Thursday, January 31, 2008

Back to the OR

We are going back into the OR tomorrow, Friday Feb 1. He is getting a cast change under general anethesetic because it is going to be very painful. He is going to reposition his foot into a walking cast, which means stretching all of the muscles that were cut and moved around. Plus, mucking around with his heal bone that is missing a 5 mm chunk. OUCH.

Luckily, it is just day surgery this time. No overnight stays. He will come home with me as soon as he is able. I will be asking for another script of codeine for him too.

He will be in this cast for 6 weeks. Then his othotist will fit him for a new AFO. He will be casted again while his AFO is being built. Then when it is ready, he will be out of the cast.

We won't know the success of this surgery for 6-9 months. That feels like forever right now.


Matthew wore special shoes during the day for a long time and the shoes and bar at night. He learned to walk in them.

Eventually, he was given the ok to stop the shoes and bar, and went into his first AFO. (ankle foot orthotic)

In the spring of 2007, his foot was turning again. He was botoxed and serial casted for 8 weeks. He did everything in those casts from camping to soccor to wall climbing. NOTHING slows this kid down.

His heel cord was better, but still tight. He was growing... a lot.

In Sept, his surgeon decided that he needed some surgical intervention to correct his foot. We agreed.

Before surgery pics You can see how the upper foot has turned inward

Here he is standing on his foot. He was no longer able to be flat on the ground. from the back you can see how his ankle and foot are no longer shaped correctly. The calcaneal osteotomy should fix that.

Compare his foot to this one makes me excited to just think about what his foot will look like after all this is done!

So, on Jan 22/08, my little 5 yr old went in and after 3 1/2 hours of surgery had a posterior medial release (all the muscles in his foot were tight) a tibial tendon transfer (moved the tendon and muscle to try to get some upward motion of the foot) a calcaneal osteotomy (removal of 5 mm of his heal bone) and some more botoxing.

He was in a lot of pain in the hospital. He was on 3 ml's of morphine per hour plus he was getting morphine boluses whenever he needed them. (12 ml's of morphine within 10 min) He came home on Friday Jan 25 on codeine and tylenol.

They split his cast immediately after putting it on to make room for all of the swelling. Trust me, it was needed. Poor kids skin was so tight I thought it would burst.

It all started five years ago...

So much of our lives seems to revolve around Matthew's foot that I thought I should start a journal.

Matthew was born with a unilateral left clubfoot. We were told it was a possibility at 20 weeks pg, so we were prepared. At 4 days old, he had his first visit to the ACH. Here is his little foot.

He got his first cast that day and we were there weekly for cast changes for the next 3 months.

He got his first set of shoes and bar at that time. Wore them 23 hours a day, was aloud out one hour a day for a bath.

At 4 1/2 m I felt there was something wrong. I got in touch with Dr Ponseti who sent me on to a great dr in Vancouver. We flew out the following week to Vancouver where he was seen, operated on and sent home. The best part of that visit, was a Calgary pediatric orthopedic surgeon was visiting that day. We were very lucky that he agreed to become Matthew's dr that day.

He was casted again for 3 more weeks before going back into the shoes and bar again for 23 hours a day.

Once he started to pull to stand, he was allowed to reduce the time in the shoes and bar to help him with walking. He did pull to stand with them though.

Matthew was diagnosed with nerve damage when he was 15 1/2 m old. Oddly enough, the same day I was rushed to the hospital for an early induction to meet Ryan. It was a difficult day, but I got two beautiful boys out of it.