Pre-Op and additional insights

Today was our pre-op appointment. It went really smooth with minimal waiting to see the various folks we needed to see. 


I was able to get answers to the last few questions I had:

• They wrote 3 hours and 20 minutes down for surgery which translates into the time the OR is scheduled for her. It includes anesthesiology and the surgery but you do add approx. 90 minutes for recovery.
• She is scheduled for 3 days in the hospital which translates into 3 nights.
• Everyone is different but 2 weeks for initial getting used to the fixator is typical.
• He is planning on putting a hinge on her knee so hopefully she will have some range of motion with her knee but her ankle will not be able to move until the lengthening is over and he takes the foot part off.
• Yes, insurance has approved the surgery.

First we met with the surgery dept. 

•  They covered my daughters/families medical history and took her vitals. 
• They gave instructions on how to bath prior to surgery which is of course thoroughly and don't use any lotions, etc.

Then we met with the wonderful Child Life Specialist:

• who used a photo album and actual equipment to show her the gurney, the mouth piece for anesthesia which puts you in a "medical sleep" and wakes you up when they were done, and the IV. 

• He let her feel that the part of the IV that stays under the skin is NOT sharp. He explained once it's in, there are no more pokes the whole time she is at the hospital. 
• Since she is 9 he explained there is medicine she can choose to take 20 minutes before they take her into surgery if she has too many butterflies. 
• Then we were given the tour of where she changes into her gown and stays with us until they take her to the surgery area and we say good bye. He advised to bring stuff to do while waiting since it can be up to an hour. He also suggested to bring any "pal" she may have with her. They are good to keep her company at the hospital.

• Lastly, he walked us around where she will stay in the hospital, including the play room, and introduced us to the child life specialist on the floor that manages the play room and checks out the toys from the playroom. 

Then we went to the orthopaedic dept.:

• where our doctor's nurse went over general info about the whole process. Luckily I knew a lot of the info but the following info was new to me:
• They say the fixator "clicks" when adjusted but beware it doesn't always "click".
• We will get a prescription (which is calculated by a computer program) for the adjustments every time we see our doctor for a check-up.
• We keep the original dressing on and make no adjustments until our post-op appt. one week after surgery.
• She suggests to have wheelchair delivered to hospital so we can get use to it and learn how to move her in and out by the Physical Therapists in her own wheelchair.
• She suggests to ask the hospitals if they re-use the pillows and if they don't take them with us because they are good to help prop her leg in the car, etc.
• She pointed out you want to check to see if your car can fit the wheelchair,
• She suggests to practice pointing and flexing the foot and bending knee if the fixator allows it.
• Pain meds will probably be Vicadin/Tylenol with Codeine. (We learned Ibuprofen prevents bone growth.)
• Take pain meds before 1st post-op appt. because they will do the first lengthening at the appt.

• Then we saw the Physicians Assistant that asked similar medical history questions as the surgery dept. did earlier and did a quick physical exam.
• Our doctor came in next to touch base. 
• He let my daughter practice turning the struts on the external fixator. 

• He announced they now make the external fixator in blue and pink and he believes he will have a pink on for her. That was pretty exciting since black is so ugly and sterile looking. 
• He said we will see him every 1-2 weeks during the process, no more than 3 weeks apart ever. 
• Lastly, we met the Physical Therapist who essentially brought crutches, adjusted them and taught our daughter how to walk with them (wide to make room for the fixator) and to hold them both in one hand when sitting down and getting up so you have a hand to catch a fall.

• We left with the crutches and she is to practice using them during the next week. 
• We will have PT 2 times a week.
• She is guessing it will take up to 3 months after the fixator is off before we completely stop physical therapy.
• She requested the nurse to try to track down a child's walker since it's easier to use than crutches initially but it sounds hard to find a child's walker.