Hip Surgery - Spica Cast

Liam had an infection that setteled in his hip joint as an infant and he had surgery to clear out the infection, but as he grew the hip and the hip joint did not grow quite as we had hoped and expected. We have been watching his hip and going to the Pediatric Orthopedic Dr. every so often for check ups to see how things were progressing. This year when I took him in, the x-rays showed the femoral head was not sitting in the socket where it ought to have been, but up out to the side, and the acetabular joint wasn't formed like it should have been to hold the ball joint down in place like it should have been.

From looking at the x-ray we wondered how he could even walk, let alone run and jump and all the other things 4 yr old little boys do, with seemingly no pain! The only 'pain' he would exhibit was in the middle of the night sometimes, and he woud complain of leg pain, cramps, etc. from the muscle being over tight and working so hard, as he walked with a limp or up on his toes of the right foot to compensate for teh disparity... Freqently he would wake up in the night crying and wanting me to rub his leg. With "Wotion!" (Lotion)...

So after the x-rays and then an MRI that the dr sent us to the hospital to do it under sedation, he told me that it would probably take surgery to repair or try to repair the problems. I asked how soon we 'needed' to do this surgery, and he said not IMEDIATELY, but certainly within a year probably at the most. If we didn't do something then, the arthritis would be worse, etc. as well as the younger the child, the quicker the bones heal and regenerate new bone growth, etc.

This was the same surgeon that did the initial surgery on him when he was an infant, and it sort of just felt like, 'Oh, this is just Liam, and more of what we/he has to deal with in his life...'. From what I with my untrained eye could see in the x-rays, it seemed pretty obvious surgery was probably what he needed. I showed the x-rays to Liam's Physical Therpist, and our Chiropractor, and they both concurred as well.

After a few months and hearing a few stories from other people about children and surgeries, it occured to me, perhaps we ought to get a 2nd opinion before having Liam undergo a major surgery. After getting in with my family care provider, then getting them to send in a referal for a 2nd oppinion to our insurance, and then finally hearing from the other Dr. in B'ham and making the appointment, the only time available was the day before his surgery was scheduled here in Huntsville.

Time went by, and it turned out that we took Rebekah to Tuscaloosa for new/transfer student orientation at the University of Alabama. We ended up staying with a sweet 'old' friend who is now a young married student/graduate and with a brand new adorable baby boy. On saturday, Rebekah stayed behind with our friends, and we came on home. Jessie ran Rebekah around a bit and helped her look at apartments. It was great, since she knows the areas and knew which apartments were in bad areas, and to not even bother looking at them...

Anyway, Rebekah found an apartment, so Bill and I drove with Liam back to Tuscaloosa on Wednesday morning to look at the apartment. It looked fine, and was a decent price, and it was close enough to school, she might even be able to walk to classes, and she gets an extra visitor guest parking hang tag so on game days, dad will have a place to park! yippee!!! So, Bill ad rebekah went back to the office to sign the contract for the apartment, and I went back to J's with the two little one's.

After visiting for a little while, we headed out to Birmingham for Liam's 2nd Opinion Dr. apointment. I figured 'IF' the Dr. had a completely different sort of diagnosis, and recomendation, then I would call and cancel the surgery for the next day, but we took the x-rays and the MRI results, and the Dr. said the exact same diagnosis and surgical treatment. He did explain it a little bit more clearly for me, or in more detail I think, and Bill was there this time, but it was the same. We thanked the Dr. and drove back home to get ready for Surgery the next day.

So, below is the running comentary I made on facebook through out our time in the hospital.



-Liam Hip Surgery –
June 2010

16 June 2010
Today we drove back to Tuscaloosa, to pick up Rebekah who stayed there with a friend and found an apartment. We have a signed lease... and then we went to B'ham for a 2nd opinion from a Ped. Ortho for Liam. We go in for surgery tomorrow morning for his hip.

Thanks all. We are expecting 6 weeks in a body cast. SO if anyone has any ideas about that? I welcome all suggestions to keeping a 4 yr old occupied/entertained.

17 June 2010
6:02 am
Waiting to get started... they haven't messed with him yet, so he's happily playing nintendo ds.
7:34 am
He's on his way back to surgery.
10:51 a.m.
We were waiting for an update... the surgical nurse finally called: Everything is going well. She'll call me again in another hour or hour and a half with another update.
11:56 am
Liam is about done with surgery. They called. He did great. He did end up getting a pint of blood... (not his first transfusion). They are closing him up now, and then they will do the spica cast and the Dr. should be out to talk to us in about an hour. Deep breath... now for the 'fun' part. When he wakes up in a cast, in pain and can't move... Hopefully he'll like all the fun new toys, and games, etc. to try to keep him busy.
3:12 pm
He's in his room. Snoring away - doped up on Morphine for the pain. the Dr. did a femoral reduction (cut a piece out of the femur bone) - it has a metal plate and 4 screws holding it in place, and Acetabular Osteotomy (cut the hip joint, added a bone graft), He is complaining that he itches, and he wanted us to take off the thing that was under the covers that was on him... The CAST! He doesn't really get it yet. he is still drugged up and not sure about what all of this means. He knows he has to lay in the bed somehow, but he's definitely not happy with the i.v. or the pulse-ox little thing on the end of his finger.
3:24 pm
Sorry for all the double photo's... I clearly don't know how to do the whole mobile upload of photos from my phone...
We found this Super hero Squad Bedding on sale a month or two ago. I got it and hid it away... so he'd have something cool at the hosp. He already asked where the blue bed was at (when we had folded the covers down for a bit). I showed him some of the pics of the guys on it, I said, “Isn’t it neat-o?” He is now determined that ‘MAGNETO’ another SHS Character is on it somewhere and he wanted me to show it to him!
3:58 p.m.
Random weird comments from drugged boy: "What if I want to climb on the wall?" I don't think he was fully aware of what on earth he was really saying. Or perhaps he knew exactly what HE was saying, and I just didn't understand.
4:43 pm
Screws and metal plate on his femur
We will have to do a day surgery/outpatient to remove them in 6 months to a year... If you wait closer to 2-3 yrs the bone starts growing around the metal plate and it's much harder to get out/off, if at all. Anyway, he will need another endoscopy in another 6-9 months, so we'll have th offices start coordinating all of that so they can do both at the same time under anesthesia one time for both.
6:58 pm
He wakes up because of a sleep jerk. He starts crying and saying, “help me, I'm stuck!” Then he asks, "why are my underwears off?" Poor little guy is so confused
"I can't move my leg! I can't move my leg because of the thingy (the cast), and I want to move my leg, but I'm stuck!" He's so pitiful!

On the other hand, he's watching Diego and starting to interact with the show and say the things Diego asks the kids to say/shout. He's still in between sleep and wake though.
8:32 pm
So the nurse comes in and talks to him... trying to get him to interact with her while she does vitals... he is SOOOO NOT impressed! He will ignore you and fight you, and he's so DONE already and we are JUST getting started!
Then he tells her she's a meanie, and starts saying Bye Bye! (meanwhile she continues to try and engage him in conversation... "I'm going to get you some medicine" "NO I don't want any medicine!!!!" "it's o.k. you don't have to 'take' it, I will just put it in your I.V...." meanwhile, he's saying NO! and getting more and more unhappy! and she is still trying to chat with him and make it ‘all better’.
Just do what you absolutely have to do, and then be done, please don’t spend 5 minutes trying to explain it to him. He’s not going to be any happier about any of it, and most likely he’s just going to get madder and more upset!
It’s going to be a long couple of days at the Hospital, and a Looooonnnnngggg 6 weeks in the cast!
9:08 pm
She also tells us we need to turn him every couple of hours. (I had read about that, but no one had said anything about it so far today, and I had forgotten to ask...), Bill asks if we can just turn him ourselves, so she doesn't have to come back and bother him again. She was sure she would need to do it. He didn't care who did it, he did NOT want to be messed with to turn on his side.

Shortly thereafter, Liam says his butt itches. (he is having lots of itches, and keeps wanting dad to reach under the cast to scratch his itches…) “Scratch my butt” he says, so dad sneakily suggests we turn him onto his side so we can reach to scratch… It Worked! Usually I don’t think I’d be thrilled with this word or the insistence it was used with, and I probably wouldn’t be posting it, but, it was kind of funny!

18 June 2010

A Looooonnnggg Night! Fever, discomfort, not understanding what is going on. He would drift off to sleep, then have a sleep jerk, and wake himself up. Very sad! He wanted physical contact...
somtimes with dad, sometimes with mom... so we had to play musical beds and figure out how to sleep with him so he could hold a hand, rub my cheek, etc... or he'd want me to rub his leg with lotion, etc... or dad to scratch his itches, (mostly way up underneath the cast on the fully enclosed leg).

the Good news is, the I.V. was disconnected (he still has a hep-lock, just in case he needs something else), and he should get the catheter out soon. The Dr. said we should be able to go home tomorrow. Yay
3:00 pm
the catheter is out! He was NOT happy!!! he yelled out, "she's a bad girl!" about the nurse. Now to see how going potty in a body cast will go! JoY!
5:00 pm Success! Yay!
Chloe Raum
I bet Liam will be a pro at peeing in a bottle by the time this is all over. He might just find it so convenient that he gives up toilets all together!
We had a BM earlier - that was interesting. Bill said, 'he just needs to hold it until dad gets home from work in the evenings, to help hold him over the toilet!' he's quite heavy and not at a very good angle for sitting up!


5:30 pm
We're Mobile! Liam has a wheelchair that reclines, so we're out of bed and cruising the hallways, and playing in the game room! he remembers the game room - the only positive memories he has of this place...
I made him a pair of shorts earlier in the week. I sewed the front and back together at the legs/crotch and left the sides open and put velcro on them so we could pull them up between his legs over the cast and then he is 'dressed'. I only made one pair so far, so I would know if it was the right size, etc. I might need to make the legs a little bit wider. Otherwise they work quite well. Yay!
This pair is Diego and he's playing baseball.

9:00 pm
The latest exchange: Liam "When can I walk?"
Dad " We'll get out of the Hospital and go home and you'll have the cast for 6 weeks."
Liam "6 WEEKS?!?! I don't want to have the cast for 6 weeks!"
I don't know that he even has any concept of 6 weeks!

Yesterday at 9:57pm

I think the calendar idea is a great one. Thanks Chloe! He loves to put stickers on his charts! (when he potty trained we made him a chart. When he sleeps all night in his own bed... he gets to put a sticker on his chart. I'll get the girls on that once we make the appointment for removal. Fantastic!


19 June 2010

6:30 am
Liam - "It's Morning time!" "I want to get up! Can I go to the game room?"
(It's not open yet for the day... he did get daddy to take him for a walk around the hallways)

8:00 am
Ya know, it's just our life - with Liam. Hard, but it's what we do... and as 'hard' as this 6 weeks will be on us, I just have to keep in mind that It's all so much harder on Liam than us.
11:00 am
Waiting for the Dr. from our Dr's office to show up sometime today to hopefully release us! All Liam can say today is: "I want to go home!" "Can we go home yet?"

Did you know you can hide crushed up medicine in ice cream? Thanks dad for that great suggestion yesterday!
It worked the first time anyway - Mint Chocolate Chip! masked any grittiness, and masked the flavor. The second time around... he asked for Vanilla - didn't hide it as well. I don't know if he got a full dose or not. By the 3rd time trying to take the meds by mouth - since the i.v. is out, I wasn't going to try to get him to eat ice cream in the middle of the night – 2:00 am! So we talked and talked about it. He finally agreed to take it mixed in choc milk.
It was not a happy thing, but it had been around 7 hours since he’d had any meds! He is supposed to or can take meds every 4 hours…

11:00 am
Now he's just pitifully whining about going home! and he even said he wanted his medicine at home - chewable tylnol/motrin... he hasn't had any med's since 2:30 am.
1:00 pm
I had Rebekah stop at the store and buy some chewable tylenol - grape flavored, and bring it to us when she came to visit us today. We gave him one of those and he chewed it up fairly easily. So I guess if he's not hurting enough to 'need' it, I shouldn't be too concerned about making him take medicine for pain.


2:30 pm
Just waiting...
Finally around 11:30 I tracked down our nurse, who had only been in once today thus far, to ask her what our plan was for the day. "Are we just waiting around for a Dr. to come and release us, so we can go home?” Is there anything else we are supposed to do today? The nurse had NO idea, and said she'd find out. Around noon I went to find the nurse to ask if she’d found out anything?
She told me that 'they'd be by around 2:30 or 3:00 p.m. to release us'. Great! we WILL get out of here today! I wonder however if I hadn't gone to ask the nurse after waiting all morning, if anything would have been done at all? We might have sat here into the night, still waiting...

4:00 pm
Going Home!!!! yay!

Sick little boy - Pic's (long)

Here's Liam at home with Amanda while we finished up the birthday party for Marissa. At the time we had NO idea how sick he was about to become. Sept 12th 2009 Sept 13th

When Liam was moved out of PICU - and moved onto the ped's floor - he was allowed more visitors. He loved when the family visited. Bill bought him some new games and books to keep us busy during the time in the hospital. This is a game of UNO - Moo! an UNO game for smaller children. It's very cute! Liam was finally able to eat something - an all liquid diet - on Monday night after not eating anything since Friday evening. Sariah is helping get a drink of Gatorade. Here is his 'SOUP'. He was so disappointed, there were NO NOODLES in his soup! What kind of SOUP is that?!?! Poor boy! We took Liam's favorite stuffed animal - his Panda Bear - with us to the hospital. The girls brought him some other favorites of theirs. Nuzzle puppy is Sariah's special doggy. The other little puppy doggy was given to Liam by a nice volunteer at Huntsville Hospital. And lets not forget that the girls brought him up his COOKIE Monster slippers (he got them from our neighbor - Caleb (Bob)).

When the girls came to visit they thought it was interesting that Liam has been put in 'his' room. The room number matched his birth date - 4(April) 29th. Here is my sick little boy - his Arm all taped up to the Arm boards to hold it straight so he didn't bend and hurt the I.V's he had in his arm. They left the stickers to hook up the heart monitors even after we got unhooked from them to go to the ped's floor.

Sept 14th 2009 When they came to get us for the CT scan they gave him a wagon ride down to Radiology. It is supposed to make it a bit more fun, however, Liam was unimpressed!

Dad and the boy taking a walk and trying to stretch his legs a little bit - as well as get some activity and a change of scenery. They made it to the nurses station.

He didn't even want to go play in the game room after he walked all that way, he was so worn out.

When Liam had enough energy and as an incentive to get him to let them draw blood, or for him to take med's we'd offer for him to go to the game room with dad. he liked playing the touch screen games. He could do that with his left hand and manage to win, since his right hand was all taped up.

We noticed after the first night he had started retaining fluid a bit. I tried to take a picture of his poor little/big belly, but he wasn't playing my games at that point! He tried to cover his head and turn away from me... ;-( By Tuesday it was so tight and swollen. his belly button was stretched completely flat (almost like a pregnant belly). The Dr's never seemed to terribly concerned about it, bit we were a bit worried, since we have too vivid a memory of our little guy last time when he had all the '3rd space fluid' (when your organs don't function well because they/you are sick, your body pushes a lot of the extra fluid (and he got a LOT of fluid from all the I.V.'s he had been given) out into the tissues of the body. Last time he literally swelled nearly twice his size! from 7 lbs up to 12 lbs in a week). http://www.west-point.org/users/usma1989/46946/hospital_stay.htm

In this picture you can see some of books and games that we brought in (or bought) for Liam. When the girls came to visit, Life didn't necessarily stop just because we were in the hospital for the week. Sariah is working hard on her schoolwork. (with a little help from dad)

Tired and worn out after a long day... (or night).

Tuesday night he was able to have actual food. He decided he didn't want noodles (in soup). I ordered whatever I could think of that was soft. He liked the rice and ate a lot of it, the mac n' cheese was pretty good. The mashed potatoes??? He claimed that they were "Yucky Stuff!"Wednesday morning was pretty much spent just waiting around to get the ultrasound of his belly and to go home. Liam likes Dinosaurs, and The Land Before Time Movies have become his favorite. We had a friend bring us a few movies to borrow, and The first Land Before Time was one of them. He would watch it and watch it, We have the first one at home, but have been able to borrow the others from the Post Library over the past months. Liam LOVES them. I liked borrowing them from the library, because, then I got a break and we were not 'forced' to watch the same movies over and over again... Well, this hospital stay ended up sending Bill to the store and he was able to buy every single one of the episodes (there are 11) for Liam. We watched all of them but one, at least one time if not more (along with a few other different movies, occasionally), but when you are trapped in bed, and can't do much, and you are so miserable... movies help to pass the time! When the nurses come in and wake you up at 2 am, to take your blood, the movies help calm you down and get you to fall back to sleep. They were well worth the price (monetarily, as well as mom's dislike of repeated movie watching...)!

We had several visitors come to see us at the hospital, and we received a few nice meals (non hospital food, yay!) from friends, while the rest of the family at home was being fed by the sweet sisters of our ward. Liam got some nice coloring books and crayons from friends, and a cute Get well soon balloon from his friend Katie - Thanks so much! He likes them now, even though he didn't show it at the time...

We also got this cute teddy bear and balloon bouquet from Bill's Office.

When we finally arrived home on Wednesday afternoon, what did he most want to do??? Play Wii!!! Of course we happily let him! So glad to have him home!!!