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Cassidy's Story
CHAPTER TEN
Updates/Fourth surgery
Epiphysiodesis and recovery
Most recent updates listed LAST.2004
Cassidy recently saw the surgeon for a follow up.
The plates and bolts will be staying in forever because removing them would likely cause further nerve damage (she already has a numb area on her leg). Her legs were measured and she has a leg length discrepency. Her left leg is about 1 - 2 cms (almost an inch) shorter than her right and this explains her limping and is probably the cause of some of her pain.
The surgeon gave her an orthotic shoe insert, which he said would take about a month to get used to, but in typical Cassidy fashion, she barely noticed it! We are now considering getting her school shoes, and shoes she wears regularly, altered with a permanent orthotic heel as having a shoe insert raises her foot within the shoe and tends to make her slip out of the back of it. She is to trial this insert for a while and on the next appointment, the surgeon will see if she needs a bigger orthotic.
Cassy wore her orthotic insert to school and asked her friends if they noticed anything different about her. Most of them said "Um, er, no", but one said "Yes! Your hips are straighter!", so it must be helping!
According to the surgeon, Cassidy shouldn't need any further surgery in the near future, apart from hip replacement in her 40s- 50's.
Feb 2005
It's now February 2005 and Cassidy has put herself into training for a 36 kilometre (22 mile) hike carrying a full pack, in September with her school. She walks briskly with me every morning and is planning to extend her training steadily, incuding using the treadmill, cycling and Pilates. I have every faith that she will complete this 2 day hike and hope that this can be an inspiration and ray of hope for any of you who have a child with this condition and are worrying about their future.
Cassidy was asked by the Glenelg Shire Council to sing the National Anthem at the flag-raising during Australia Day celebrations recently. We are all so proud of her!
March 2005
We just returned from another appointment at the Royal Children's Hospital. Cassy's leg length difference has been getting worse and despite the orthotic shoe insert, she still limps noticeably. The surgeon seemed a little surprised that she doesn't appear to compensate in the normal way for her leg length discrepency -she just limps along happily! Although it's only a difference of 2cms (just under an inch) the fact that she doesn't compensate for it makes intervention more necessary.
At 13 years old Cassy is nearly at the end of her growth period so it was with bated breath that we waited for the results of the knee x-ray they gave her to determine if the growth plates had closed or if she was still growing. We were hoping that she was still growing as that meant that the surgeon could opt for more minor surgery known as 'epiphysiodesis'. My gut feeling that she was still growing was right! Yay!
Epiphysiodesisis an operation on the epiphyseal (growth) plates in the knee to slow down the growth in that leg. This means that the longer leg will stop growing, giving the shorter leg a chance to continue growing and catch up over time. What happens when the legs are the same length and the shorter one threatens to take over the other, we don't know...I'm sure the surgeon has plan for that!
So, on April 1st Cassy will have this surgery at the good ol' Royal Children's Hospital which only takes about 1/2 an hour, with a couple of weeks on crutches afterwards. We'll keep you posted!
FOURTH SURGERY
April 2005We have just returned from the hospital after Cassidy's "Epiphysiodesis' surgery to help correct her leg length discrepency.
It took about an hour and basically what the surgeon did was drill into the growth plates above and below Cassy's knee (on the longer leg). This has the effect of traumatising the growth plate, causing it to fuse and stop growing and allow the short leg to catch up. The results will take a few months to become evident of course and her progress will be closely monitored.
Cassy flew through the surgery and immediate recovery with ease. She said it was the easiest and best surgery she's ever had and was happy and chirpy the next day as she was discharged. She is on crutches and wearing a splint to stop her leg from accidental twisting or impact, as this would damage her knee. This will stay on for about 4 weeks, when we'll go back for a follow up and see if she is ready to start weight-bearing on it. She will start some gentle knee bending in a few days.
Pain wasn't really an issue this time and Cassy didn't need much more than paracetamol and a little codeine (she had a little morphine in post op). Traveling is a problem though as Cassy's legs are so long and her leg has to stay straight for a while -we couldn't get her into the car with her leg straight (she's 5 foot 7 1/2 inches or about 171cms tall). In the end we got her into the car by getting her to put her leg in first and folding the rest of her in after!
The surgeon was excellent and was careful not to make the scars too big, taking into consideration that Cass was a young lady and may like to wear skirts etc. The dressings are still on, but when the scars heal I will will put up some photos of them.
Well, over and out for now -I will report more later!
Catriona.
May 2005
Cassidy is now walking. David took her to her follow up appointment and the surgeon said all had gone very well and that she could remove the splint and walk between her crutches. Typically, Cassy swiftly decided that she didn't need the crutches and only took them with her as a precaution when she went on her school camp (one month after surgery). She was very careful and didn't join in some of the activities.
Her knee and leg were very swollen for the first few weeks after surgery and there was a lot of bruising. The bruising even pooled in her ankle and tended to also pool around the bottom of the splint -perhaps the tightness of the splint disrupted her circulation? It wasn't all that painful, just not pleasant to look at!
About a week after surgery, we took her dressings off and Cassy started gently bending her knee. She said it didn't hurt too much, but it felt like grinding and initially, it would just hit a point where she had to stop and she couldn't possibly push it beyond that point. Now, 5 weeks post-op, she has almost a full range of motion but still a little swelling.
The scars are only a few millimeters (1/8th inch) long and there are 4 of them -either side, above and below her knee. She has another follow up in June, so I'll update again then.
June 2005
Nothing much to report. All looks well at this stage, the surgeon will see us again in November.
September 2005
Cassidy just completd a 2 day 30 kilometre (18.6 mile) hike, carrying a full pack. She reported only mild discomfort and had no problems. The video does show her limping more than normal though, but after a good sleep, she was back to normal! We are so proud of her!
