Surgery Day ~ Pelvic & Femoral Osteotomies

pelvic & femoral osteotomiesOne of the hardest things I’ve ever had to do in my adult life {twice, now} is send my baby off to surgery. On December 17, we took Sara in for surgery #2: pelvic and femoral osteotomies in the continued effort to correct her hip dysplasia. On November 1, 2011, when she was 17 months old,  she had an open reduction surgery to put her dislocated left hip back in the socket and spent 12 weeks and 5 days in a spica cast. If you’re curious what they did to her this time, I described the pelvic and femoral osteotomies here. December 17 was not a fun day. Here’s how it all went down.

Surgery Day ~ Pelvic & Femoral Osteotomies

Sara was the only surgery scheduled with our surgeon that day, so she was first up, and scheduled for an 8 am surgery. I prefer surgery early in the day because it makes the fast – no eating or drinking after midnight – a lot easier on little kiddos.

pelvic & femoral osteotomie

We had a 6:30 am show time at the hospital and arrived a tad late. We had been instructed to head to the Same Day Surgery Check – In Area – a public room where all people waiting for surgery go –  and they gave us a buzzer {like you’d get in a restaurant}.

When the buzzer went off a few minutes after we got there, it was time to head to the next layer of waiting room. This room was a private area. It had a TV and we turned it on PBS Kids right away. And there we waited while Sara’s vitals were checked, nurses and doctors prepped her for surgery, and the surgery team came by to answer any last minute questions we had.

I had stressed out about how to tell Sara about her surgery and we waited to do so until the week before her surgery. I was worried she would fret and simmer in anticipation but she mostly took the news in stride. However, she said some tough things to me in the days leading up to December 17, so I know she was thinking about it. She said things like ~

Don’t put me back in that cast or I will cry.

Will they have to cut my skin to fix my hip?

When can I stop seeing my hip doctor? When I told her as soon as she stops growing, she said, Then I’m ready to stop growing now. 🙁

Because I knew she had a pretty good idea what was going on, I anticipated drama while we were waiting for surgery that morning, but she was pretty taken with the TV and didn’t say much.

waiting for surgery

One by one, everyone came in: the nurses to check vitals and give us her surgery garb; a member of the surgeon’s team to mark her left hip and answer last questions; and, the anesthesiologist to talk about pain control options and anesthesia. Our surgeon had not seemed too keen on an epidural block to help control post surgery pain, but I wanted her to have it. I managed completely natural and drug free childbirth {at home} four different times, so I have never had an epidural myself. Normally, I would say keep these interventions to a minimum. But they planned to slice my baby’s bones in two – her femur and her pelvis. And that’s not natural, like I consider childbirth to be. I wanted her to have all available help to manage the pain. I impressed on the anesthesiologist that I wanted her to have the block and asked him to make that clear to the surgeon. In the end, she got the block.  And after everything she went through post surgery, I’m really glad she did.

pelvic & femoral osteotomiesThe last thing we did before she went with Daddy to the OR was give her the happy drugs – the ones that calm you down and make you forget. I had these with my back surgery and I hate them, yet love them at the same time. I didn’t want her to go back to surgery screaming, but I didn’t like the after effects from when I had them a couple years ago during back surgery either.  I remember how loopy and sick I was and I think it was partly because of those drugs. We gave her half a dose and that seemed to do the trick. She was totally relaxed and ready to go with her suited-up Daddy who carried her back to the OR and stayed with her until she was out. It was so important that one of us go back with her – but I just couldn’t do it. I was a complete and total emotional wreck and the last thing she needed to see. 

pelvic & femoral osteotomiesDan said she did a great job with him in the OR. Very little fussing and no real concerns. That made me glad. But then the waiting started. We expected a 3-4 hour surgery and that’s about what it was – though it took longer to see her again. Dan left her in the OR right around 8 am and we got to go to her finally around 1 pm – once she was in the recovery room and free of the intubation tube.

And boy was she upset and mad. I knew she would be. It broke my heart. I know it’s for her own good, but I took my seemingly normal 3 year old in – one who could run and jump with the best of them – and allowed them to break her bones and stick her in another spica cast. 

pelvic & femoral osteotomiesThe xray techs brought the xray machine to her bed in recovery to show us what the surgery entailed. She has an impressive amount of hardware holding her femur in place and her hip socket is nicely shaped and looks fabulous. Our surgeon said her operation was a big success – everything went exactly as planned. She lost very little blood, and her bones went back together exactly right. Her legs are perfectly symmetrical and the surgeon said everything was just great. Hunky dory. 

But try to explain that to a 3 year old who’s upset about being “stuck” again.

Why can’t I walk?

Get me out of here, she yelled.

Someone help me.  

Hearing my baby say these things was horrible, terrible, worse than I ever imagined. I felt so awful before her first operation because I couldn’t explain it to her, but this time was worse. So much worse. Because I did explain it, but she just can’t comprehend why and her tortured looks killed me.  🙁

Anyway, we finally got her out of recovery and up to her room. The hospital was full of Christmas cheer – everywhere we walked someone gave us something for her: new toys, candy canes…and then when we got to her room, Santa even came by with the biggest bag of goodies and three more just like it for her siblings. I’ll give a big shout-out to the Eastern Iowa Lions Club members who made that all possible.

We started to settle in – she had a morphine drip to help with the pain and we went round and round about how to administer it. Seems hospital policy is that the patient can push the button, or the nurses can. But not the parents. Okay… ?? How do you rely on a three year old to manage her own pain? We finally talked them into a small continuous morphine drip – we were concerned {and rightly so} that she wouldn’t push the button on her own. Because she didn’t. And have you ever been in a hospital and tried to get a nurse? They do have other things to do besides coming in to push a button. The last thing we wanted her to do was get behind on pain meds the first day and get sick. I’ve been there – it’s a horrible, downward spiral. 

Overall, the day hadn’t been so bad – but it took a huge turn for the worse when the cast petaling people came in.  They put a huge, plaster spica cast on her in the OR, but it also needed a protective fiberglass layer added later on and water-proofing. See this spica cast has a hole in the crotch for going to the bathroom through. It has to be water-proofed or it ends up being a big, huge mess. Well, somehow the cast people made that hole too small. And she swelled up more than anticipated. And the cast people could not get the water-proofing tape where it needed to go – a really. big. deal. The doctor had to be paged – as he left without checking the cast – and came back not 15 minutes after he left. He agreed that the cast could not remain the way it was and would need to be fixed.

But how? Well… image a cast saw and huge clamps and hand saws. Yup. Not 5 hours after her surgery, they had to saw around on the stinking cast and make it right. If I hadn’t been beside myself earlier in the day, I certainly was then. They doped her up on more morphine, got a stereo, bubbles, and ear muffs, and started sawing away. We were so traumatized. Everyone was. The nurses. The surgeon. Everyone. It was really horrible. But after about a half hour of sawing and cutting, it looked a little better. And after a few hours, the cast techs were finally able to get the water-proofing around the crotch, and life went on. And that was the end of Day 1.

We’re now almost 2 weeks into spica cast. When we were in recovery, another little boy was wheeled out next to her. He was also in a spica cast – his third. And his older brother had been in two of his own. The nurses asked his parents if they could do anything for them, and the dad said, please fast forward two weeks. And he was right. The first two weeks have been pretty challenging at times. But we’re slowly getting there. Sara’s not as depressed as she was, she’s off all pain meds, and we’re plugging along, counting the days.

I’m holding my head up because I have to. But some days, I don’t feel very strong. And I know she’s beyond done with this whole mess. January 27 cannot get here soon enough. 

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Comments

  1. Michelle, I read your posts all the time and very much enjoy them. That is a tough situation you have; would be worse if the problem could not be fixed. how horrible that the cast was not designed correctly first try. Poor little girl. I hope she has a very speedy recovery. Judy
    • Thank you for the well wishes, Judy! We sure hope this does the trick and fixes her hip. Not promises though. Her poor cousin (10 years older) is having surgery #5 here in the next year for the same problem - watching her struggles is not fun. :-(
  2. Having 'lived' at the hospital with our son for so long, I can feel for your situation. Praying for your sweet girl and for you caring for her. Very wise on the morphine drip....there is no way she would keep her pain managed that way....even with the best nurses...what a privilege to be able to care for her....
  3. I know this well as i also was a child at same age when I had open heart in 1967 and then they never tested the blood for the blood transfusion so the future is bleak.and the loss of family recently ..be so grateful she is able to hug you still Kids are resealant and yours will recover like a trooper, I also have a awesome God who says so. I send prayers and my recent lost of hubby of 20 yrs is the hardest I had since I lost mom 3 weeks before that .Time and values are so taken for granted today.May ''all of us '' remember not to take so much for granted and be so grateful..for little things like your precious little one .. God Bless you and yours. hugs and hug your family for me ..holidays and all i am sure missing mine ...gone all on the month on Nov 3 weeks apart mom ,hubby and brother too And them hug them again ...just little tighter <3
  4. I'm a new follower... I have a 8 month old... Omg this post broken my heart! I had a minor surgery on my other daughter at nine months old... And that was hard , so I can't imagine going thru this. Like u said, it's for her benefit but omg to see them in pain! It's awful.... I'm glad she did "ok" but I'm sorry that you all had to go thru this! And I can't believe that awful luck with that cast!

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