Sunday, January 12, 2014

The right one is not right

In May 2013, Emily had an x-ray of her hips and back.  We have done this every year for as long as I can remember.  Unfortunately, it is not uncommon for kids with cerebral palsy to have hip and back issues. The extra tightness in their muscles can cause their bodies to "pull" in one direction or the other.  And that can cause any number of issues.

The results of Emily's hip x-ray in May was:
There is a valgus deformity of both hips. The femoral heads are slightly flattened. The right acetabulum is flattened. The right hip is partially subluxed. The left hip is seated in the acetabulum.
IMPRESSION:
1. Valgus deformity of both hips.
2. Right hip dysplasia.
3. Partial subluxation of the right hip.

In plain English, that means that both of Emily's hips tend to point out (valgus deformity).  The left hip is perfectly fine.  The socket on her right is misshaped and not holding the leg, so it is partially dislocated.

Here is a pic of the hip to give you an idea of what it is supposed to look like:
 Nucleus factsheet image
Copyright © Nucleus Medical Media, Inc.


We met with the orthopaedic surgeon in June.  That was the first time we got to see the x-ray.  Emily's right femoral head had slipped out of the socket and was up higher on the pelvic bone that is pictured on the right in the pic above.  Her right leg is actually quite a bit shorter than her left because of this.  

The doctor said he could correct it with surgery.  Since Emily is not ambulatory, the surgery is not required, but the chances of her hip getting worse without surgery were pretty certain.  It was about the last thing that I wanted to hear.  At the same time, I knew that we had to move forward with surgery.  Emily was already experiencing pain and discomfort and I did not want that to get worse.  At the time, the surgeon was scheduling for 6 months out, so we had some time to get used to the idea and to get prepared.  

I held it together when talking with the surgeon, but when our regular doc came into the room along with a PT that we know, I completely lost it.  They are both women and moms so I knew that they would understand.  I got myself together to take Emily to therapy, but when someone asked if I was OK, I lost it again.  She took me out to the hall and we talked for a bit.  Then I went to the car and had a good long cry - an ugly cry.  I also called Mike to give him the news.  I was completely devastated to hear the news that she needed to have major surgery.  After my crying was done, I did feel a bit better.  I was determined to move forward and figure out how to make this go as smoothly as we could.  

Fast forward six months and surgery day is just about here.  Emily's is scheduled for surgery this Tuesday, January 14.  She will have a hip osteotomy (the bones of the leg and pelvis will be cut and repositioned to their proper alignment).  She will have some hardware put in to keep the bones in place.  Since the chances are good that the left hip will eventually have the same issue, the doc is actually going to do both hips.  He will also do some tendon lengthening in her heel cords, hamstrings and hip abductors.  That means that the tight muscles will be cut and stretched (this is also a pretty common surgery for kids with CP).  

Emily will spend 5-7 days in the hospital after the surgery.  She will spend at least 6 weeks in a cast that looks a bit like this:
http://3.bp.blogspot.com/_jfwdA0R_fRY/TSPyrvooP8I/AAAAAAAAAqc/S9SbD-h9DDw/s1600/h9991427_001.jpg

The cast on the left is most similar to what she will have. The top of her cast will either start at her ribs or her waist.  The bottom will cover her feet.  She will not be able to go to school during the casting process.  It will be too difficult to transport her and if the cast goes up to her ribs, she will have to be reclined.  She will receive home instruction during this time.

I have been asked if this surgery will help Emily to walk.  The answer is No.  This surgery is meant to improve her quality of life. I do not want her to live in constant pain.  She had a repeat x-ray in December and the right hip is getting worse.  She has definitely been in pain and let us know that.  We have also heard some crazy popping sounds when changing her diapers that will make anyone cringe!  We are not excited about sending our girl into surgery or the lengthy recovery process, but we are trusting that this will help her in the long run.

She is going to one of the best Children's hospitals in the country with the Director of Pediatric Orthopeadics doing her surgery.  I am thankful for that, but I am putting my trust in God to watch over my girl.  He is the one who created her body.  He knows what she needs and He will bring the healing that she needs.  My faith and trust is in Him to carry her through this process and to give us wisdom and strength as well.  With that said, we would definitely appreciate prayers during this time. 

4 comments:

Tara said...

I hope the op went well. How is Emily doing now? Has the pain disappeared?

Amelia doesnt need this op- her hips are fine. I think Emily has spastic pentaplegia am I correct?

Barbara Therextras said...

Hoping you will share about the surgery results soon. Hoping all is well with your family.

Barbara Therextras said...

Hope you post a follow-up soon.

Big brother, Little sister. said...

Hope Emily recovered well and is back to her schooling and beautiful self! Bron xx