Yesterday Wesley and I spent the day doing pre-op for his hip surgery this week. It was a long day! By the time we were finished we spent 5 hours between the doctor's office and the hospital, he'd had two blood draws and a catheter for a urine specimen (though we tried to bag him... he didn't go during the visit...).
I also got a lot of my questions answered like what time to come, how long the surgery will last (about 4 hours), how long we may be in the hospital after (maybe 1 night, more likely 3-5 days), and of course more details about the actual procedure.
Here's what (I think... at least, to my current knowledge) they are planning to do...
Due to his really bad scissoring, Wesley's hips are both dislocated. This isn't a conscious thing he's doing, it's due to his adductor (groin) muscles being too tight- a result of his cerebral palsy.
First on the list is to 'release' or lengthen the adductors in his groin area. That will give him more movement in general in his legs, and it just may take care of our diapering troubles, where he pees out of absolutely EVERYTHING...
Next they will do a bilateral osteotomy. Again, my understanding, is that they will do this in stages depending on what the hip looks like once they get in there. They are hopeful that his hip socket may be well formed (but it is unlikely). In that case, they wouldn't have to break and reform the pelvis. If not, then they will. They also have to take a look at the femur and determine whether the angle of the head is compatible with the hip socket. If not, they will have to break and reshape that as well. Unfortunately, the success of the leg bones even drawing down into the pelvis and the possibility for relocation is another question mark and if that's not possible, they won't even begin the rest of that procedure.
When they finish one hip... they will see if they have time for the second... We are hoping and praying that the surgery will be as SIMPLE as possible, as PAIN FREE as possible, and that both of his hips will be able to be done in this ONE surgery! If they can't do both, then we will have to repeat the procedure for the other hip in 3-6 months...
As far as casting goes, Wesley will be in a fiberglass cast from just under his armpits, through the waist and down to his ankles. It's possible they'll stop it at the knee/calf, but likely will go all the way down to the ankles. The expectation is for him to be in the cast for about 6 weeks. Depending on how he heals, it could be longer, but not likely shorter.
Care of the cast, well, that appears to be the fun part :(. I've got some WONDERFUL friends who have been there before us that are wonderful and have shared their tips and info with me! The cast will have a 'cutout' at the diapering area so we can, of course, take care of his toileting... It's been suggested to me that we buy some size 2 diapers and some small adult diapers as well as some nighttime incontinence pads for adults. Put the pad inside the small diaper and tuck it up into the cast to 'catch' everything, then put the adult diaper on over the cast to keep the other diaper in place.
I've been warned-- several times-- that he WILL pee and poop IN the cast, that it's just inevitable... which sounds awful :( And that the smell is horrible no matter what... Doesn't this sound like fun :(?
Ok, so diapering won't be fun... but even LESS fun will be trying to keep him entertained and happy while having 3/4 of his body immobilized and of course in pain for a while...
The hospital will provide us a carseat or a 'harness' for use in the car. Not quite sure yet how that's going to work, because they said to use the carseat you have to have a reclining seat back (which a 15 passenger van does NOT), and the harness requires for him to lay down... which would require a bench seat... which we only have 2 seats available for (not three...). So, transporting our family all together may become a little more complex, but in general it will be fine. Just may have to bring two cars along for a while. Thankfully we usually have the ability to do that, so it will be ok! :)
Next question was wheelchair. Obviously, the wheelchair we have won't fit him when he's all casted. It is the PERFECT size for him right now! But that doesn't allow much room for a cast :). I'd heard from others that using a single jogging stroller is a good solution if a wheelchair isn't available, and I'm thankful that our doctor said that they will be loaning us a reclining wheelchair with a leg support. WHEW :). We also have moved Wesley's bed out to the family room to get him used to being in there before the surgery. He is waking up LAUGHING at night too, so it is helping the other boys sleep as well! LOL
He's done well, been there two nights and has three more before we're headed out for surgery so hopefully it will be familiar when he comes home to sleep there! That way if he's uncomfortable or needs help during the night we can camp out on the couch with him to take care of him without having to keep anyone else awake.
We also have a children's recliner that he uses and hopefully will be able to use with the cast on, and the end of our couch reclines and he likes to sit there as well. We have heard that an outdoor lounge chair will also work well (a soft one!).
So... lots of things we're learning!
One more thing... a 'cast cooler' was recommended to us by several people! It's basically something you hook your vacuum up to which pulls air up through the cast. It is a life saver in the summer months, I understand. http://www.castcooler.com/castcooler_works.html
I'm sure we'll be learning a lot more... but for now that's all off the top of my head. Dumping it all here helps me, helps Mike and any other folks that might be helping care for Wesley, and it also may help someone else in the future if they, too, are faced with spica casts and osteotomy surgery... So.. there it is!
Now for a dip in the POOL :) It's a beautiful Spring day!!