Fearfully and Wonderfully made


It has been a long hard day
October 11, 2006, 7:30 am
Filed under: Surgeries

It has been a long day for the Ayers family – painful in several ways. 

Today was Giovanna’s appointment with both her upper and lower limb specialists.  While I had many good things to report to her docs -there were some concerns – especially with her legs.  The good news is that I don’t have to see her upper arm specialist for a whole year!!!!  She is pleased with her progress and that she has not lost any of the gains.  We are looking into some alternatives to swim therapy because Giovanna is getting tired of it for the moment.  We are hoping to find a good alternative to continue working those upper arms.

On the flip side, the legs are having some issues.  She has been complaining that her legs hurt – part of that is due to growth, but it mostly due to the fact that her feet are not flat.  Her doctor is leaning towards doing a procedure called Ilizarov – a procedure used to lengthen limbs. 

The Ilizarov Apparatus is a set of external fixators comprising rings, rods and Kirschner’s wires. It is different from the conventional external fixators in that it encases the limb as a cylinder-the limb itself being shaped like one and it uses wires instead of pins to fix the bone to the rings. (Definition given on Vardeen hospital web page).  To see a picture of the apparatus go here:  http://www.drmendbone.com/ilizarov.htm

The procedure requires that they go in a break some bones, attach pins to bones, ligaments and tendons and then attach the external rings with “clickers.”  These clickers are then used to pull various tendons, ligaments over a period of time (12 weeks was the estimate for Giovanna) in order to lengthen them.  For the bones, the procedure is similar in that the external rings are used to hold the bone into the correct position, help the body to put down more bone with the idea that the bone will then stay in the right place instead of moving back to where it was comfortable. 

This means 12 weeks of no mobility and 12 weeks in a wheelchair!  After this come 6-8 weeks of a weight bearing or walking cast and then what ever rehab and PT required to rebuild her body from 12 – 18 weeks of limited or no use.  They send you home from the hospital with pain meds and antibiotics because the pin insertion sights generally become infected. 

While this is daunting – it is better than one of the other alternatives which was to remove bone and fuse what is left, and limiting her movements even more and cosmetically making her feet different sizes. 

I was given 3 options at Shriners today – to schedule the surgery while I was at the hospital today; take some time to think about it; or delay the surgery to a later time.  This surgery came for a sooner time frame due to the pain that she is experiencing.  She would have to have the surgery at some point.  I decided to take time to think about it because Gary was not at the appointment.  We need to discuss this as it will have a huge impact on the family.  And I also made a follow up appointment so that Gary and I can both be there and talk with the doctor.  We will actually meet with both surgeons at Shriners – and they both have different opinions as to what surgery we should do!

Please pray that we can have some time to research the procedure; discuss the potential impact on the family; wisdom to know if both legs should be done at the same time; and to ask the questions needed when we meet for the consultation on 08 Nov. 

When I first saw the picture of the Ilizarov apparatus, I was numb.  There are not words to explain what I felt or was thinking.  The more time I had to mull over this option, I was overwhelmed at the bigness of this procedure. 

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