Sunday, January 17, 2010

Capers of An Almost Two Year Old in a Cast

I am enjoying a moment of peace as Eli plays outside, on a warm winter day, and the rest of the Johnson’s nap. At last check, he was in the neighbor’s fort saving the United States. It is never a dull moment in the Johnson household, and last night was no exception. We ventured down the street to my good friend Jill’s house with an offer of chili for supper. As Jill and I carried on chatting and laughing, Sidney appeared out of the corner of my eye. I did a quick assessment and realized something was missing. Her cast!

Over the last day or two, the cast became looser as swelling decreased. We felt it needed to be taken care of Friday; however her thumb was still out. A resident advised it was ok to try to get through the weekend. Her cast is not to actually come off until February 1st.

As she came bounding across the room, proud of her recent freedom, my friend Jill jumped to the call. I was in a full panic mode, thinking about how gruesome the grafts might look uncovered too early. Jill had already swept Sidney into her arms and was assessing the situation. My morbid curiosity took over, and I looked at the grafts which as a side note look great. It was so strange to see her little fingers separated.

Everyone agreed keeping her hand out of any dirt was the most emergent task. Jill quickly devised that a Dixie cup would serve to keep the fingers protected but not allow anything to touch the grafts. We first put the whole hand into a medium cup then realized she might start digging at the sutures with her thumb. The larger cup was quickly replaced with a smaller cup and her thumb left out with band aids holding them on. Jill quickly found a clean tea towel and wrapped it around, using packing tape around the outside. The look was completed with some form of princess sticker.

After a tense hour waiting for a resident to call, we were on our way to Iowa City. It was already close 9pm. This actually worked well, because Sidney was asleep and not moving the fingers as much. The orthopedic resident advised to have him paged. This made the entire trip a bit shorter. There was a plane crash in Cedar Rapids the same night, so we were warned it was busy.

We were back by 2am, and my friend gladly kept Eli overnight. Their home has become an extension of our own, so I was relieved she was the one keeping Eli. Eli was thrilled with staying at his friend’s house.

Sidney no longer has her hot pink cast and was forced to get a white cast. Two residents worked to get the cast on her small arm. When the first cast was put on, the resident advised her did not think was going to stay on, so he cut it off and made another attempt. This seems to be much tighter, and we are optimistic it will stay on, because much of the swelling is down.

Sidney was a trooper through the whole thing. As she sat sucking on a Tootsie Pop at 11pm and watching old episodes of Rosanne on TV Land with Tom and I, she acted like nothing was out of the ordinary. Even as I sat in the ER, knowing our drive home was over an hour, I felt like the luckiest person in the world. While we were waiting for the resident to come in to cast her arm, I walked back into the room to see Sidney propped up on the bed with dad sitting in the chair at her bedside. She looked at me and took her free hand to pat the spot next to her on the bed, saying come sit by me mom and take a load off. These are the moments that erase three years of waiting.

Friday, January 8, 2010

Surgery Complete

Tom and I woke up bright and early Thursday morning and left for Sidney's surgery from my sister-in-law's house, in Iowa City. My father in law voluntarily slept on an air mattress the night before and easily navigated the snowy streets with 4x drive. Of course this easy navigation happened after we scraped the side of my sister-in-law's car backing out of the driveway. Sorry Steve, my laughter is, again, at your expense. I should have mentioned that Tom's dad was a very calming presence and made the experience much easier.

Surgery started at 7:15am, and we were there an hour early. This time in preop included all the bells and whistles sounded by the anesthesiologists. Most interesting were the six residents who came through to look in on Sidney and discuss the procedure. Iowa City deals with a lot of children, from all over the world, however I am certain Sidney's hands were quite unique. Sidney was given an oral sedative and taken off to surgery.

Surgery took about four hours. It took longer than anticipated, because the surgeon had to replace the original and much tighter sutures on the separated fingers with looser sutures. This was the area where a skin graft was taken from Sidney's hip and placed on the newly separated area. Looser sutures were used to increase blood flow to one of the fingers which was a bit too purple. Three hours passed after surgery while Sidney had a small fever and threw up apple juice in recovery. The fever passed, and she had a fairly uneventful night and simply waking up for pain meds. Her fingers were a perfect pink hue by the time we left this morning.

We returned home to my mother and Eli who had spent the entirety of the surgery watching the blizzard.

Sidney is fast asleep on a muscle relaxer and codeine with her very pink cast. More to come when I have had some sleep but wanted to give a quick update and to say thank you for everyone's prayers and kind thoughts.

Saturday, January 2, 2010

On the Path to Healing

As the scent of pine remains in our house, I am reminded our family experienced an amazing Christmas. It was such fun to watch the kids excitement. Sidney is obviously too young to fully understand the concept, but it did not take long to get into the spirit of diving into a pile of packages. Eli was quick to follow up with his standard line of, "you know gifts are not the real meaning of Christmas." We had several occasions to experience this. I am happy to report we made it through four family Christmases unscathed and will round out the season with our last family Christmas today. Thirty people will converge on my father-in-law's house, chaos erupts, and we will have a great time!

Part of this season has been spent thinking about this coming week. Sidney will have surgery on Thursday, Jan, 7th, in Iowa City. This surgery will separate the webbing between two fingers as an outpatient procedure. Our surgeon let us know they will call with times the night before, but she will likely start surgery around 7am. Good thing mommy likes coffee, because we will have to be there around 5:30am. If all goes according to plan, surgery will take about 3 hours. With an army of family, friends, fellow adoptive parents, and fellow church members praying, we are very optimistic about the days ahead.

Separating Sidney's fingers involves taking a skin graft from a donor site on her upper thigh which will be used to cover the inside area between the two webbed fingers. A cast will cover the full length of her arm, to prevent it from slipping off her small arm. We are unsure of what the skin graft will entail as the tissue from the donor site is quite deep. This depth aids in the healing process.

When I look at Sidney's hands I am quickly reminded how differently her hands might have grown without surgical intervention. This particular procedure would not have been available to Sidney in the orphanage. Under the governments medical care, a few procedures are covered. For example, procedures 1-25 are available, leaving anything else up to a person to pay privately. Obviously, funding a major surgery is out of the question for many people. This is well known by the average Chinese person, so when Americans are spotted with special needs children the reaction is many times very positive. Sidney is only one example of socialized medicine. Why, again, are we begging for socialized medical care in the United States?

I asked the hand surgeon what happens to a hand with webbed fingers without surgical treatment. She advised Sidney's two webbed fingers would continue to grow at different rates, causing the hand to become disfigured. This is also true on the other hand which does not have webbing but bone growing incorrectly over the growth plate. Without correction, the base of her finger would actually grow wider.

This is such a simply thing to do which will completely change Sidney's life. We could not be prouder to be the parents facilitating this care!