May 19, 2016 "Surgery #9"

Rayden's bilateral posterior clubfoot release surgery was scheduled for 7:30 am. Since we had to check in by 6:30 we decided to spend the night at the Ronald McDonald House. We haven't had to stay there since Rayden was in the PICU in July. The renovations are complete and it looks beautiful. We went for a walk outside to look around. Rayden spotted the wagon and just had to take a spin. Trying to get him to sleep was a little difficult but he finally gave in around 10pm.

We arrived at UNC at 6:30am, checked in and went straight upstairs. After a quick goodbye kiss to family, Michael and I took Rayden straight into pre-op. Rayden knew something was going on. He DID NOT want the nurse touching him! He said 'NO' to the ID bracelet, pulse oxygen, blood pressure and weight. Poor thing. We spoke with the anesthesiologist and Dr. Cuomo. She reminded us that she would make a v-shaped incision in the back of his ankles so that as he grows the scar will almost straighten itself out. Then she will have to divide the Achilles tendon in order to reach the other tendons in and around his ankles. She will release ligaments and capsules around the joints and between the bones. This will allow the bones to move into the position they are suppose to go in hopes to ultimately change the final shape of his bones. On her way back out of the ankle she will resect (cut out) a portion of his Achilles tendon, enough that it will hopefully NOT grow back together. She also reminded us that she would make a medial incision as well to release tight tendons on the inner part of each foot. She is worried that his skin will

be really tight so we may have to do cast changes every two weeks throughout the six week recovery. After talking with the anesthesiologists and Dr. Cuomo, the nurse took Rayden away at 7:30. Although this is Rayden's 9th surgery, he has never been put to sleep for more than 1 1/2 hours. This surgery was expected to last 3 1/2 hours. I was really worried. I was also anxious to know if the anesthesiologist could tell if Rayden could feel anything.

Michael and I were very thankful family came to support us during this long wait. (Nanny and Papa Bradley, Nanny Jane, Aunt Patsy and Pamela) After eating breakfast in the cafe we still had several hours of wait time. Talking with them made the time more bearable.

Dr. Cuomo came to the waiting room around 11, much sooner than we had expected. She stated that she and the anesthesiologist believe that Rayden could NOT feel anything, which is good and bad. It's good because it will make his post-op care much easier having little to no pain, but bad because this means he has more paralysis than we originally thought. So a blessing AND a curse... Although this is not what we wanted to hear she did follow with some much better news. She was almost excited when she stated his ankles came up super well. So well in fact that she didn't even need to do the medial incisions as she originally planned!! She said his ankles came up to a great position. (more than 90 degrees!) She added that this was the fourth surgery like this she has done in the past couple of months and by far the most satisfying. That sounded great to me. She also stated that his skin stretched beautifully, therefore we only have to recast one time in about 3 weeks. At that time Rayden will be fitted for new AFO's.
I was called back to the recovery room around 11:10. Rayden was just laying there awake looking around. The nurse said that he didn't seem to be in any pain at all. When I got closer he heard my voice and saw that I was there. He immediately reached up and started to moan. Poor baby sounded so hoarse from the breathing tube. The nurses gave him to me and we offered him some juice. His throat was obviously hurting because after only one sip he moaned even more. The nurse gave him some tylenol and went over the discharge papers with me. Even though they believe he is not able to feel anything they are still sending us home with some heavy pain meds, Valiums for muscle spasms, and a stool softener.

When I opened Rayden's diaper bag to get him some clothes he saw all of his paci 'friends'. He just HAD to have them all. He loved on them, taking turns sucking each one as if he were telling them all about his day. Super precious!

Casts #18 are Carolina Blue this time in honor of our awesome UNC medical staff. Although he still has the bend in his knees, I have NEVER seen his feet so straight! I am so anxious to get these casts removed and see his sweet little feet.

Of course, Rayden slept all the way home and another 2 hours after we got there. I suppose the anesthesia had to get out of his system. When he finally did wake up I gave him some Motrin for swelling. He immediately started crawling around on the floor as if nothing ever happened! I'm so relieved that he is not in any pain, but saddened at the same time.