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Cassidy's Story
CHAPTER FIVE
Second Surgery
Bi-lateral Femoral Osteotomy
We returned to the Royal Children's Hospital for x-rays and examinations several times a year for the next few years. This was a little hard on us given the distance (5-6 hours) but the Government reimbursed the fuel costs after each trip -truly the 'lucky country'!
Cassidy took up tap dancing an excelled at it. She attended 3 year old kindergarten then started school a year early, after begging us not to send her to kindergarten for another year as she couldn't stand "...another year of pasting"! Subsequent testing by a psychologist discovered she had a very high IQ and social skills to match, so with great enthusiasm and no difficulty, she started school at 4 years old.
Things went along smoothly for Cassidy and just as well, as her father and I were focussed on baby Lachlan, who suffered from 'Pyloric Stenosis', meaning his stomach valve was weak and he would projectile vomit after every meal. He got very very skinny for a while there. We were terrified at the prospect of another child having surgery, but thankfully the condition stabilised with solid food and surgery wasn't necessary. Lachy still has trouble eating, can take hours to finish a meal and throws up more frequently than most kids.
When Cassidy was about 6 years old, the x-rays and arthrogram ( a procedure using image guidance such as a moving x-ray and or ultrasound to �see� inside the hip joint space while injecting a special dye called contrast) showed that her hips were not progressing well. The sockets were shallow and the head of the femur was growing too large, particularly on the left side. We were given the news that more surgery lay ahead in the form of a bi-lateral (both sides) femoral osteotomy. This involved cutting both femurs (thigh bones), rotating the head of the fumurs to a more stable position and bolting them back together with plates.
We made the big trip again and Cassy seemed quite happy to be back at the RCH. Lachy liked the hospital too, especially the playgrounds and MacDonalds. Cassidy sailed through all the pre-op procedures like an old pro and even requested a needle for her anaesthetic instead of the gas, which she knew made her vomit when she woke up.
Immediately after the surgey (before waking) she was placed in traction, presumably because her femurs were too high in the hip socket. It didn't seem to distress her or cause pain, despite looking a little scary. This remained for a few days whilst in hospital, then was removed easily by a nurse. Cassidy was not in a brace or spica cast, but was told not to move her legs beyond a certain angle. Fortunately she was a very sensible little girl and did as she was told.
The nurses used a pain rating method between 0-10, 0 being no pain, 10 being extreme pain. They also used picture of faces ranging from smiling to crying. Pain relief was via a 'bolus'. This allowed Cassidy to have control over her pain. The system worked by allowing her to give herself extra medicine when it hurt. A special machine with a syringe of morphine was attached to a cannula, or 'drip', (a small plastic tube into a vein). A handset attached to the machine was programmed to deliver a safe dose of morphine (a 'bolus') when Cassy pressed the button on the handset. I think there was also a small amount of morphine going in continuously. It took about five to ten minutes to work, and if she was still sore after this time she would press it again. When she had any procedure or movement coming up (ie for bathing, toileting, etc.) she would press the button about five minutes beforehand to make it less painful.
Undeniably the worst time of all was when the dressings came off. Getting her into the bath to soak and loosen the dressings was painful enough, but when the nurse began peeling them off, it was pure agony for Cassy and she screamed wildly throughout the whole procedure. It was absolutely heartbreaking and although we video-taped it (not knowing it would be so traumatic) it is still too hard to watch.
When home-time came around, a wheelchair was provided by the RCH which was able to be reclined to the correct angle and extended at the foot end to support her legs in just the right position. Once again, pillows and cushions were our best friend!
