Thanks for following along with me on this journey with Joshua. Many times I question why I even blog, who I do it for, and should I just stop. The business side of things make sense, to put our little shop out there, to share ideas and knowledge, to grow the business, but the personal stuff? Well, quite frankly personal stuff is always much more important that the business stuff. I feel the need to write, I have always liked to write and have diaries that go way back. I am no ‘writer’, but the blog gave me the opportunity to share, in a non judgemental way. My spelling is off, my grammar shocking, and I can’t keep on track. I write 2 word sentences. Like this. It doesn’t matter if anyone reads what I write, but I have found there are people reading it. You are reading it. So I write, for you, and I will continue to write, and feel and experience. I write for me as an outlet, as entertainment, as relaxation, as leisure… I write for you to share.
So what exactly did Josh have done?
His feet were ‘windswept’, (see photo above from home before surgery) meaning they didn’t sit straight like ours do, the left one pointed left, and the right pointed very left, often tucked in. It was difficult to fit AFO’s (ankle foot orthosis, plastic shields to hold his feet in place) and is often associated with spasticity of the calf muscles. There was a 3 – 5cm incision made in each ankle to cut the tendon, the feet realigned and set in plasters to hold them in place. The plaster goes to the knee. The wounds need to be checked so the casts will be removed, and he will have new casts fitted. These stay on for 6 weeks. He will also be fitted for new AFO’s at this point.
I have some photos of his feet on my camera before we left. I found child #3 up on his bed watching a movie with him and snapped some photos of the pair of them. The lazy old man cat was there too. I just don’t know how this cat tolerates being kicked all the time, but if Josh is home… he is up there on the bed with him at his feet. You really can see the size difference between the kids’ feet here, even though Matty is 11 and Josh 14.
The largest part of Joshua’s surgery was the “Proximal Femoral Varus Osteotomy + De-rotation”. I do not remember this, so I am reading it from my surgery sheet. Joshua does not have much movement as he cannot walk, so the muscles around the hips have become tight and stiff (spastic) and the alignment of the hip joints and the shape of the bones have become altered. The spastic muscles pulling on the thigh bone have pulled them out of the hip joints. One side was worse than the other.
An osteotomy is reshaping of the bone. A proximal femoral varus osteotomy involves realigning the thigh bone deep into the hip socket. This prevents further deformity and hip dislocation. We do not want that. That would be bad. Very bad.
They cut from the outside of the upper thigh, and a small wedge of bone was removed from the top of the thigh bones. The head of the thigh bones were pointed deeper into the hip sockets, and rotated. Pins, plate and screws have been inserted to hold them in place. Josh will come back in about a year to have those removed. (joy) The bone that was cut will heal itself with new bone in about 6 weeks. The legs need to stay wide apart for the entire 6 weeks so he has a wedge between them at all times. Not that he has been able to move them anyway; they are too heavy with the plasters.
The other operation (if this wasn’t enough) was the “Adductor Release”. The adductor muscles run down the insides of the legs. These muscles pull are the ones that pull the legs together and if these become spastic then Josh will have difficulty pulling his legs apart, even more so after the previous surgery. He had another cut on the inside of his legs, in the groin area and the tendon (that is attached to this muscle) was cut and divided. He also needs the legs to stay apart for this surgery for 6 weeks, so it makes sense to do both at the same time with the wedge.
Wish I could get this video thing sorted but wordpress won’t let it upload for some reason. Might need to get fancy with you tube. There’s always something to learn huh?
His chair has gone off to chair repair land, to have a board put in place so his chair will accommodate him with his legs out straight. Transport will be tricky.
This afternoon we removed all his lines and transferred him into the chair using the hoist. That was fun, not. He tolerated sitting up, as he has tolerated most everything, he has been SO good. Much better than I thought as he can be difficult even on a good day, but he has hardly complained at all throughout this whole ordeal.
(had a photo here of Josh in the chair and also Josh with his new toy but lost them somehow… will update this post tomorrow) found them!
He is on the mend. Josh is laughing today; he sounds like a nut-job. It’s funny, but it hurts, so if I go too close to his face, he laughs and then cries. His breathing sounds normal now, thank goodness and he’s relaxing more without heavy medication.
Another day done.