done!

Mason is in recovery, and we just talked to the surgeon who said everything went well. He will be in recovery for a couple hours (he tends to be slow coming back) and then will move to a room on 5 Henson.

More info later--thanks for checking on him!

on time

They took Mason back for surgery about 7:30.....so it looks like being first has its perks.

first in line

The hospital called and left a message that said Mason is to report at 6:00am tomorrow. I guess no one told them that he is NOT a morning person. Ugh.

Nothing to eat or drink after 4am - so I'm guessing his surgery is scheduled for 8am, although they didn't say in the message. The doctor said he would be first on the docket, so things should be underway by 8:00, I would guess, barring any last-minute emergencies that might keep the ER or the surgeons busy.

I will update this blog from the hospital tomorrow after we talk to the doctor and are in the waiting room.  Thanks for checking in.

November update

"I have a new philosophy. I'm only going to dread one day at a time."

Mason had his pre-op clinic visit today, and we got quite a bit of information during the visit....so much that it was overwhelming!  

First off, the surgeon made it very clear that this is not a routine operation.  In fact, I believe she used the words "major deal" and "tricky" in her description.  She has some concerns that she wanted us to be aware of, number one worry being the risk of infection.  While the last infection was contracted through the pinhole from his external fixator, and we won't have that kind of situation this time, there is a fear that staph bacteria doesn't really ever "go away", it just gets walled off (cellularly speaking) and contained. But, cutting into that area could open the floodgates again.  So, to guard against that she will be doing her best to avoid the area where the infection was located.

While there were many other issues, infection seems to be the biggie.  Mason will get antibiotics through an IV while in the hospital (he will spend at least one night), but will not get a prescription for that when he leaves.  Seems strange, but the docs say that would not prevent him from getting an infection, and might in fact make his strain become resistant.  So I will be on pins on needles between visits, worrying about infection. I'm hopeful we would recognize it was happening this time, but I know that reactions can be different every time. And of course, if he does contract an infection, they will treat it much like they did last time--the evil drug therapy.

So here is the basic scoop of what she is going to do.  She will be performing an acute lengthening/osteotomy on the ulna bone to straighten/lengthen it so it will allow the radial head to slide back into it's correct position.  That means she will cut, then pull the ulna bone apart, straighten the bone,add some bone graft - likely from Mason's hip - and put it where its supposed to be and plate/screw it in place. Then she will put the radial head back into the elbow socket - and make it stay.  To do this she may need to use donor ligament to tie the joint back together. There are *a lot* of unknowns going into this procedure, and we are going to have to be extremely flexible, as we won't know exactly what all will need to be done until the procedure is underway.  There will be two surgeons, our regular orthopedic surgeon AND an upper extremity specialist, who deals a lot with nerves and such, another area of concern in this procedure.  

That is the procedure in a nutshell, but there is so much other stuff to think about.  

Our number one goal is to make Mason pain-free.  Our number two goal is to increase his range of motion.  I want both goals realized.

This picture is of the offending elbow.  You can click on it to make it larger, and you can see how the radial head is sticking way out of the socket. (on the right side of your picture).  This causes total bone on bone action in his elbow, which has caused the joint to erode.  We are hoping that once the elbow joint is functioning more normally, that it will heal itself.  If that does not happen...well then, that is a whole new story.  

On the left is Mason's left forearm, where if you click on the pic to enlarge it you can see how the ulna has bowed, and is pushing the radius out of alignment.  On the right is his right forearm, which is straight, with a normal elbow joint.


So, I have my work cut out for me, worrying for the next few months!!


Right now his surgery will probably the first one of the day - it is scheduled for Tuesday, November 22.   I will find out the exact time the day before.


** A few people have had trouble posting comments. I think I have fixed the problem - you can now pick "anonymous" as your profile if you don't have a gmail address, and type in the verification code it gives you, and you should be able to post. Thanks for checking in.

September Update

64 days.

That’s how much time between now, and the new date for Mason’s surgery.

He is now scheduled for Tuesday, November 22.  This was switched because there is an upper extremity specialist (with a limited schedule) who is joining our regular surgeon on this procedure.  We figure 2 heads/set of hands are better than one, so this is a good thing.  The plan is to keep him overnight, and follow him very closely, as he is now at increased risk for infection.

I have done some research on the procedure they will be doing, and it looks like there is a good success rates when done on kids with dislocated elbows due to ulnar bowing……resulting from injury.  Of course there is NO documentation about it being performed on someone with bowing that was not caused by trauma….but still I am cautiously optimistic. 

Mason will go in on November 2 for a clinic visit, and I think they are planning to do a bone age study on him to get a handle on how much more he might grow, since the discrepancy between the closed growth plate of the ulna and the rest of his arm seems to be pretty problematic.  The good news is that your arms and legs quit growing before the rest of you, so maybe we’re getting close to stability there.

For now Mason keeps marching on, figuratively and literally, as he is rocking the SMS drumline.  I will update after he has his visit early November.  Thanks for checking on him. :)

where to begin....

An update is long overdue, I know.  I guess the main reason I have not updated is because I was hoping for some good news to share.  Unfortunately, there is a shortage of good news where Mason's arm is concerned.

It became obvious fairly quickly that the physical therapy was not helping enough to warrant continuing.  As a matter of fact, it got more difficult instead of easier, and Mason's therapist cut him loose around the middle of May.  She said she felt there was more wrong than muscles and tendons, and she was right.  We went back to the surgeon and the x-ray showed that Mason's radial head is not where it should be.  It looks dislocated, but its not quite that simple.  The theory is that the ulna has a bow in it that is forcing the radius out of its normal alignment.  This means Mason has bone rubbing against bone at the elbow joint, and it is pretty painful.  It only seems to be getting worse as he continues to grow in every other bone in his body, and is making most everything more difficult and more painful for him to do.

After much deliberation with colleagues, the doctor has a plan to fix this surgically....and is willing to do this right away.  However, Mason wants to wait until marching band season is complete, as he has really been looking forward to participating in drumline. Band camp starts in 4 weeks. He just completed summer PE today - he took it this summer to make up for dropping it when he was on restriction from the last round of surgeries.  It seems there is no good time to have a surgery that will take you out of commission for 4-6 weeks, and put you on restriction for 4-6 months.  And of course, this is all best-case scenario, which we now know is not something we can count on.  Mason has an increased risk of infection because of the last bout with staph, so there is a very real possibility that he will have to take the evil medicine for an extended time after the surgery. Sadly, that would be more desirable than other possibilities lurking.

And of course, this will not be the end of things, but we can only look at the immediate future or we will go crazy.  We may go crazy anyway.

So, one can see why he would like to salvage a little summer, after living through a pretty crummy winter.  Because of this, Mason has tentatively scheduled the surgery for November 18.  This will give him Thanksgiving break to recover, and we can avoid having final exams the week after surgery.  (That was not the best planning last year!).  Of course there will be other things that will be missed or ruined as a result, but letting Mason have some control over this is important on many levels. There is a possibility that the pain will become too much for him to handle, in which case we will have to schedule in surgery and just deal with the fallout.

For now we are trying to enjoy summer, which is flying by at a record pace.

physical therapy begins

Mason started physical therapy for his arm a little over a week ago.  I guess technically it is occupational therapy, but the idea is still the same......trying to get mobility back.

The "normal" range for supination/pronation of the forearm is about 80-90 degrees, active, meaning you can do it yourself.  On Mason's first visit he measured 20 degrees active, and about 40 degrees passive.  Active is what you can do, passive is your potential - what can be done for you.  (yes, that is painful, having it done for you).  So as you can tell, he has a major deficit going.  :(

However, after only 1 week he was able to bring his numbers up to 40 degrees active and 60 degrees passive!!  I was very excited at this news!  He has been working hard, but it is sooo difficult because success comes in such small increments. 



Kinesio tape job.

 Last appointment he was measured for a splint, which if we choose to use it (I think we will) promises to increase those numbers even more.  His therapist believes it could make a difference, so we are waiting to hear what the insurance company says.  This is something that Mason will wear a few times a day for 30 minutes or so, and he will be in control of the pressure applied.  It is somewhat reminiscent of the external fixator, except that he won't wear it all the time, and it is addressing tendons and stretching them rather than the bone.  But it will hurt. sigh.


So the saga continues.  "Adversity introduces a man to himself." --Unknown