, so that is better than I thought. I can't believe what a big smile she has! They are so resilient- amazing! So happy things are going well so far. :)