Pre-Op

Greetings and a Reminder:

I write this blog as we go through ET Mehta Casting with our daughter Olivia. The blog is intended to inform, possibly inspire, and raise awareness of Infantile Scoliosis and its treatment/cure. Please share our story. For more information please check out http://www.infantilescoliosis.org/ 

Today was Olivia's pre-op appointment at Children's. Here's a run down of how today went. :-)

Our appointment was at 8 AM. The way traffic has been lately we left at 6 AM to ensure we got there on time. I AM NOT a morning person....

Anyway, we got to the hospital for 7:15, and ate breakfast in the lobby. We then went to pre-op admitting at about 7:55 and was taken in to be seen by Nurse G at 8:10. She asked me a slew of questions about Olivia, family history, you know, the usual gambit. Then she weighed, and measured Olivia and took her temperature. I think Olivia is still traumatized by having an IV placed so she has a very low tolerance for being touched in doctor's offices. Needless to say you would have thought Nurse G was poking her with scissors or something! Her temp was fine and she measured out at 32 inches and weighs 25 pounds! I think she needs to lay off the pancakes. ;-) Following this (and diaper change number one) we were sent back out to the waiting room to wait for round two, which was meeting with the anesthesiologist. 

About another ten minutes goes by. Olivia was entertained by the large fish tank, a toy made out of removable plastic gears, and the other children in the waiting room. We were then seen by anesthesiology. The gentleman was very nice and informed me that they will be using a general anesthesia in the form of gas. For her MRI she was given a strong sedative through an IV, so this will be a different experience. Once she is under then they will then insert an IV for fluids. I was told that due to the short time she will be under she will actually absorb very little of the gas. I signed a consent form and was sent back to the waiting room so I could continue my world tour. 

Sorry if this seems so detailed and boring. I just want to explain as much as possible as a "what to expect" sort of thing as a reference. 

We were in the waiting room maybe 5 minutes this time when we were then sent to billing to cover insurance stuff. The woman there couldn't get over how Olivia knew how to open my wallet and remove it's contents (a skill that I'm sure will never grow old). She also commented on my Alex and Ani bracelets so I wrote down the web address for her so she could check them out. After filling out paperwork and a short survey we were released from Pre-Op and sent up to Orthopaedics.

Allow me to note what an amazingly patient girl Olivia was during all this. It was 10 AM by this point. 

Once on the second floor I was asked by a nice gentleman if I wanted to try out their electronic check-in system. Sure! Why not! He seemed pleased at my interest. I checked in and then filled out a short survey on how I felt about the do it yourself check-in kiosk. It was fine. Of course in the back of my head I think (a perfectly good human needs the job of this kiosk), but I kept my mouth shut. After about another 10 minutes we were sent in to wait to meet with Dr. G and his team. 

We were met by a woman who was representing the Orthopaedics Department on a nationwide research study asking if we could include Olivia as part of the study. It wasn't changing any of the things we were doing. According to the paperwork they are conducting the research study so that they can "evaluate the long-term clinical outcomes of Early Onset Scoliosis." They "want to determine the effectiveness of various treatments in correcting the deformity while allowing for additional spine growth." I said that they could include her. Again, I'm all for awareness and helping in any way that I can for others like Olivia down the road. 

We were then met by two nurse practitioners while we waited for Dr. G. Both were extremely informative and helpful. Here is what I learned in our conversation (Oh, and we're at diaper change two at this point):

- We will be staying on a floor that is specialized in Orthopaedics and will be attended by nurses who are trained in cast care. 

- She will have a roommate (I expected this).

- It gets cold in the rooms so layer up. 

- They will do anything they can to make sure that we are comfortable

- They have special entertainment that goes through the floor. They have put in a special request that the dogs come to visit Olivia. :-)

- Information I already knew but will share here: 

     - There is wi-fi

     - One parent is allowed to sleep bedside (which will be me). There will be a pull out chair or a window bench to sleep on depending on room location.

     - There is "room service". She told me to order a little extra for me :-). They also have a small on on floor kitchen.

Here are the questions and answers from my previous post:

1.) Olivia has fair skin. What can I do to best protect it from irritation? Will I be able to bring moleskin home?

Under the cast she will be wearing a special t-shirt and the entire interior of the cast is a soft cotton. They will line the cast generously with moleskin, and I can also bring some home to use as needed.

2.) What are the pros and cons to having a shirt put on under the cast?

They always put the shirt on under the cast. They cut it out where skin is exposed, so you wouldn't actually know the shirt was there because of the exposed belly. I don't know if there's like an additional shirt of something, but this will do for now. 

3.) When it comes time to change Olivia's cast what is the start to finish process? I'm curious to know about a timeline on X-rays, sedations, and if the skin under the cast gets any breathing time. 

The cast change is a two day process (though this can vary based on your doctor). We will go in to have the cast cut off and they will look over her skin and whatnot. If they find a significant amount of irritation they will wait a few days until the next cast application, otherwise they will cast her the next day. 

They will x-ray when she is in each cast while she is sedated. 

At this point Dr. G came in and we got to meet him. Olivia surprisingly took to him very quickly even leaning against him to play peek-a-boo with one of the nurses. (She's such a flirt) I got to see her initial x-ray again (which I will include in a future post. I forgot to get a copy of it from radiology). Dr. G is measuring her curve at 41 degrees, which is 6 degrees more than originally determined by Dr. H. He also told us to expect the cast to be on at least a year. I was already expecting this however. From all I have read 6 months is rare. 

On a positive note he did feel that her rotation, especially for the curve that she has, wasn't too bad. He doesn't know for certain exactly what the rotation is, but he doesn't feel it's awful.  For those of you who are curious the rotation is a twist in basically the shifting of her ribs to accommodate the curve. 

I was also told by all three that I can email them at any time with any questions that I have and they will get back to me promptly. This is great! I prefer to communicate this way. When it's in writing I don't have to try and remember what was said. If there is a major problem with the cast (she's uncomfortable, she's destroyed it somehow, it's too tight etc) we are to let them know right away and they will see what they can do to remedy it. 

I can't say enough about the men and women that are caring for Olivia. Everyone we've encountered so far has been wonderful. They are patient, understanding and accommodating. It really helps make this whole process less stressful. You can tell that they enjoy what they do and care about the children they treat. It is really a comforting feeling to know that you're in good hands. 

We were done at 11, but didn't leave until 11:30 because I forgot the parking ticket in the car, so I had to schlep Olivia back to the garage, get the ticket, walk back to the hospital to get it validated and then walk back to the garage to pay it. Oh! AND I forgot what floor we parked on! GO ME! We did get out OK and we survived. 

Her casting is scheduled for 7:30 AM Monday morning. We need to be at the hospital by 6. It will be a long day seeing as I haven't seen 4 AM since those late night feedings, but we'll manage. 

Following our appointment we went to visit our dear friend Daniel. I will leave you with a couple of pics. Olivia will enjoy her last opportunity in a swimming pool tomorrow at her friend Ella's house, so I will be sure to take lots of pictures and post them here. 

Until then...