Hunter Sitton at the plate.
Yesterday, was casting day. The surgery staff called Thursday afternoon and filled us in on the scheduled time, along with the eating and drinking schedule. Normally, with little ones like Hunter, they ask you to stay in the hospital the night prior to surgery and they begin the casting as early as possible so that the waiting isn't so hard on them. The reason that they call it a casting surgery is that they undergo anesthesia. It's hard to believe that since October, yesterday was the fourth time that Hunter has received anesthesia, which is more than either James or I have had in our lifetimes.
Since they fit us into the schedule, his assigned casting time was 1:00 p.m. Since it was later in the day, we didn't have to stay in the hospital over night. but just had to arrive by 9:00 a.m., to fill out paperwork. We were told no food after midnight and no clear liquids after 10:00 a.m. Hard on a little nugget and his hungry tummy.
Let me just reiterate how much we love Scottish Rite, the hospital, the staff, the ease and speed of things, and the comfort level exuded by the Scottish Rite community. It was a long, tough day, but they made things so wonderfully easy for our family. We checked in and were taken to a private room to relax and then they began the admission process.
Not much to do in a hospital room. Time to start reorganizing the furniture.
They started by asking us the common questions, checked his height and weight, gave him an I.D. bracelet and put him in a hospital gown.
Playing with the remote and calling all the nurses.
Catching up on some reading while we wait.
This sweet face was occupied for about 10 min and then he started to get upset. Who can blame him. I'm sure he was thinking "What are these crazy people doing to me?! I'm in a yellow dress and no one seems to hear that I'm HUNGRY! Where are my pancakes?!"
They came to walk us down to surgery about 12:00 p.m. Before we made our way down, they had me give him some "goofy juice" by syringe. You would have thought that I was forcing him to eat brussel sprouts and liver with the way we had to hold him down to take the meds. It finally kicked in as we made our way down to the surgery area. He literally looked like he was drunk and then started cracking himself up. We are so blessed, because Hunter is almost always a happy boy. If he's not, you know something is terribly wrong. However, the goofy juice brought "Happy, happy, happy" to a whole new level.
The nurses took him from my arms and told us that in about 45 minutes that they would page us to come see him. We went and tried to eat for the first time yesterday. James asked if I was okay and ready to give up my "squishy" hugs for the next year or so. I fell in his arms and tried to hold back my tears, I knew Hunter would be okay, but it is so difficult to see your baby in pain. I kept thinking about something that my friend Jules read and posted that I have copied and read over to myself many times from October until now.
"Joy is the settled assurance that God is
in control of all details of my life, the quiet confidence that ultimately
everything is going to be all right, and the determined choice to praise God in
all things. Joy is a settled conviction ABOUT God. It's a quiet confidence IN
God. And joy is a determined choice to give my praise TO God."
I went over this phrase in my head as we waited and before I knew it we were being called down to go see our little man. The doctor came and spoke to us and said that everything had gone beautifully and that he was a perfect dream. He was asleep mind you :) We were then paged to go back to recovery to get him. He was crying with his eyes closed and a nurse was trying to comfort him. Apparently, she had tried to give him a bottle of apple juice and he had gotten more agitated. My little man has never really taken a bottle and went to a sippy cup at 6 months, so I can understand why he would be frustrated on top of everything he had just been through. We were all walked back to the room where we were to wait until he was fully awake and then they would conduct a standing X-ray to compare his curve numbers in cast to the numbers pre-cast. He had an IV in his arm, and they were trying to take his blood pressure. He became completely inconsolable and all of my tricks weren't cutting it. I tried to hold him tight, but with the new jacket he was sporting it was more difficult than I expected. James and I looked at each other with fear in our eyes. That was the only moment that we both thought, "Oh my, what have we done?!" Finally, he quieted down and peacefully fell asleep.
This is the Mehta cast that Hunter now proudly adorns. My friend Katie suggested that it was almost like putting on the armor of God and I thought that was a good way to look at it, because God will certainly make him strong and courageous throughout this process. As you can see, the cast sits above his shoulders like a tank top. The upside down V is the top of a mushroom shaped tummy hole that they leave for expansion during eating and breathing and will allow us to get to him if we should ever have a choking emergency, which I pray that we never have. They place a shirt underneath the cast to protect the skin and it is long enough that it actually pulls down below the cast and wraps back upwards to cover the bottom half. The cast actually sits on his hip bones, so when looking at this picture, the end of the cast is where his diaper begins. Diapering will definitely be a challenge, but we will figure it out. Cast care and cleanliness is essential and any water is out of the question. Probably a little boy's dream...no baths for a year and a half..yes!
He slept until about 4:15. The nurse came in and took off the drip line and we decided to wake him in order to try to get him to drink some liquids and take the standing X-ray. In my mind I kept thinking, "Don't poke a sleeping bear", but we woke him and he was only semi-angry. He quickly agreed to drink some juice and then we made our way to the X-ray room. James and I supported his arms and legs as he stood for the X-ray. Scottish Rite doesn't mess around. By the time we walked back to our room, our doctor's nurse already had a print out of the X-ray for us to view. We ordered Hunter some chicken nuggets and french fries, because they had to observe him eating before we left for the day to ensure that he didn't get sick. Next his doctor came in and looked at Hunter sitting in the cast and decided that they needed to trim the edges above his thighs so that it wouldn't rub. They brought in the saw and while it was quick and painless, it was terrifying for Hunter. About that time the fries came in and thank goodness, because everyone knows that nuggets and fries are a cure all for most little boys. The doctor went over the copies of the X-rays with us at this point.
Prior to making the trip to Scottish Rite, Hunter had had two X-rays with his previous orthopedic. One X-ray was taken at the end of October and one was taken at the beginning of January. The first number that we were given by the initial ortho, I believe, was 37 degrees. We were told in January that the curve had increased 7 degrees from October until January. Generally curves greater than 20 degrees are observed because they likely may resolve on their own. Curves greater than 20 degrees are addressed with some form of treatment.
(Mehta casting, while the most gentle and effective cure, is not common practice for all orthopedics. Reason being, a good number of orthopedic surgeons want to do surgery or use casting/bracing as a holding pattern prior to doing surgery. Remember, difference of philosophy. )
If a curve is greater than 40 degrees, it can be decreased, but may never become completely straight, but many get close. If you remember a previous post, I think something like .1% of children with Progressive Idiopathic Infantile Scoliosis have curves greater than 40 degrees. We knew we were probably in the danger zone. The more that I have read and the more parents that I have talked with whose children have this condition, made me have the realization that Hunter's X-rays with the first orthopedic were incorrectly done. An accurate X-ray can be done standing or lying down. The protocol is that the arms must be at the side and not pulled above the head. Duh...that makes sense when you think about it. If the arms are above the head then spine would be lengthened and the curve would appear straighter. His arms were pulled above his head in both previous X-rays. That in and of itself makes me want to scream! Again we are on the best path now, but incompetence makes me furious. Parents, please question what your child's doctor does or doesn't do for their ultimate well being. You are their voice and I can't stress that enough.
So, prior to our first X-ray at Scottish Rite, we knew that Hunter's numbers could very likely be much greater than what we had thought they were. His doctor solidified our fears as he told us that his curve was actually 60 degrees pre-cast. However, he also brought great JOY in the same sentence as he told us that his X-ray in cast showed that with the traction and compression of the cast that his curve was 28 degrees! I am tearing up right now as I write this. There is hope. God is good all the time!
X-ray before casting at 60 degrees.
X-ray in cast at 28 degrees.
We took the little man out of the hospital and are making our way home as we speak. He was a champ last night. A little uncomfortable but that is to be expected. Poor baby will have to relearn how to push himself up, walk, balance, etc. Last night James put Hunter on the floor and he looked like a turtle helplessly stuck on his back. Good thing Aunt Cara is an occupational therapist because we may need some training. I was able to put clothes on him and they seemed to fit. However, he has developed "noassatall" syndrome and I will promptly be buying him some toddler suspenders so that he doesn't show his baby plumber's pants to the world. Again, you've got to laugh when you can.
Love to you all. Thanks for following our little man's journey. Stay tuned for more adventures to come.