The Big Day

A quick update from the hospital... Caroline's surgery went well. She is resting comfortably tonight. We are very relieved and grateful. Tomorrow I will give details and hopefully post some pictures. Tremendous thanks to all of you who thought of us, prayed for us, sat with us, brought us food, and loved us in many other ways today. Love, Melissa

Tomorrow

I just read my last post--the drama! You'd think it was the end of the world. Really, it's not, I KNOW it's not. But it's still a big deal when you're going through it.

So tomorrow's the day. We have to be at Vandy at 6a.m. and are scheduled for surgery at 8:15. At this point, we really don't know what to hope for, other than a safe surgery with no complications. There is lots of ambiguity and controversy as to how to best treat this, especially at this age. She is kind of on the cusp between 2 phases; before 18 months is typically treated one way, & after 18 months another. Obviously, the less invasive procedure would be preferable--but it is much less likely to work long-term. Our dr. has said his team leans to the conservative side, preferring to do as little as absolutely necessary, in hopes that she won't ever need the further surgery. But, that's unlikely. I tend to think it'd be better to do it all in one shot, as long as the outcome is just as good. So, our prayer is that our sweet Caroline will be in the hands of Jehovah Jireh--the Lord who provides. Even in the midst of these excellent doctors, He alone knows what the best outcome will be.

Ellery & Lauren made their "spica dolls" for Caroline yesterday, and finished coloring them today. It was very sweet, and Caroline seemed impressed :)

Off to bed...updates tomorrow.

Melissa

Soundtracks

I'm not sure why, but recently I've been struck by the way music plays in my head, like an accompaniment to my mood. My own personal life soundtrack. I told you yesterday about the "Day 1" song. Well, today, it's the Darth Vader theme from Star Wars. Lately it's been more like the tavern scene from Star Wars; I've been very anxious as I waited for surgery day. But now it's "surgery-eve" and a tone of fear and doom plays alongside the pit in my stomach. Yet, even as I write this, several other songs are fighting their way into the front of my mind-- -Isaiah 41:10 "Do not fear for I am with you, do not be afraid for I am your God, surely I will strengthen you, surely I will uphold you with my right hand of righteousness;" -Zephaniah 3:17, which is painted beautifully around the ceiling of Caroline's room (thank you Karen Speake!) "The LORD your God is with you, he is mighty to save. He will take great delight in you, he will quiet you with his love, he will rejoice over you with singing." -I AM by Nichole Nordeman (thank you Amy Westerman!) "When I am weak, unable to speak, still I will call You by name. 'Oh Shepherd, Savior, Pasture-maker,hold on to my hand,' and You say 'I am.' " All of you who ask, "What can I do for you?" THIS is what you are doing for us. This is the difference prayer makes. Ok, so maybe I like this blogging thing...

Recap

Those of you who have been getting the email updates, go ahead & skip this post. You've already seen it. If you haven't gotten the email updates, skip it anyway unless you are prepared for a lot of technical blah blah blah... If, however, you are like me & fancy yourself a medical professional disguised as a stay-at-home mom, read on. This is a copy of an email I sent last week: Since Caroline began walking about 6 weeks ago, she walked with a limp favoring her left leg. At her 18 month check-up last week we were referred to a pediatric orthopedic surgeon. At the appointment last week, he told us she has Developmental Dysplasia of the Hip (DDH), a condition in which the hip sockets are not developing correctly. Caroline's DDH is quite severe. Her left hip is completely dislocated & the hip socket appears very shallow. She also appears to have a milder form in her right hip, without dislocation, that they will monitor as she grows. 18 months is considered a late diagnosis, and the later the diagnosis, the more complex the treatment. Our surgeon confirmed that there is a "good chance," around 40%, that she will need further surgery down the line. As for the upcoming procedure, there is much they will not know until they get her in the OR. First, they will do a bilateral arthrogram, which is where they inject dye into both hips in order to see them better via xray. Then they'll attempt a "closed reduction,"--put the hip back in without surgery. Her dr. is doubtful about this being successful, and even if it is, it has to be very stable in the socket. Sometimes they'll need to lengthen one of her tendons to get the hip back in. If the closed reduction is unsuccessful, they will open the hip socket surgically and put the hip back in that way (open reduction). At that time, they may also do a femoral osteotomy (shorten the thigh bone) or pelvic osteotomy (bone graft to reshape the hip socket). They cannot know for sure if those are needed until they get in there. One or both of those procedures are most likely what she'll need later on--they are most successful at age 3 or 4, but will do earlier if clearly indicated. The surgery will probably take about 3-4 hours, obviously less if the closed reduction is successful. No matter what happens in the OR, she will be put in a hip spica cast for about 3 months afterward, with a cast change (under anesthesia) after 6 weeks. The cast Caroline will probably have is a "one and a half" cast with a crossbar, which means all the way down her left leg & halfway down the right. She'll go for frequent checks as it is possible for the hip to re-dislocate even in the cast. Assuming all goes well, she will probably go into a brace after the cast is removed. Once she does start walking again, she will limp for some time--maybe forever. There is also a 20-40% chance of damage to the blood supply to her hip, which can be very serious. As with any surgery, infection & complications are always possible. So we have plenty to pray for! On the bright side, we met with the Child Life Specialist, who answered lots of questions and brought in a teddy bear wearing a spica for Caroline to play with--she was rather intrigued! She also gave us coloring sheets about spicas for the older girls, and cloth dolls along with plaster so they can make their own spica dolls at home. We also checked out some sibling books for Ellery and Lauren. The anesthesia department at Vandy is superb and went over all the details with us. She will probably get an epidural while she's under general anesthesia, in order to make her recovery more comfortable. The length of hospital stay will vary depending upon the procedure they ultimately use, but will probably be a couple of days. We were hoping this would all be behind us come July, but it's looking like it might be a longer road than that. We are very grateful to be in the expert hands at Vanderbilt Children's, and even moreso to be in the hands of the Great Physician. We know he will use all of this for his awesome purposes. Now you're up to date, AND you can start using cool words like "osteotomy" to impress your friends!

Day One

Ok, so here I am, singing to myself "Day 1, day 1, God made light when there was none..." because that is exactly how I feel about this blogging business. I am starting from absolute scratch! (I am not comparing myself to the Creator of the Universe! You know what I mean.) Yes, the irony is thick. I have never really understood the point of blogs (no offense), and yet I find myself being asked repeatedly if we have one for Caroline. So, due to popular demand, I reluctantly drag myself into the twenty-first century. The things we do for our children... My next post will be an overview of Caroline's condition & some brief history of how our world went a bit wonky 18 days ago. I've got to save up some energy for that one. Whoo-hoo! My very first blog post ever! Aren't you proud of me? Too bad my mom doesn't even own a computer. (Don't you dare tell her I said that!) Melissa