Today Nick had his pre op visit at The Rubin Institute for Advanced Orthopedics (RIAO to the regular readers). Nick had X-rays and photos taken of his leg. We signed consents and answered questions so he could be included in a study on the PRECICE (All caps is the companies thing not mine). We had the chance to connect with all the usual suspects and people we adore such as Ann, Marilyn & Lee. Of course we met with Dr. Standard and Chris his Physician Assistant, and then some Fibular Hemimelia families. In particular we met a family from Ohio who stopped us in the hall to say this blog was the reason they were there! It is WONDERFUL to see the is blog serving it’s first purpose, which is to provide hope for families.
Some Surgery Updates: Nick’s current discrepancy is 5.8cm. We will be aiming for 5cm of length, which will take an estimated 67 days (lengthening 1/4 mm, three times per day). This is more than we thought. I had a feeling things would change as Nick has been growing so much! His predicted femoral difference is 3.6 cm but it’s ok to over-lengthen the right femur. Then Nick will need to do an internal tibia lengthening at age 15-16 of 5.5cm. That means he has 10.5cm left to go as of today. He has lengthened 17cm through his previous surgeries, therefor Nick would have had a discrepancy of 27.5cm at maturity if we had done nothing. That is almost 12 inches.
And knock knee is back. So Nick will get an eight plate or peanut plate in his knee. This is his third one. Talk about ‘chasing the valgus’! That was a surprise too!
Pain management might be treated a little different this time but I will post about that tomorrow and about Nick needing to get an IV before he is under anesthesia. Long story but it sounds like it is for the best.
Next stop Pre-Op Education with Nurse Lee. We received our Teal Book (we have three Purple Book’s from Nick’s external fixator days) and we got to check out this:
That is the magnet we will use to lengthen Nicks’ leg. Also known as the ERC 2P (according to the manual. It is the newest version. There are only three in the United States and we will get one. Nick enjoys feeling like guinea pig although I don’t see him as a guinea pig at this point. Just the fact that there are only three of these is neat and there are some differences between this version and the last. This one has a camera in it so we can see that we are positioning it correctly on Nick’s leg. He will have a mark on his leg that we will put the magnet over. The magnet is surprisingly heavy. I am hoping to have Nick do a video about it. I really don’t feel capable of explaining right now. I am still absorbing the details.
Then we got to meet a gal who has the PRECICE in right now and her mom. I have messaged with her mom over the last few weeks and that has been so helpful to me. Connecting with someone who is in the thick of it is huge!
Our next top was lunch and the grocery store to pick up some snacks to share. Then off to Hackerman Patz House where we got to meet Noah and and his dad (from the Fibular Hemimelia and Limb Lengthening Awareness group). Noah is having surgery this week too. This was pretty prefect. The boys played ping pong and video games and the grown ups chatted.
Then we got to meet Kinsey and her family! What a day!!! Connecting and chatting was great. It always is.
Below is Nicholas talking to his siblings on the phone. Saying goodbye to the kids was so hard this morning. I know they will be fine it’s just hard! Saying goodbye is the moment when everything gets real! Here we go…