December 21, 2018 "Casting #22"

Rayden has actually been very good about NOT standing up and putting any pressure on his feet. He has always been told that he could not walk without his shoes on so this is actually the same concept for him. He doesn't even try to stand up or get off the couch. He asks for help and crawls around from time to time. I am very pleased with how well he is following directions and I pray that he is healing properly.

Since Rayden's feet and legs were swelling so badly after surgery Dr. Vergun had to bivalve the casts, which means simply cutting down both sides and pulling them apart a little to give the legs and feet room to swell. Now that a week has passed and the swelling has gone down she wants to push the casts back together and rewrap them. They did not REMOVE the casts so this is still casting #22.

We discussed the fact that Michael and I requested an MRI before she performs the hip surgery on January 8. Dr. Vergun was NOT the first surgeon to come out of surgery on him saying "that's not what I expected." We want to be more prepared from now on. Dr. Vergun understood our concerns and said they were completely valid but also explained that this was risky and unnecessary. To do an MRI of the hips he would have to be put to sleep and they don't like to do this unless it is absolutely necessary. She said his feet at this age are still cartilage which is why she couldn't see everything on the x-ray prior to surgery. But the hip bones are completely formed and will show up on x-ray so she is not expecting any surprises. After saying all of that, her intern came in and asked me to sign a new consent for the hip surgery. The funny thing is that there was something new on the consent form. She is now going to do bilateral arthrograms in the OR before surgery. They will inject a dye into the hip joint to look at the coverage of the femoral head better on x-ray. The intern said this will help them see how much of the head is covered so they can decide which acetabular osteotomy to do at the time, apparently there are several different kinds.

Dr. Vergun also stated that she would take the casts off in the OR before surgery so she could get his legs the same length and recast him again when she is finished with the hips. She agreed to have Bob Collins, our orthodist from Wilmington, to come into the OR and mold him for new AFO's after she removes the casts. Of course, upon completion of the hip surgery she will have to recast his feet to complete the healing process. I'm not sure how long all of this will take but it sounds lengthy.