Life as a Leach

Oh CHOP... We have had an ongoing disagreement with CHOP orthopedics over which pulmonologist we should see.  We adore our pulm at Hopkins.  She has been with Abby since the beginning and really gets the whole picture.  She truly cares about Abby and we feel like she always has her best interests in mind.  CHOP ortho really only seems to value the opinion of their own pulmonologist with the Center for Thoracic Insufficiency team.  We have nothing against him!  He is a very nice guy and very knowledgeable, but we see no need to switch pulmonologists when ours is wonderful and 2 hours closer.  We don't care for the attitude of superiority we sometimes feel at CHOP and feel like all of her doctors should work together to give her the best care possible, no matter where they work! (Not to mention, Hopkins is not a two bit hospital!!) With Abby's recent lung decline and us feeling that a surgical intervention is needed, Abby's pulm has been communicatin...

Today did not go well. Dr. Campbell thinks putting the rod back in could disrupt everything and be too much of a risk of infection.  Her last 2 CTs show that her lung volumes are basically the same, so he feels she is stable.  We voiced our concern that she is not functionally the same, but he thinks the risks outweigh the benefits.  He wants to do another ct in May to measure lung volumes then. This is all we know and we were completely blindsided.  The nurse practitioner was just as shocked as we were because she thought we were getting a date today too.  Turns out, we are going to be waiting even longer and she may not even have the surgery at all.   We are devastated, to say the least.  This left us reeling.  We will pick up the pieces and keep going, but today we are heartbroken to hear this news.

Today did not go well. Dr. Campbell thinks putting the rod back in could disrupt everything and be too much of a risk of infection.  Her last 2 CTs show that her lung volumes are basically the same, so he feels she is stable.  We voiced our concern that she is not functionally the same, but he thinks the risks outweigh the benefits.  He wants to do another ct in May to measure lung volumes then. This is all we know and we were completely blindsided.  The nurse practitioner was just as shocked as we were because she thought we were getting a date today too.  Turns out, we are going to be waiting even longer and she may not even have the surgery at all.   We are devastated, to say the least.  This left us reeling.  We will pick up the pieces and keep going, but today we are heartbroken to hear this news.

We met with Dr. C this morning.  He had had a phone conference with our Ent and pulmonologist at Hopkins last Wednesday.  Together, they decided that putting the VEPTR back in on the right side was the best option.  He checked her wound today and doesn't feel that it is healed enough to do another major surgery.  The incision he will make it any in the same place, but there's always a higher risk of that new skin tearing if it's not fully healed. So....he will do the surgery, but not yet.  We made an appointment for January and he will reevaluate then.  We just need to keep her healthy until then.  We don't have a tentative timeline yet--we will discuss that at the next appointment.   We are thankful that he is now willing to do it--we just wish it was going to be sooner rather than later.  But we will hunker down for the winter and get that back completely healed!

I spoke to the plastic surgeon this morning.   He spoke to Our orthopedic surgeon (who is already in surgery) and the plan is to remove all of the hardware, leave the wound open, attach a wound vac, and close later this week on Wednesday or Thursday.  They are concerned about her high white count and think the only thing that will get rid of this is to take out all of the hardware. :(. We will deal with the kyphosis later, but this is what needs to be done right now. Ortho has 5 cases today, so Abby will probably be last since she is an add-on.  One of the wonderful NPs came in to see us and cried when she heard the plan because she knows what a hard year this has been.  All this pain and suffering, only to have the hardware taken out.  I'm thankful she gets it. (She made me cry, of course!) Abby has gotten sick 3 times today and is feeling pretty miserable, so she's getting some anti-nausea meds and some pain meds to get her comfortable and hopefully make today...

Abby had a follow-up today at CHOP.  They are very encouraged by her progress.  The X-rays may have shown some movement of one of the rods, but it may also be the angle of the X-ray.  He wants to follow-up with her in another 6 weeks and do repeat X-rays.  But to be safe, the halo is going to stay on for at least an additional month, which means it won't come off until the end of April at the earliest.    We hadn't gotten our hearts set on a date for this very reason, so it's fine.  We figured it would happen, which is why we are just saying it will come off in the spring.  I'm glad he is erring on the side of caution. The orthotist changed the chin and forehead pads, as well as her brace shirt.  Everything was SO nasty!!  And there were crumbs all in her shirt!        I was able to gently wipe her down while the brace was off, but it was very painful because her skin is so raw.  I see lots of lotion in her futur...