Onward to Surgery

We had a check in/follow up appointment with Jonathan's Ortho doc this past Tuesday. The purposes of this visit was to discuss MRI results, get some new Xrays, and start surgery planning.

Not Jonathan's actual doctor- LOL

Of course, our doc is so awesome that she emailed us the Monday after JP's MRI and let me know she didn't see anything unusual for his condition.  The visit itself went wonderful, the xrays did not (mainly for the fact that Jonathan was not happy at all and I find Xrays getting harder each time).

We met with Dr. Nichols and she talked to us (and even showed us) the results of the MRI. I found it so interesting to see JPs condition outside of the xray (aka bone visual) perspective. A few pics (sadly) reminded me of the ultrasound I had at 20 weeks where I felt his leg/foot were a blob, but thankfully I know better. Dr. Nichols did tell us (which Keith reminded me she thought this on one of our first initial visits when JP was born and she did a manual exam/assessment)the MRI shows a residual fibula. In other words, at lower part of his leg/near the ankle joint JP has some fibula. I'm not sure what the case is of those that have the residual vs those who don't, but would be interesting to find out.

The doctor showed us a step by step diagram of what Jonathan's first surgery would entail.They will position his foot underneath his leg (vs the out and down position it is now). She described some of the bones that would be broke and reset (which I hope is right or at least how I understood), "fix" his ankle and straighten his tibia. The straighten of the tibia would require a donor bone to act as the wedge (or at least how I understand it).

So for me the take away is this- Dr. Nichols feels the best course of action for this surgery is to focus on position the foot right and straightening the bend, so her plan is to cast him for 6 weeks. For Keith and I there is a sigh of relief as we thought JP would have a external fixator (in my terms a big metal contraption that goes into his leg with wires and all). With the ex-fix there is a lot of extra care with turning pins and making sure there are no infections in said pins. So knowing we just have to deal with a cast, it seems this surgery is feeling easier. We will also only need to worry about altering his clothes (and for only one season! The fixator would have been on for 3 months. And the altering of clothing is more my preference then anything.) Jonathan will probably have his first lengthening next year or so, a little closer in sequence which will definitely involve the ex-fix, but I remind myself one step at a time.

 The amazing thing about Dr. Nichols is she likes to consult her peers/teachers. So her hope is to share JPs MRI with one of the "pioneer" doctors at Sinai and tell him of her plan to see his thoughts and visions. She is open to change her course if he feels that's best and to me that's why I love her!

So the plan for now is surgery August 9th a few days in the hospital and dealing with life in a cast for 6 weeks. Knowing my very active/crazy baby boy, it won't be an easy task, but to me and Keith a little easier then the ex-fix! There are no more doctor appointments between now and surgery, so we get to enjoy our summer with him and he'll have a pre-op appointment the week of surgery. We continue to thank everyone for their constant well wishes and prayers and will continue to need them as the surgery approaches! Why we feel this road might be a little "easier" (and I use that very lightly) without the ex-fix, it will still be hard to hand our sweet boy over for a 4 hour surgery.