Results from the Pre-op

Thanks everyone for your thoughts and prayers today. Our friends - a couple that we knew in Maine - both took the day off of work today to stay with Jack & Robin - WAY above & beyond what we'd expected. They got to Kelly's apartment around 6:30 a.m. and we left for the hospital. The kids slept until about 8:00, which is what I expected. They ate breakfast, got dressed and went out to see the movie "Bolt", and get lunch from McDonald's. They returned from their adventures shortly after we got back from the hospital. Their day was unstressful, and enjoyable for the kids, which is what we had hoped.

Meanwhile we got to the Orthopedic dept. at 7:25 a.m. Olivia was probably wondering why we had woken her up so early, but she was a trooper. We were the first appointment of the day, and Dr. Todd was fresh, and ready to explain the procedure. He checked Olivia's legs to make sure he had the proper plan. His plan changed somewhat from what I understood going into today's appointment. He is going to do both the hamstring and hip adductor muscle groups next week. He feels she may benefit from these on the same day. The hip surgery is still planned for April. At the bottom of this post, you can read the WebMD.com description of what Olivia is having done next week. If you don't have the stomach for that kind of thing, stop at "Thanks again..."

We finished with the doctor at 8:30 and went to see his case manager to schedule follow-up appointments. We will go back on January 26 for Dr. Todd to check her surgical sites. February 26 we will return to see the effects of the surgery. At some point (either on Feb. 26 or later) Dr. Todd will do another hip x-ray to see how her hips are doing. That is when we'll plan the second surgery.

From there we went to meet with a pediatric inpatient ward nurse, as well as the anesthesiologist. This was a VERY LONG waiting period for us. Meeting with these two totaled about 30 minutes, but we were waiting for 1 1/2 hours on that floor.

Olivia did not need to have lab work done. We're thankful that she did not have to add that to the day.

Finally we went to pick up the medicine that she'll need after her surgery. In hindsight, I wish Dave would've gone to the pharmacy while Liv & I did all of the stuff with the nurse -- he could've made it up to see the anesthesiologist with time to spare. But since we didn't do it that way, the line was EXTREMELY long for the pharmacy. We literally waited for 2 1/2 hours for her prescription!!! I couldn't believe how long it took. There was plenty to keep us entertained, though. I don't know why, but I think it's hilarious to see adults fall asleep in public places. Undoubtedly there are the nodders, who startle when they start to really nod off, and look around to see if anyone saw them. Also you'll have some people who tilt their heads back a little, which causes their mouths to gape wide open. There was this one gentleman who was sitting in a row of chairs that had another row backed up to it, and I thought for sure that he was going to nod backwards and whack the lady sitting behind him, but he held his position, and had a good snooze.

On a serious note, Walter Reed is an amazingly sobering place to be. There are many young service members there that have lost limbs and have sustained injuries because of their commitment to fight for our freedom. I am very honored to take my children into such a place where they are witness to the sacrifices that are being made for their freedoms. When we were at Wright-Patterson I heard a phrase that is epitomized at Walter Reed: Heroes caring for Heroes. Walter Reed takes care of some of our nation's most severely wounded service members and veterans. Even though we waited for a long time at the pharmacy, we were waiting alongside REAL American Heroes.


Thanks again for keeping us in your prayers. Thanks to God for the blessings and freedom we have.

_________________
This is the WebMD.com description: http://children.webmd.com/orthopedic-surgery-for-cerebral-palsy

Orthopedic surgery for cerebral palsy

Orthopedic surgery is used to treat tight muscles and spasticity related to cerebral palsy. An incision is made in the skin over the affected muscle. Parts of the muscle are then cut to release the tightness.

What To Expect After Surgery

After orthopedic surgery:

• Joints that were previously stiff can move more easily. However, the affected muscle may be weak.
• Some people may need to wear a cast or brace to support an area where movements are not under control. In addition, some people may need to have additional orthopedic surgeries.

Why It Is Done

The type of orthopedic surgery done to treat problems from cerebral palsy depends on which muscle groups are affected. Some basic goals are to loosen the:

• Muscles that make the hips turn toward the body (partial release of the hip adductor muscles). This surgery increases hip movement, allowing a child to sit and walk more easily.
• Muscles on the back of the thigh (partial hamstring release). These muscles control the tension in the thigh and around the knee, allowing a child to sit and walk with a more normal posture.
• Tendon at the back of the ankle (Achilles tendon lengthening or heel cord lengthening). This surgery helps a child walk with a flatter foot. (Olivia does not need this)
  

Orthopedic surgery usually is considered when a child with CP has:¹

• A bone or joint deformity that causes pain or interferes with function and is getting worse over time.
• A permanent contracture.
• Dislocated or irregularly functioning joints.
• A spinal deformity that is not improving with other treatment.
• A deformity that makes some caregiving functions, such as bathing, extremely difficult or impossible.

How Well It Works

Corrections made during orthopedic surgery may be temporary. As a person grows, the same muscles or other muscles may become tight and cause contractures. Additional surgery may be needed.

Risks

Surgery of any kind carries the risk of bleeding, infection, or need for repeated surgery. Orthopedic surgery carries the additional risk that it may resolve some problems only to create more as a child grows and develops.

What To Think About

If surgery is postponed until the child is older than age 2, doctors may be able to release many tight muscles during the same surgery, instead of releasing only one muscle at a time. Avoiding repeated surgeries has many advantages, such as decreasing the number of times a child needs to go to the hospital, decreasing overall time spent in physical therapy, and less disruption of the child's school and social life.

Before a child has orthopedic surgery, it is important to determine whether he or she will be able to walk after the procedure. The goals for children who will walk differ from the goals for children who will not walk.

Surgical procedures are individualized according to a child's age, type and severity of CP, and overall health and well-being, and whether other conditions are present.